Myopic Shift Post Cataract Surgery

[curio255]

My doctor just told me that I have experienced a myopic shift post cataract surgery and this is what could be causing my continued blurriness at 5 weeks post-op. I believe he said that I may now be off by about 0.5 diopters. I am wondering if they put in the wrong IOL script. I also have a Grade 2 PCO and some residual minor CME that I was told should resolve soon.

Should I wait a few months, get YAG surgery, and then go for LASIK/PRK or should I go for an IOL swap?

[Ron_AKA]

I would suggest waiting until the CME is resolved and then get a full refraction of your eye to see where it is exactly. Some issues to consider. Sounds like you are already aware that lens exchange is made significantly more difficult if you have YAG first. Through experience I have found that Lasik has a couple of issues. First it is not very effective if you need to be more myopic. Using it to reduce myopia no problem. And for very small changes it may not be as predictable as you would expect. There is a third option to use a piggyback lens to make the correction, and leave the IOL in place. There is a lens made specifically to do that called the Rayner Sulcoflex Aspheric. It also may have issues with getting just a small change.  

[John C Hagan III, MD, FACS, FAAO]

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[curio255]

Thank you for your response. Why does the edema typically occur at the macula and not elsewhere on the retina?

[John C Hagan III, MD, FACS, FAAO]

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[John C Hagan III, MD, FACS, FAAO]

The reliability of the formulas used to determine IOL power for a targeted post op uncorrected refractive error have a confidence range of +/- 0.50 diopters. So you are within the predictive power of the formula.   If with glasses you see 20/20 you don't need Yag Cap you need glasses or contact lens.   Most surgeons would recommend you wait till all CME is gone as that can also cause the vision to be blurry. If CME goes away you might be happy with your vision. The drops you are taking to get CME go away should likely be continued if you are unhappy with vision and procede with Yag Cap as that can also cause CME

[curio255]

Thank you for your response, doctor. Why does the edema typically occur at the macula and not elsewhere on the retina?

[John C Hagan III, MD, FACS, FAAO]

Because of the anatomical structure being different

[curio255]

Hi Doctor. Can you please specify regarding how the anatomical structure of the macula attracts more instances of edema versus other parts of the retina?

[John C Hagan III, MD, FACS, FAAO]

Curio255. You have asked over 40 questions. Unless something major comes up I will not be responding to your posts. Most of your questions can be answered by internet research

[curio255]

Hi Doctor. I understand, but please note that I have only asked about 15 original Questions or so in about a 6 month period. This average is just over 2 questions per month. The count for my profile is inflated due to some responses to your responses, with some of those responses simply being me thanking you for your answers. In any event, I appreciate all of your help.