desperately need answers

[MaryRoe]

History: Left cataract removed 15 months ago. Alcon Acysof lens.R. eye to be done 2 weeks later. Has not been done. L. eye vision distored since C..removal and all the complaining, tears, and fear did not get me anyplace with this surgeon. He fired me. Have not read a newspaper since or driven in the dark.Oil Painting is past history. Saw new surgeon (2 months post-op) Saw  Large PVD and sent me to a retina doc. Retina doc said PVD was all over the eye and suggested surgery but said I could wait if it would settle. I chose to wait. He told me to go back and have the other eye done, ASAP. With insurance changes ended back with  same eye doc who fired me.He wanted another look. He indicated that both the new surgeon and  retina doc were wrong and I did not have a PVD and for me to get with it.Told me I am expecting too much from cataract surgery so he fired me again. Went back the other day to the surgeon who diagnosed the Post-op PVD, to schedule surgery on R. eye. He asked what the retina doc had said, months ago. WE told him he offered us surgery or a wait and see. This doctor examined my eyes and said the PVD is still there and this must be why I have distorted/blurry vision and for me to have a vitrectomy.  He went on to say he will not do the other cataract eye until I have surgery and stated I may also get another PVD after cataract removal in the other day. Questions: How safe is a Vitrectomy and does this usually cure PVD's?  My symptoms on the surgery eye are blurriness/words running together and eye not focuisng when trying to do fine work, i.e. sewing, reading, etc. The distortion is brighter (blue color) but the eye is not working. The other eye with the cataract is blurry vision but no distortion. Hubby feels I should live out my days and forget about eye doctors.Original doc said PVD was not caused from Cataract surgery but because I am an old Lady. Retina doctor said it was caused from the Cataract surgery.  I am needing your expertise advice. Thanks.

[MaryRoe]

Thank you doctor. For years I have had a single black floater that occasionaly passes by and then disappears for another 3-4 months.  I was never bothered by this.  (left eye only) My immeidate post op problems was left peripheral blindness, large globs of floaters with flashing lights and zig zag figures all over the surgical eye.  Vision was distorted and horribly blurry, red, quivering, watering.   I got no where with the Professor. He told me all this was normal and talking to other cataract patients, I knew this was not normal.  Had he informed me about Large posterior PVD's and stuck with me and referred me to a retina doctor early on to calm my fears and anxiety, I would of been a happy camper.  He did none of this and fired me when I tried to see an associate of his. Another employee asked him to see me again when it was learned I had a large posterior vitreous detachment. I thought he would of referred me then but he did not. He denied  a large PVD and RX'd antibiotics and fired me again. You had better believe  his ego came into play as he told me I was his only patient that has ever complained to him. His poor lil feelings were hurt.  I was the one suffering.  I needed answers.I needed a hug.  I am well educated and a retired CEO and know how people (women) should be treated.  

I appreciate your input and also feel the other eye needs surgery now. (last week's doctor will not do it until the vitrectomy)  I am depending on the right eye to carry me through and cover for the left eye that has distorted, hazy, non focusing, vision.
I will contact two more retina doctors for their input and find a good cataract surgeon who does not have an EGO problem to removed the rt. cataract.  Hubby says no as he is scared more than I am.  He has lost faith in eye surgeons.

I did receive some phone calls from well wishers (i.e. catholic priest, an M.D. a DDS)  the day after a segment was on TV about eye patients having similar problems and how they have suffered.  One lady also indicated that her doctor fired her. (sounds familar) (-:  They had a Sclera problem and found a doctor in Boston to insert a special lens and now they can see. I heard very few Opthamologist recognize this or know about this.  I truly feel more is going on than this Large Posterior PVD.  It is either the curvature of the cornea or the wrong power in the lens.   The macular looks good.  I may well end up in Boston if I can get a referral letter as this is needed.  Then Dr. Kutryb, I can get on with my life.  Yes, Boston is far (wish it were Florida again as we love Florida and the fine doctors there) but hopefully we can get a referral letter and move forward.  God Bless You also for helping so many here on MedHelp.  Cindy Thompson deserves the Gold for all she has done with her website, Medhelp.  Happy Memorial Day.

