Toric lens cataract surgery led to increased and still increasing astigmatism

[royster]

(A) With Surgery day as Day 0, and using the Negative cylinder convention, these are some data points for  Sphere, Cylinder and Axis for  my LEFT eye :
1.  Day negative 45, from Long standing optometrist :   :   -9.50   -2.25  162
2.   Day  +8 from Surgeon : :  +1.75  -3.25  170
3.  Day +12 from long standing optometrist ::   +2.50   -4.00   164
4.  Day +16 from USC Eye Clinic :    +2.50  -4.25  165
5.  Today  Day +20, With the right eye completely covered or closed, I see multiple visions when trying to read
through my left eye, and all ranges of over the counter reading glasses fail.
(B)  Day Zero surgery   Acry Sof iQ TORIC  via  Alcon
       Model  SN6AT5   POWER :  7.0 D   3.00 CYL
      Length 13.0 mm   Optic  6.00 mm
      UV With Blue Light Filter .  
(C)  The surgeon's staff seems very reluctant to  provided me with their Pre- and Post-opt  measurements,
Please help me understand  what happened here, and my options for this LEFT eye, with the RIGHT eye to follow
Many Thanks  

[CBCT]

Yay!

[royster]

Yes CBCT, I received a graph showing how the Astigmatism varies with the orientation of the lens and the minimum value at the optimal orientation. LIke a V.
Wanlien3, since the postsurgery Astigmatism increased steadily before leveling off, it is doubtful that a large initial error was made.Rather the trend line suggests a continuous unidirectional rotation.
Many Thanks To All for your feedback.
Royster

[wanlien3]

The other possibility is this:
Assuming your pre-operative cylinder is mainly due to corneal astigmatism, it looks like the magnitude of the cylinder almost doubled, with the axis remaining almost the same.

This can happen if the implant is accidentally implanted with the axis at 90 degrees to the ideal axis. In such a case it should be a simple matter to rotate the lens by 90 degrees and then the problem is solved.

[wanlien3]

...'I also paid for the in surgery option of recalibration of the measurements after the cataract was removed'

That is intriguing. I have always wondered how in surgery measurements can be accurate when, usually, we try to do our keratometry/topography measurements with the eye in the most natural state possible (ie in clinic, before pupil dilation, sitting down on a chair in front of the machine)

I am speculating that this machine gave an erroneous read-out...this can only be confirmed by reviewing your case notes and any intraoperative video.

If that is the case, then a simple lens rotation (your spherical equivalent is close to zero) or lens exchange if ideal implant toric power is different, should solve your problem. I would strictly follow normal calculations based on pre-operative measurements and not intraoperative measurements.

[CBCT]

Did you get an appointment?  He da man!

[royster]

Many Thanks CBCT for the suggestion to visit Samuel Masket at Advanced Vision Care.
Perhaps due to my unusual eye dimensions and texture, the toric lens rotated out of alignment but has now settled down.  Further a correcting rotation now of 86 degrees clockwise will lead to the intended optimal results.
Many Thanks
Royster