Vision after cataract surgery not what was planned

[Suziq42]

I had cataract surgery 3 months ago.  The surgeon and I decided to implant a lens for distance vision.  For reading I would wear eyeglasses.  After surgery, I see my computer screen, about 20 inches away, clearly with the IOL, but I cannot see distant objects clearly.  Interestingly, if I look through the lower bifocal (reading) lens of my previous eyeglasses, I can see the television screen across the room fairly clearly.  When I discussed my inability to see distance with my surgeon at 5 weeks post surgery, he explained that both instruments (the best ones, he said) calculated the same strength for the IOL.  This is at a very well respected teaching hospital; the surgeon is the one from whom the center is named.  Is this a reasonable explanation for the result being different from what he and I had planned?  What recommendations do you have?  I am scheduled to have surgery on the second eye, by the same surgeon, in a few weeks. Do you recommend that I get another opinion?  If so, should I discuss what happened with the second surgeon or should I let that surgeon try to solve the problem by him/herself?

[etrader]

If it helps I agreee with the above comments, lens calculations are not precise and can be somewhat off, discuss with your surgeon, hopefully he can take your result into consideration for the next eye - hopefully you will get a little closer this time. Best of luck.

[SoftwareDeveloper]

In rare cases there are mistakes made like the power of the lens implanted not being the one the doctor had decided on.  If a mistake was made its important to discover that.

The formulas for determining IOL power aren't an exact calculation. They are based on data collected from prior surgeries about what eye measurements with what IOL powers lead to what results. There are different formulas used to estimate the IOL power and usually more than one is checked, but even when they agree its possible for them to be off since each eye is different. Usually they are fairly accurate, but less so in the case of high prescriptions, especially high myopia as this page discusses:

http://www.doctor-hill.com/iol-main/extreme_axial_myopia.htm

That is partly because only a small percentage of the population has such eyes so there is less data (in addition to the issues that page discusses regarding the potential for problems with the methods used to measure axial length).

You don't give an indication of what your vision was like beforehand in terms of the prescription, or how far off your refractive error is now to guess at  the likelihood the formula simply got it wrong.

[Anomalychick]

Iol miscalculations happen. Often. If the computer is clear youre probably about a-1. It doesnt mean the doctor made a mistake. Its not a perfect science.