[Michael J Kutryb, MD]

I have just a few thoughts.  PVD's are extremely common and in my practice almost never require vitrectomy unless the patient is extremely, extremely, extremely bothered.  In fact, I would say in the last 10 years that maybe one or or two patients out of maybe 2000 with PVD's have had vitrectomy surgery.  The PVD is a naturally occuring process due to aging and can be accelerated a bit by the cataract surgery but it is an inevitable process.  The PVD by itself will usually not bother the patient that much unless you are unfortunate enough to have a large clump of floaters right in the middle of the vision (which seems what you may have.)  In this situtation, you can just give it time and hope that it breaks up on its own eventually, and you also get used to it or you can get a few opinion until you find a retinal surgeon that might do a vitrectomy which has a pretty good chance of improving the floaters. Please get a couple of opinions from retinal specialist so you know that surgery for this situation is really not that common but can be done for select cases.  In the meantime catarct surgery on the other eye might help to improve your overall vision.  Also remember that floaters or a PVD are no one's fault - just a normal aging change.  Having eye surgery is one of the things that can make it hapen a little sooner but If it didn't happen after the cataract surgery, it was going to happen any day in the future.  I suspect that surgeon #1 may have had his feeling hurt or felt disrespected after doing what he thought was a good surgery? Just a guess.  I'm sorry for your problems and I hope that you can find some help and move forward.  Good luck and God Bless.

Michael Kutryb, MD
Kutryb Eye Institute
Titusville, Edgewater, FL

[londonbridge]

I am not a doctor, only a patient such as yourself. While my issues with my lens implant were different (see my thread explanting restor) what I can say is that you deserve to find a competent and caring surgeon to work with you. There are surgeons out there who will work with you to provide the answers and care you need.
The docs on this forum and the other people can help you locate someone in your area. There has also been posts on the top eye hospitals in the country. Seek several expert opinions and take your time before making a decision, but don't feel that you have to give up and accept problematic vision for the rest of your life.  The original Doc is rude and insenstive to attribute your problem to your age. Good luck to you.
londonbridge

[londonbridge]

I no longer need glasses for distance with one eye for intermediate and my contact eye for distance. I do need reading glasses and find that my prescription reading glasses which also correct for my minor astigmatism that remains in my IOL eye and in my natural eye work well. They also have a small distance prescription (-.25) that sharpens up my intermediate IOL eye a bit.  
If a new glasses prescription made a big difference, you may want to consider waiting to do the catact surgery for a bit. With any monofocal  you will lose your natural eye lens ability to accomodate, or move back and forth to focus. You will have a fixed focal distance. Only the crystalens accomodates due to its hinges built in. The multifocals don't accomodate or work very well in my opinion and experience. Just a thought.
Good luck.
londonbridge

[sally987]

Thanks, londonbridge.  Do you still need to use glasses for distance, to help w/ the astigmatism.  I don't go to the eye doc next until July 15, so I have time to mull over all of these options and decisions.  I put things off and opted to get a new eyeglass prescription at my last visit, and wow, what a difference that makes.

[londonbridge]

Sorry Sally987 my last post was actually in answer to your question to me....
londonbridge

[londonbridge]

Yes I did weigh the options. My astigmatism was similar. I trusted my surgeons advice in the long run. I like you wanted the least risky option, since I was already going through the risk of an implant and the dissatisfaction with my original Restor. My surgeon told me that ther surgical procedure was not any more risky and that if it didn't correct for the astigmatism there would not be a negative factor. It corrected somewhat for the astigmatism, but not significantly in my opinion. I did read that having a little astigmatism can actually help with reading, not sure why. There are some posts on this forum about toric lenses. The newest ones do not have problems with rotating in your eye and you should inquire about which one is being used. Mine is an Alcon  Acrysof Toric.
Take care and good luck with your decision.
londonbridge

[sally987]

Hi, MaryRoe and londonbridge!

Londonbridge, I have a question for you.  I haven't had any cataract surgery yet and am considering the toric lenses.  If you have a mild astigmatism, were you on the fence at all in choosing between a standard lens and the toric?  My astig Rx is +1 and +1.50 (for cyl) and 102 and 088 (for axis).  Was wondering if anyone knows whether the standard implant is less risky than the toric?  I want to do whatever is least risky, since I have other issues: beginning stages of glaucoma, thin corneas, and large pupils.

