Uneven pupil

In May 2010 I had very successful cataract surgery/astigmatism correction on my left eye. Pupils equalized within a day and scar tissue was successfully lasered a few days later as well. About 6 weeks after surgery it was discovered that the bottom of the pupil had become pointed and distorted. This distortion is working its' way around the iris, so now it is narrower at the bottom and slightly on the bottom right. The pupil itself would be somewhat larger than the right one, even if it were round.

The ophthalmologist who did the surgery said the underlying muscles in the iris were not acting in unison to allow an even constriction. He diagnosed Corectopia. However, both irises are exactly where they should be, just the left one is distorted and the pupil is out of round. It appears that this may be closer to Anisocoria, but not exactly. Can you tell me anything that would give me more information on an out-of-round pupil/iris?

I will post a picture as soon as I receive it from the Doctor.

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

There are a number of causes: the pupil often has to be stretched at the time of surgery if it does not dilate well this can cause it to be different in size. Adhesions can develop that can scar the iris against the IOL the last is the most serious and that is where the capsule was torn at the time of surgery and vitreous from the back of the eye comes forward and "peaks" the pupil. This can also occur after a yag laser capsulotomy which you say you had so its the most likely cause.

Only an exam can tell which of these is your problem.  If your vision is failing get a second opinion.

JCH MD