Cataract

I had lasik in 2000 on both eyes. In Nov. of 2006 I had cataract replacement in my R eye. In July of 2007, I had cataract replacement in my L eye. I have worn readers since 1993. Since my cataract surgery, my R eye has 20/25 vision with a floater that is very bothersome. The retinol specialist suggested having my L eye cataract removed with the possibility that if my L eye was corrected, I would not notice the floater. I had my L eye cataract removed and have had no better than 20/80. The Dr. said my choices to improve my vision are: replace lens in L eye, have lasik in L eye, remove floater in R eye. How do I decided which is the right surgery? I am 54, good health, play tennis 3 times a week (not now, as I cannot see the ball) and am a photographer.

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

It's not clear to me why you only see 20/80 in your left eye. A "floater" is not likely to cause this. Replace IOL or lasik are solutions for implants that have left a person markedly under or over corrected.  Even then with an appropriate glasses Rx in front of the eye if your eye is otherwise healthy it should see better than 20/80.  Too many things don't add up.

I would suggest an independent second opinion with a retinal Eye MD ophthalmologist and a third opinion from another cataract/IOL Eye MD surgeon.

JCH III MD

[Nated]

Thank you for your comments. I think I wasn't clear in my explanation. I have 20/25 vision in my R eye; only my L eye has 20/80. But when the floater in my right eye is in my field of vision, my eyes drive me crazy. I feel like my L eye then tries to compensate for the right eye and it's like a camera trying to focus...every time I blink or move my eyes, it feels like they are trying to refocus. When I read, with reading glasses, I constantly have to revisit words or lines as it is blurry.

I have had three (two in one clinic as one suggested I see his sr. cornea/lasik specialist) Eye MD surgeons look at it. All have both suggested the same surgeries...either lasik to imrove the eyesight or to replace the IOL. One believes that IOL replacement should be done first, the other two surgeons said I should have the surgery I was comfortable having. All surgeons say that my eyes are in great health, the surgery was supberb and there is no scar tissue. They also said that there are very few IOL replacements and I think I'm frightened to have another eye surgery. I have tried 7 pairs of contacts and two pairs of glasses and they help, but not completely. I think what I really want is reassurance that IOL replacement surgeries are done and people are happy with the outcome.

Thank you

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

I still need further clarification. Why does your left eye only see 20/80?

Which IOL do they want to replace or do lasik on? Right or Left?

JCH III MD

[Nated]

No one knows why I am only seeing 20/80 in my left eye. They want to replace the IOL on the L eye. They explained that do to the lasik, IOL measurements are not as tried and true. Before lasik, doctors knew exactly what lens to use when doing cataract surgery. Now with so many of us having lasik, there is a slight risk of people not getting the IOL lens that will give them the best vision.

My choices are
1) have the IOL replaced in the L eye.
2) have lasik in the L eye without replacing the IOL.
3) have the floaters removed by vitrectomy in my R eye.

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

You need to run, not walk to a different place for your care. I would certainly not do any of these things without a definitive diagnosis. As I said see an independent retina surgeon and a cataract/IOL surgeon.

Your recommendations really, really sound bad to me.

JCH III MD Board Certified Ophthalmologist

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

PS: Please let us know what these consults show and what the cause of your reduced vision is due to.

JCH III MD