Avatar universal

Toric IOL rotated twice - is it better to fix it with re-rotating or LRI

I had toric multifocal IOLs inserted in both eyes in the end of April this year.
My first post-op appointment was scheduled for 5 weeks after the surgery, where it came out that IOLs have rotated in both eyes. In one eye the shift was about 40 degrees, in the other one a bit less.
I had second surgery, which went well and the IOL positions were amended.
However, the IOL in right eye moved out of position again, more than 30 degrees. The lens in the left eye was stable. The right eye is very bad, compared to the left, and gives me daily headaches after I read or work with the computer. OD cyl is now -1.5, ax 40.
I suggested to rotate the lens again, but the surgeon said that it is not necessary, because 'the left eye is seeing well enough'. He also refused to prescribe spectacles (which I feel I do need to get rid of the constant headaches in right side), saying that I will adjust to this vision better if I don't wear glasses.
Since I do have vision problem with the right eye, I went to another specialist and they did prescribe a good pair of glasses, which have helped a lot with the near vision. The headaches are gone now that I can use the glasses, but the fluctuating vision and double images in the right eye remain.
Even if cyl -1.5 can be corrected with LRI later on, I doubt that the LRI would help to get rid of the fluctuating vision - it's as if I can see an object well when I really strongly try to focus on it, and then a few seconds later I don't see the same object as clearly any longer. And then, I can see the object again. This applies only to the right eye, the left is fine.
I understand that the time interval for possible IOL rotating is quite short. Can anyone help me understand, why my surgeon won't even be bothered to consider it? Should I be more demanding in regard of another rotating surgery, or just wait for the vision to stabilize over the upcoming months and then get LRI performed later in the Autumn?
3 Responses
1731421 tn?1358823371
This can unfortunately happen. If a rerotation helps, then do it. If it's not going to help then go for the LRI or LASIK/PRK touchup.
If I were to attempt a rerotation I'd probably insert a capsular tension ring permanently into the eye to gain some rotational stability.

Best Wishes,
Timothy D. McGarity, M.D. Ophthalmologist
Avatar universal
When inserting the capsular tension ring would one see it afterwards? I have some edge glare from my lens would it be the same with the tension ring?
1731421 tn?1358823371
You won't see it. It rests way out peripherally in the capsular equator. Edge glare is common with many IOLs. It dissipates with time.

Best wishes,
Timothy D. McGarity, M.D.

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