Cataract surgery confussion

[Polley49]

I recently had cataract surgery. I have cataract in both eyes. My doctor did the right bad eye first. My vision was fine before surgery. I was farsighted and need magnifying glasses for reading only fine prints.   I was able to walk around, read street signs from a distant and close up.

After surgery, I no longer can see people faces at a distant. I cannot watch TV, read what’s on and screen, or see the time on the VCR unless, I get up from where I am sitting and walk up to the TV or clock to read what’s there.

Everything is distorted at a distant. I informed my doctor of my symptoms as to the outcome of surgery. He ran several tests, take pictures, and he said  that “It's nothing to be overly concern about”. "He said, that he thinks that he made me too nearsighted".  He said, that it can be corrected, with something piggy back..but he suggests, that we wait until he removes the other cataract from the left eye, which his plan is to make  "plaino" which means farsighted.

I never really wore glasses before. I used to buy the over the counter for reading, when I no longer can read fine prints. I now have Cataract in one eye, and near sightedness in the other with no prescription, all the was done 3 weeks ago. I am bearly functioning except for reading without glasses.. We schedule the second surgery for June 15th, which I can cancel. I have a feeling that my measurment was incorrect or he overcorrect it.

I had a second opinion from another eye doctor, but he is not experience in cataract surgery, and he knows this doctor and his work very well. The second doctor also suggest, that I have the left eye done using the "plaino" making it farsighted, the outcome would be that one is nearsighted and one is farsighted. DOES THIS SOUND LIKE A FIX TO MY PROBLEM? I need a 3rd opinion.
I DO NOT KNOW WHAT TO DO.... HELP!!!.

Can anyone or specialist who have experience this problem, please send me your feedback…..Thanks

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

Time will tell.

JCH III MD

[Anthropositor]

Going to your comment on the multifocals, for me, the chances are far less that I would choose a multifocal, than hey were six months ago.

Another troubling element for me, that is considered entirely routine and satisfactory by the physicians that use them,, are the usual haptics on the monofocals and many multfocals as well.  That has been one of the reasons I have been looking at the various accommodating lenses that have a much larger area of contact with the lens capsule.than the two points of the conventional set of haptics.  When I first saw the picture of the Synchrony lens, it was the haptic design that struck me even more than the dual lens stack.  Although I instinctively look at this lens with considerable optimism, I would not elect to both take my chances with the lens, and use a surgeon who was doing his first one.

It would be nice of there were some information from the previous patients about such things as post-operative glare problems, and whether accommodation was effortfull or was entirely natural seeming.  The whole lens structure cerainly seems bigger and heavier which certainly can't be entirely advantageous.  The incision to get it in is a bit larger, for instance.  In an era of steadily shrinking, foldable lenses and smaller and smaller incisions, these are both developments which appear to be going in the wrong direction.  But maybe not...

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

--

[Anthropositor]

Thanks Dr.. Hagan for posting Elan's lament here.  It is certainly food for thought.  Here I am, strongly considering, the Synchrony lens, with an extremely short track record compared to Rezoom or another mulifocal.

I can understand your feeling of frustration and anger about both the money and the results.  But I think the most serious problems for you were that your doctor, though experienced with other lenses, was doing his first Rezoom.  There is a learning curve with any procedure.  If your doctor was frank about this in advance, then he didn't "rip you off."

There is also something of a learning curve for the patient.  I can't tell from your comments how long you have had these lenses, but if it has been a short time, you may find that as time goes on, your lenses may become less difficult for you to adjust to using the different focusing zones of the lenses.  If you had expectations that your sight would just be instantly perfect, because, after all, you were paying a really premium price, then your unrealistic expectations are a part of the problem.

I anticipate that if you are patient, and do your best to adjust to the new lenses, you may find the new lenses more acceptable than you think they are now.  I got the impression that you got both eyes done, but surely, not at the same time?  If that is the case, you had some clue with the first eye, that things might not be as you had expected.

And if I was going to hold my doctor's "broken English " against him, I guess I would do it before the surgery, not after.  I do wish you well though, and if you are still experiencing serious glare problems after a few more months, I may have some ideas which could provide you with some relief.  I have been working a lot on the glare issue in recent months, and I'm glad to say, it has worked out pretty well for me.

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

Someday (not soon) there will be a multifocal that is simple, safe, gives fantastic night vision and frees almost everyone from glasses. To get there there will be several generations of multifocal IOLs that leave many people very unhappy.

