Toric lens implanted; blurred distance vision

Greeetings. I had traumatic cataract removed 9 days ago, and due to bad astygmatism in that eye, had a Toric lens - set for distance vision - implanted. Only thing is, I can focus well in this eye at roughly 18 inches, but beyond that it is blurry. IE the exact OPPOSITE of what I had expected. For the moment, my surgeon says I have to wait another few weeks to see how the eye truly settles in, vision-wise. But at the same time, he says that it could well remain this way, with blurred distance vision (the opposite of my "good" eye). I'm curious whether anyone has an experience with this, and whether I can reasonably expect my vision to change - and more specifically, develop good distance vision as anticipated - in the coming weeks? Is 9 days out too early to conclude that my vision - for whatever reasons; maybe bad lens power choice? - will remain as such, and need to be corrected in another way (glasses, or perhaps future sugeries)?. Thanks very much for any insights on this matter.

[Michael J Kutryb, MD]

This question revolves around your current refraction now after surgery.  The IOL measurements are not 100% accurate and there is definitely some margin of error.  It sounds to like you probably have some myopia now - which was unexpected but not unheard of.  There are certainly no guarantees what the refractive outcome will be after surgery.  There may be a litte shift in the first few weeks but at 9 days you probably aren't going to change too much more.  So you may be able to wear glasses or consider a second surgery to try to reduce some of the myopia so you could see better in distance without glasses.  THis second surgery - like lasik or prk or piggyback IOL would most likely need to be paid out of pocket since it would not be covered by insurance.  Now since you since you paid extra for the toric IOL you may have some legitimate beef with your surgeon since the extra expence of the toric IOL didn't really give you the distance vision that he probably suggested you might get.  If your vision is really blurry as you state for distance I would have a serious talk with surgeon and ask why did I spend the extra money if I didn't get any better results.  Perhaps the surgeon may cover some of the expenses if needed for second surgery.

Michael Kutryb, MD

[moppin]

I had April 23, 2008 cataract surgery and paid for premium toric lens also.  To date (10 days later) my vision progressively becomes more blurred each day. Dr. said lens has not rotated, and says may have edema behind the eye so sending me to another eye Dr. Monday.  But I am so disappointed, expecting the BEST from paying for the toric lens and getting not even good enough distance vision to see for driving!  I've postponed my other eye surgery until I can figure out what happened with this one.  Personally I question paying for the toric. 2 brother-in-laws had standard cataract surgery and both were seeing good distance within 2 days!!

[Michael J Kutryb, MD]

Understand completely.

MJK MD