Cataracts and astigmatism

Two weeks ago, I had cataract surgery on my right eye.  The surgeon put in a lens to correct the distance vision in that eye, and at the same time, made two small incisions to correct my astigmatism.  After the surgery, my vision was not as good as I had hoped, but I knew that was a possibility.  What concerns me is that the main problem seems to be my astigmatism.  Before the surgery, the astigmatism in both eyes was aligned in the same way.  In the test charts, the verticle lines looked darker in both eyes.  Now, the astigmatism in my right eye seems worse, not better, and now the horizontal lines are much darker.  I know that it is a bit early, as my eye has not healed yet, but my doctor is being quite vague with his answers about if this is normal, and what I can expect.  At this point, his only suggestion has been that I pay him $2000 more for him to perform laser surgery on the same eye, to finish correcting the vision.  Is this 90 degree shift in my astigmatism unusual after this kind of proceedure?

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

You are much too early to declare the operation a failure. You had the LRI (limbal relaxing incisions) to reduce or eliminate the astigmatism that existed preoperatively so the darkest line of the letters would be expected to 90 degrees from the incision. If you were lucky and the astigmatism was completely cured the letters would look uniformly the same color without a dark streak.

I would just wait and see what things are like 6 weeks from now.

JCH III MD