This was posted elsewhere today.

by Elan


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Elan
Member since May 2008  



, 3 hours ago
To: ReZoom Lens - Very Disatisfied
My eye surgeon said I had cataracts.  In  broken English, he said ReZoom would allow me to see near, far and in between.  Who wouldn't jump at it. Only catch, $4000.00 out of pocket.  I was used to mono contacts. How I wish I had gone with just distance in one eye. I was only told their might be slight halo's.  HA!  LOOKS Like Christmas lights all coming at me at night which leaves me terrified.
I was his FIRST ReZoom lens.   And he was not warm and friendly.
I feel I was ripped off big time.  This is an older doctor who had done many lens but I was first ReZoom he had done and Company Representative had to be there for first lens he put in.  I should have stopped then.  My eyes water a lot,  night vision is frightening leaving me unable to drive at night.  I can't read up close. I can see at a distance fairly well.  It has been almost six months. Is there any recourse?  If lens is put in and no laser used, it should be able to be changed back. I do NOT want same doctor but why should I pay another?  Would to God, I had only one done.  He never said ten words to me and was not gentle in surgery.  What alternatives are there?

[Anthropositor]

Yes, thank you Dr. Hagan,
I was under the impression that the first one didn't post. when it actually did.  But I wanted ro respond to your other post anyway.  I too was surprised at the Synchrony Dual

Optic Accommodating IOL.  If I did this link right, it will show you a picture and a succinct description.  I wouldn't be surprised if you found it as thought provoking as I did.
  http://www.crstoday.com/PDF%20Articles/0307/CRST0307_03.pdf

I appreciate your input doctor.

I think my course of action may well be to get some sort of monofocal IOL in the initial (right) eye to get some reasonable vision back, then watch as results come in with this lens as more of them are done, considering it for the second eye.  It's been fifteen months since I was originally scheduled.  That is certainly time that has been used to good effect.  Particularly with regard to contrast sensitivity and glare during night and twilight driving.

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

Anthropositor I answered your question elsehwere in another post.

JCH II MD

[Anthropositor]

Heartfelt thanks to the doctors helping people on .  I am 67 year old male, cataracts both eyes.  Surgery canceled February 2007 in an abundance of caution brought about by communication problems, and the desire to wait because of the rapidity of the advances being made in the field.  Not experienced with doctors, Not having seen one prior to the cataracts for two decades.

Hisotry: Eyes misaligned as a child. (crossed) Still monocular, switching the image my brain apprehends at will.  Left eye has always been dominant and is borderline useful now.  Contrast sensitivity is worsening and driving will not be an option much longer.

Surgeon selected monofocal lens and scheduled its' installation without reference to other options. I concluded from reading between the lines, she only does monofocals.

In the intervening time I have been learning all I could about eye anatomy and the options available in lenses.  I feel very fortunate I did.  Came across a dual optic lens which is not yet available in the U.S.  Around 900 eyes done so far, worldwide.  Presumed cost will probably be in the $2000+ neighborhood, which would put my home on the auction block if any other adverse health events pop up for me.  Couldn't do that.  If I could, I would have seen a doctor for the stroke a couple of years ago instead of dealing with it myself.  Visiogen makes the lens.

My game plan: Since I am monofocal anyway, and need to do one eye soon, I may get a monfocal for the first eye, which might give me five years or so to sort out what to do with the second eye.  What do you think?  Reasonable game plan?  Any considerations or ideas I haven't thought of?  More to say.  Ran out of lines.  Thanks.

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

Glad to help.

JCH IIIMD

[Polley49]

Hi John
Thanxs very much for responding. My second opinion doctor comments are exactly like yours. Your answer was greatly appreciated and your suggestions would be taken into consideration.

Regards,

Polley

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

If you eye that had cataract surgery can see at near with out glasses and WITH GLASSES you can see at distance that is not reallly a complication and most people need glasses after cataract surgery.

You might chose to have the other eye IOL to try and make the distance good without glasses. You migh then use one eye for distance and the other for near. That is called monovision. For some people it can be difficult to adjust to. Others love it. you may still need glasses for some things.

We have said that picking IOL power is not an exact science and under and over corrections are not unusual. You can ask your surgeon to have the staff perform a second set of measurements on the eye not having had surgery. You can get a third opinion from a experienced cataract surgeon. You can wait a month or two while you adjust to the new vision.

If you don't like monovision or you later want the near eye corrrected for distance and to depend on reading glasses you can wear a contact over the near sighted eye or have lasik.

JCH III MD