Pupil won't stop dilating post Visian ICL

[cylack]

I had the Visian ICL (internal contact lens) surgery recently. The right eye went perfectly and I have 20/20 vision. I had complications with the left eye and ended up having 2 surgical procedures. After the first lens implant the surgeon determined the lens was not vaulting correctly and was rubbing against the periphery of the cornea. This was on a Friday. He had me on dilating drops (cyclopentolate hydrochloride 1%) to prevent the ICL lens from rubbing against the cornea. The replacement surgery was scheduled for next Tuesday since the office was closed for the 4th of July. Unfortunately the lens did not arrive on Tuesday and I had to wait till Wednesday for the surgery. So at this point my eye had been dilated for 5 days. Of course on the day of the surgery on Wednesday the eye was dilated again, so the eye was dilated for 6 days.

After the surgery the next day my pressure shot up to 48. I was put on glaucoma meds which lowered the pressure back to 11 by the following day. Unfortunately in the interval I had developed a slight cataracts; the doctor had informed me prior to surgery there is a 10% chance of cataracts when the ICL lens has to be replaced.

My problem now is this. It has been 6 days after the ICL lens replacement and my pupil still won't stop dilating. The doctor said it could take up to 1 week for the pupil to stop dilating, but I have not noticed any gradual improvement. Yesterday he put in some pilocarpine drops and determined that my eye muscles were still working. He did say that if the pupil won't stop dilating he could go in and do a purse string suture to fix this. What are the complications and risks involved with this? Even though I am not noticing gradual improvement in the dilation not going away, can it suddenly go away in the next few days? Thanks for any advice.

[Arleigh]

My eye doctor said she used cyclopentolate to dilate my eyes for a routine eye exam. My vision has now been blurry for  6 days. Had a follow-up visit and she said I now need glasses. Never wore glasses; had no vision issues prior to the dilation. She did not know whether my eyes would ever go back to normal. Not only are my eyes now blurry, but I have headaches and chronic eye discomfort. What is going on with this drug?

[Sandy Feldman, MD, MS]

Dear cylack,

No one can predict whether the pupil will return to normal. Try to be patient and take one step at a time.  It is possible that your pupil may slowly return if medication induced; however, if caused by damage by the lens or pressure, it might not return to normal size.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California