Oblique glares in the night after cataract surgery.

[09panther]

I have been having shortsightedness since 12 years old and am now 59 years old. I had my cataract surgery on my left eye end of Jun 2012. Since then I discovered 2 adjoining grey scotoma forming a spreadeagle-like grey shadow in my left central vision at the 7-O'clock to 12-O'clock positions on the computer monitor(or any brightly lit objects). Whenever I come out of a dimly lit room, I can see a scintillating luminous green crow foot in the central vision of the left eye. The green crow foot is made up of 3 to 4 straight lines at the 7-O'clock to 12-O'clock positions joining towards the central vision, which blinks at a certain rapid frequency.

During the follow up treatments l kept asking the cataract surgeon what  the grey shadows about. But each time he just brushed me off and prescribed some eye drops to put into the left eye several times daily. This follow up treatment went on for about 3 months before I decided to seek the 2nd opinion from another cataract surgeon who confirmed that I am having macular edema in my left eye as well as an ERM in my right eye. The cause of the edema was unknown and was probably due to my 4 years old diabetes.(HbA1C were maintained at 6.0 - 6.3% then.)
After about 4 months of treatment with eye drops,  I am grateful that my left fovea has its beautiful curve back to normal in the OCT scans. But I still see the same grey shadow in my left eye. This could be cataract-induced type of edema causing damage to my left retina.

I am seeing curved or crooked lines in both eyes.
The 2nd cataract surgeon also diagnosed that I have ERM on my right retina and a very minor cataract on the lens which did not warrant any surgery on it
The image in the right eye seems to be bigger by about 30% compared to that of the left eye.

He advised me to opt for the removal of the minor cataract on the right eye first to rule out the possibilities of my longstanding shortsightedness and not the minor cataract was causing the macropsia in the right eye.
Then the ERM peeling to be carried out in the future, as this would ensure the retina surgeon to see the ERM better for the peeling in the future.

So, I opted for the right cataract op on 16/04/2013. Though, the cataract was minor and did not really causing any problem.
After the right cataract removed and implanted with a clear lens for nearsightedness as was the left, I can see very bright glaring car lights and street lights during night driving, crossing diagonally from top left to bottom right at 10-O' clock to 4-O'clock positions.This bright slanting lights are driving me crazy. It makes night driving very tough. This phenomenon did not happen on my left eye.

Questions:
1) Will the scotoma in the left eye go away or it is irreversible and will deteriorate as time goes by?
2) Is it normal to have oblique glaring lights after  cataract op?
3) What does this phenomenon call? And what causes them?
4) Will this oblique glares go away?
5) Is it true that having the cataract op done before the ERM peeling will facilitate the retina surgeon to see better at the retina when he peels it?
6) Is it true that if the ERM peeling is done first, the cataract surgeon might have difficulties placing the IOL in the capsule as vitreous humous is removed from the eyeball and there is nothing firm to support the lens capsule? ( I just want to know whether the 2nd cataract surgeon is more honest than the first one.)

Please forgive my English, as I am not a native English speaker.
Kindly keep me informed, professional or personal experiences are welcomed!
Thank you!

panther.

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

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[09panther]

Thank you for the prompt response and advices!

I have read most if not all of JodieJ's postings which are very informative and educational regarding her's and others' experirnces in the ERM peels.

Will keep browsing the cyberspace for more info.

Grateful that most of the respodents are sharing their personal experiences for the well-beings of others who are in the same dilemma.

Thank you Dr.

panther

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

I am not even going to attempt to answer these questions as they cannot be used for guidance for what is a very complex medical problem. These cases are VERY unique and individualistic and generalization such as after a regular cataract surgery on a normal eye is.

I would suggest that you:
1. Use the search feature and archives and read the many postings about membrane peals of epiretinal macular membranes (ERM) which is the most common cause of macular pucker. Those postings by JodieJ are especially helpful.
2. This is a complex situation and do not run into surgery until you fully understand risks, benefits, alternative of doing nothing at this point.

3. If possible after you have done this reading get a third opinion.

JCH MD