Concerns after cararact surgery

I'm writing concerning my 80 year old mother who had cataract surgery yesterday to help improve her distance eyesight and especially night driving. She does not wear glasses, except for reading. She had the surgery yesterday and after 40 hours her vision is very blurred post surgery. prior to surgery, her eyesight was considrably better. Our concern is that everyone else we know who had the surgery, their eyesight was much better and clearer the day of surgery, and certainly not any worse. When she went for her follow up appointment today, the doctor simply said, she may have to wear glasses. The surgery had made her eyesight worse, not better. Is this normal? Is this a side effect or complication? When should she have better than prior to surgery eyesight? What may be the problem?

[Michael J Kutryb, MD]

You really need to discuss this carefully, in detail with the surgeon. If he does not take the time to explain it to you, then at least the technician should be able to. We have to separate two things here:  1.  removing the cloudy cataract 2.  changes in the refractive state of the eye (ie myopia, hyperopia astigmatism.

Of first priority is making sure the surgery was safe and the recovery is coming along normally.  If everything looks great surgically, then the second priority is seeing what the resultant refractive error is after the surgery.  A surgery can be done perfectly well but strong attention also needs to be paid to the desired postoperative refractive target and also the amount of astigmatism expected.  Find out from the surgeon if the surgery went well first.  Next ask about the pre-operative refraction including astigmatism and the desired postoperative refraction.  Is she close to the intended target?  If not, why?  Why does she get the impression that her vision is weaker after surgery than before?

Please understand that a lot of patients just assume that they will not need glasses after surgery and that simply is not the case.  Yes, many of my patients see very well at distance without glasses after cataract surgery but I never make promises or guarantee.  My only statement is that I will do everything to the very best of my ability to maximize the vision as much as possible using all the state of the art equipment and techniques that are available.

Discuss the situation with the surgeon.  Don't be shy, don't be put off, and insist on having your questions answered.  It is the surgeon's duty and responsibility and let him know in writing if you have to.

Michael Kutryb, MD