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Significant change in refraction

Hello Dr. Hagan. I was scheduled for LE cataract surgery in April of 2019. I got cold feet and cancelled in order to do some research and become more informed. Then came the pandemic and I just now started the process again. Friday I got a new evaluation at a different practice and was somewhat shocked to find that my manifest refraction had changed from -1.00, +2.00 @ 180, and is now +1.50, -1.25, @ 087. What do you make of this? Does it seem likely that I would go from myopic to hyperopic? And my astigmatism change from ATR to WTR? I'm confused.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
The first RX is written in PLUS cylinders  the second is in MINUS cylinder.    That is why they look so much different. It's like your weight in pounds and kilograms look very different even though the weight is the same.  Your new RX in plus cylinder is  +0.50 Plus 1.25 axis 177   so different yes but not that much.  Progression of the cataract could account for those changes.
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Thank you so much for that explanation, Dr. I was afraid that they had mixed up my chart with someone else, or there were some serious changes going on in my eye. Yes, I believe my cataract has become more dense over the last 2 years. Regarding my astigmatism changing from +2.00 to +1.25, when you say the progression of the cataract could account, are you saying that the shape of my cornea hasn't necessarily changed? Rather, the worsening cataract has changed the way an image is presented to the retina? Does the progression of the cataract make it much more difficult to determine the proper iol power? I have 2 main worries:
1) that I may end up farsighted in that eye.
2) that the difference between my eyes may become greater than 1.5 dioptor.
It's so difficult to trust the process. I thank you for all that you do for us, Dr.
There are several times of astigmatism in the eye, most comes from the cornea called corneal astigmatism but the lens of the eye can cause astigmatism, it is called lenticular astigmatism.   For a competent surgeon and staff using modern technology and IOL formula the deviation on IOL power is less than plus/minus 0.5 diopter.   Most surgeons allow for this by making the distance eye targeted as -0.50 rather than 0.00    If the eye is unusually large or a lot of astigmatism you can ask your surgeon to have two sets of measurements made before surgery at two different times but two different technicians.  This is an ultra common surgery and surgeons with good reputations generally have the testing down well. Also while I w0n't go into at length, if a person is significantly over/under corrected there are ways of dealing with that.
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