Can cataract surgery cause astigmatism?

[BJF]

I had Restor IOLs implanted 18 months ago.  Very soon after surgery my distance vision was 20/30 in both eyes.  Six months later it was 20/40 and 20/50.  Now a year after that it's 20/60 and 20/80.  My reading vision hasn't changed from 20/30 in both eyes.   I'm told I need YAG because of clouding of the capsule, which I'm scheduled to have done.  I'm also told, however, that because of age-related changes to my cornea, I probably will not be able to get back to the 20/30 I had in the beginning and will need glasses for distance.  I'm concerned that maybe the surgery caused the cornea changes, because I'm only 59, and it's only been 18 months.  I'm surprised that there would be that dramatic a change in the cornea that my IOLs will no longer be able to give me the vision I had right after surgery.  Should I expect the cornea to keep changing as I age and have to keep changing prescriptions for glasses?  Could the surgery have caused this problem?  Thank you very much for any input.

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

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[BJF]

Thank you for the replies.
I don't know if the surgery was done through the cornea or the sclera.  My doctor said that it's possible after the YAG that it will go back, but he didn't sound very reassuring.  My doctor is one of the top surgeons in my area, so I'm assuming, hopefully, that he did everything correctly.  I will ask him about the cornea versus the sclera.  Maybe that will explain what's happening.
Thanks again for your help.

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

Get a second opinion, from a cornea ophthalmologist if possible. Find one at www.aao.org


JCH MD

[pasadena_commut]

Was your surgery through the cornea or through the sclera?  Astigmatism associated with a scleral incision tends to heal over time, returning back to the pre-operative values.  Since your astigmatism is going in the opposite direction it makes me wonder if your surgeon went through the cornea, and perhaps this exacerbated some underlying condition.