Enjoy the weekend~

[londonbridge]

I did have a Restor implant removed at Massachusetts Eye and Ear Infimary in January after six months of misery with it. (Measured wrong leaving me farsighted, double vision, halos, ghosting, very poor for the night driving I needed etc.) I was very fortunate and had no complications. I chose a toric IOL set for mid distance to replace it. I now where one contact in my non operated dominant eye for distance and my IOL in the other. I use reading glasses and have prescription glasses that are noline bifocals to use also, which helps my mild astigmatism and for reading. I can only wear these over my contact. My eyes are too many diopters different to wear glasses when my contact is out. This is inconvenient, but I am waiting until the cataract in my right eye is worse before further surgery. I have a thread "explanting restor" on this forum. Some people have had IOL's removed up to two years later. You need to find a highly skilled and experienced surgeon and ***** the risks and benefits of explanting. It can be done, but it is not a simple procedure and carries risks. However I and others have done this successfully and I can not express how much the quality of my vision improoved once I did the explant.
We are very grateful for your husband and other veterans who have served our country and wish him a peaceful memorial day.
londonbridge

[MaryRoe]

Thanks you so much.  I will report this to the FDA on tuesday.  Alcon asked me to send my records to them, i.e. measurements, etc. months ago and I asked the surgeon to do this but apparently he did not.  I now have all the reports and found some interesting things in them which I will not go into. I will contact the person I spoke with at Alcon and get these up to them.   I have also reported this incident to the state medical board and to our county health board.  Yes, post op complications can occur in any surgical procedure but a good doctor will sit down and talk these thru with his/her patient. I made a bad choice in chosing this doctor.  All my other doctors and DDS I will scream it from the mountain tops how much I appreciate them. They have never abandoned me.  They are aware what I am going through and they listen to me. For this I am so grateful.  
London did you have an implant removed?  If so, how hard was this and did it do any damage.  Mine has been in now for 15 months.  Thanks for your support.  I hope you are doing well.  Memorial Day is Monday and I am very thankful as my husband returned safely from Viet Nam. We proudly display his Wings.  God Bless You.

[londonbridge]

I am glad you are getting some answers. This will give you the hope and courage you need to persevere with your eye issues. If you still wish to report information to Alcon you can do so yourself, if you obtain your own records from the MD (he has to give them to you if you request). You can also submit an Adverse Medical Device Report directly to the Food and Drug Administration via their website. which is www.fda.gov/medwatch. You will enter a report under the Manufacturer and User Facility Device Event (MAUDE). I believe it is important as consumers to advocate for our interests with the proper authorities. The more reports and records they have at their disposal, the better they can make decisions to help others.
londonbridge

[MaryRoe]

I LOVE Italian food.  That is why I live on nexium.  (-:   I am 1/2 Italian and 1/2 French.  My maiden name is French. I made a copy of your post so I do not lose the name of the Hotel.  10 years ago I was ill and could not find a soul here to help me so we flew to Shands Hospital in Gainsville, Florida and they also had a place to stay with reasonable rates. AND, I was diagnosed and helped there.  These kind doctors even loaned hubby their golf clubs while they treated me.  Their really are some nice people out there.  You are one of them. Thank You, again.  

[londonbridge]

Yes there are excellent eye doctors at Massachusetts Eye and Ear Infirmary in Boston. That is where I and others have gone. There is a hotel called the John Jeffries House down the street from the hospital and you and your husband can stay there at reasonable rates for Boston. It is exclusively for hospital patients. If you go I can reccommend a good Italian Restaurant down the street...
Have a good Memorial Day yourself. I wish you all the best.
londonbridge

[MaryRoe]

You are so kind in answering. Even though this doctor had Professor in his name he was the biggest JERK, I have ever encountered.  He could not see the large PVD floating around within a day post-op or he did see it and kept his mouth shut. I nearly killed the grandkids in the car in the back seat as he told me to quit whining and drive the car. I went over a curb and the SUV tilted but I managed to stop the car. Was having left peripheral blindness after surgery also.  I plan on seeing many more eye doctors.  Hubby is burnt out by the way I was treated and this nerd is listed in the What's What Book. The retina docs and the one I saw the other day are scratching their heads as to why this doctor did not address this problem and refer to a retina doctor early on.  Alcon asked for my records to see if there was an error in the lens but to my knowledge he did not send them.  I want to be darn sure it is a PVD problem causing by poor post-op distorted vision and not something else, too.  I gets bouts of inflammation in that eye lasting for about 2 weeks and then settles and returns.   I heard the VERY BEST EYE DOCTORS are in Massachusetts.  about 1400 miles from me.  I may have to bite the bullet if I cannot get answers here.  I will take my time. I want to read to the grandchildren again, sit with my husband in the mornings with our coffee and read the newspaper and be able to drive safely.  This is now all gone. 15 months is a long time.    Good Luck To You. also.  I love your name, London Bridge.  Have a great Memorial Day.