How to get back to decent vision?

[kivrin]

I had cataract surgery Tuesday on my left eye. During surgery, the lens capsule collapsed because of weak/non-existent zonules. The surgeon ended up putting in an implant between the cornea and iris. Now the vision between the two eyes is really difficult/awkward. I can see with my right eye with glasses, but the vision is very poor in the left eye, and it is causing horrible headaches.
Previously, I had LASIK in 1994 on both eyes. My refraction was about 18 diopters at that time. Currently, I wear about 5.5 diopters with glasses. I have contacts but they really are very uncomfortable and itchy.
I understand this is going to take time, but I have a job. I need to be able to see to drive and work. My doc keeps saying that the prognosis is good, but is not really giving me a timeline. He says I should be able to do everything I want today. There is no way I am safe to drive, and I don't have a good answer to give my boss (much less my husband's boss -- he is an OTR driver and is not home for 3 months at a time. He is home to drive me, but we can't exist without jobs.)

[JohnHaganMD]

First at this point don't worry about the difference in vision with both eyes in your old glasses. That would have been a problems with your eyes working together even if no problems.  What you should judge the success of the operation of the LE is what the vision is WITHOUT glasses especially at near. If you can find a place where the near vision is good or the distance vision with the LE without glasses is better than the RE at distance without glasses it's probably healing okay.  You have an "anterior chamber IOL" most IOLs are "posterior chamber"

What most people do is either have an optician remove the thick -5.5 lens on the LE and just don't have a lens on it while the eye is healing or get a clip on occluder and put on your glasses frame to cover the vision from the LE.  Don't wear a patch on the eye, the occluder goes on the glasses frame.

best of luck.

[kivrin]

Thanks. I went to my normal ophthalmologist and she got me a bifocal contact for my right eye that makes things pretty bearable. I still have intense nausea if I read much with both eyes. Vision does seem to be getting better with the left, although it is nowhere near acceptable.
Two follow up questions:
1. As I am doing research, there seems to be some concern with a phakic IOL and chronic iritis. I have had bouts of iritis for the past 3 years, all the tests come back negative, so its been labeled idiopathic, but I can pretty much guarantee to get iritis if I am stressed. Is iritis still treatable with this phakic IOL in my eye?
2. The surgeon said he will have to take out the stitches. How is that done? Do I have to basically have surgery again? How long will stitches be in my eye?

[JohnHaganMD]

This is my opinion and my experience: I don't recommend phakic IOLs in my patients and your history of iritis and a subluxation lens in the other eye would rule out phakic IOL.  If your RE has a cataract it may need surgery soon and that can balance the IOLs off. You could continue CTL on RE.  

Removing stitches post cataract surgery is done in the office at the slit lamp (biomicroscope) under topical anesthsia (drops)  I don't know how long before the surgeon removes. Generally 4-8 weeks