Unable to read even large print after cataract operation

[Artemis99]

I am 63 and have always been very myopic (R -11, L -8). I also had mild astigmatism. About twenty years ago I had excimer laser treatment which was very successful. My then ophtalmologist kept me somewhat myopic (-2.25) so that I was able to read without any problems and only needed glasses for driving, going to the cinema, etc. Unfortunately I have recently had to have cataract operations - left eye in January and right eye in February. I am most unhappy with the result. My distance vision is much better than before but I am unable to read even large print. I am a university lecturer so I have to be able to see my students and also to consult my notes. I told my opthalmologist very explicitly that I did not mind wearing glasses for driving, etc but that I did not want to wear them in class. In order to be able to do my work I have had to buy OTC reading glasses (+4) but have to put them on/take them off constantly. My opthalmologist has said that he can easily "put another lens in front of the other" in one eye, which should solve the problem. However, I have not been able to find any information about this procedure anywhere. Could you explain? I am extremely worried about having an additional lens put in and possibly obtaining an even worse result.

[JodieJ]

You have my sympathy.  Probably your safest option at this point would be progressive glasses, which would give you good vision at all distances.  Another possibility would be trying monovision by wearing a contact lens in your non-dominant eye.

[Sandra M Brown, MD]

It is possible that the ophthalmologist understood your comment "Must be able to see my students" to mean that you should have clear vision for intermediate range, NOT near / reading range which is what you normally get with -2.25.

If these were my eyes I would not have a piggy back lens put in. Your high nearsightedness is already a risk factor for complications after cataract surgery and you have gotten through the first round OK, so I wouldn't push my luck.

Also in highly nearsighted people there is a greater degree of unpredictability in the IOL implant power selection so you may not have ended up exactly where your doc (and you) wanted you to be.  This is particularly true after LASIK surgery - there are many articles written on this problem.

Although I understand your frustrations, if you have had safe, successful cataract surgery without complications I would not "blame" your optical result on the surgeon but rather appreciate his skill in getting you through it in good anatomic shape.