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Vision after cataract surgery
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Vision after cataract surgery

I am VERY unhappy with the choice I made regarding my vision after cataract surgery (done on both eyes in April of this year). YES, it was my choice to ask my surgeon to give me good distance vision, and that's exactly what I ended up with. I can see without glasses to drive and watch TV. And I know that popular opinion on this forum is that distance vision should be the goal after cataract surgery. And honestly, I'm trying very hard to adjust to this new vision. BUT I need reading glasses for absolutely everything I do, and I mean EVERYTHING. I didn't realize how much my life focused on close tasks. I now need to wear glasses all day and all night long - more than ever! There is absolutely no break from the glasses. The only time I don't need them is on the 30 min commute to work and back. I panic if a pair of readers is not within my reach because without them I can't see to do anything. And I also know that things will improve once I get my prescription glasses. BUT that still won't allow me to see things up close without glasses or contacts. I obviously made the wrong decision and am paying for it now. My question is, now that my dry eye problem has been resolved, can I think about getting laser surgery done down the road in order to get my close vision back? I've read some posts where laser surgery has been recommended in cases where the person is not happy with their vision after cataract surgery. Thanks for any advice.
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11 Comments Post a Comment
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233488_tn?1310696703
First you have had a good surgical result in that you have good distance vision.

Second there is no "consensus" on this forum that one should try and get the best possible distance vision after surgery. I myself have said that because I'm myopic and use to reading without glasses I would leave my own eyes myopic after surgery.

Third lasik does NOT work well in your situation in that lasik is to correct myopia and your eyes would have to be made myopic to see without glasses.

Some reasonable suggestions:  Wear progressive bifocals all the time,  continue with your reading glasses and hang them around your neck,  get fit with either bifocal contacts or do a monovision contact lens to read with (one contact).

In my opinion and IOL exchange is not warranted.

JCH III MD
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Avatar_f_tn
If your cataract surgeon does laser vision correction, schedule an appointment to determine whether you're a good candidate (extremely likely) and when can have the procedure done.

If you're that unhappy with your vision, disposable contacts can provide good near/intermediate vision TODAY.  Hopefully, there's an optometrist in your area who stocks a variety of lenses so that you to try them out in the office.  You could either wear a contact in your nondominant eye (some version of monovision) or multifocal contacts in both eyes.  With all the available options, I'm sure that you could find something that will work for you until you have LASIK/PRK.  (If you've never done monovision, it would be a good idea to try it out with a contact lens before you go for laser vision correction.)


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If, as Dr. Hagan states, LASIK/PRK won't work for you, I've read that CK will work.  In addition, it's supposed to be safer than LASIK/PRK.

Your worst option, in my opinion, are drug store readers.  Compared to progressive glasses, they're the pits.  
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233488_tn?1310696703
CK works by burning the eye into shape. Its not permanent and has to be repeated every 2-4 years. The long term effect of repeatedly burning the cornea is not known. If the opeation fails it creases irregular astigmatism and wouldneed a rigid contact lens to correct for years.  Our practice does not do or recommend CK. I don't know any ophthalmologists that have had this on themselves.  Proceed with caution on CK. I would not have it done on my eye.

JCH III MD
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Avatar_f_tn
Lorac0813, by now from reading this board and learning of the serious eye problems others have, I personally think all of us who have had cataract surgery should be thankful our sight is as good as it is. Obviously there are choices and trade-offs but at least we can see unlike others who are not so fortunate. I think Jodie & Dr Hagen have made some good suggestions about the contact lenses, why not try this and see if it helps you?
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Avatar_f_tn
Even though my eyes are somewhat dry, wearing a 1-day Acuvue moist contact in one eye is incredibly comfortable for me.  Actually, it's almost too comfortable, since I've forgotten to take it out at the end of the day on more than one occasion.  I've even inserted a second lens the next morning and not discovered my mistake till that afternoon when I noticed that my vision seemed to be off.  I think this lens might work out well for you, too.

I've read reports from cataract/refractive surgeons who use CK on all their multifocal patients who turn out to be a little farsighted.  It's said to be much safer than LASIK/PRK (per the surgeons' reports.)  But 2ndsight has a good point.  And even if (by some miracle) we enjoyed perfect vision into our 40's, we'd still end up exactly where you are now.
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Avatar_n_tn
Hi Dr. Hagan, thanks once again for your advice. I will try to be patient and wait until I see the optician specialist in June and ask him about either progressive glasses or multifocal or bifocal contacts, as you suggested.. It's just so frustrating! These d*** reading glasses drive me crazy. I will take your advice about LASIK/PRK, and CK, as well. Perhaps it is best for me to discontinue exploring those particular options at this time. And I AM thankful for my good distance vision, I truly am - I just miss seeing things up close.  Thanks again for your good advice. P.S. I am no longer considering an IOL exchange at this time.
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Avatar_n_tn
Hi JodieJ, thanks for your advice. I may try the 1-day Acuvue contact lens, as you suggested. I've never yet come across a contact lens that is comfortable for me but if you have dry eyes like me and they work for you - maybe I should give them a try.

It's interesting that you say that drugstore readers are the worst. In my brief experience with them I think I have to agree! They're horrible.

Thanks again for your helpful advice!
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Avatar_n_tn
Hi 2ndsight, yes, you are right, I should be thankful for the good distance vision that I have, and I AM, truly, it's just that after so many years of being able to see up close, and then suddenly to have that taken away - it's quite an abrupt change.

As both you and JodieJ ( as well as Dr. Hagan) suggested, perhaps contacts are the way to go for me. I will explore that option as well as progressive glasses - although I haven't heard good things about them from the people I know who wear them. But still, their experiences aren't mine, and I should try them - perhaps they will end up being the best option of all!
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Avatar_f_tn
I think progressive glasses are great.  Mine have aspheric lenses, which don't distort my peripheral vision.  I had no problem adjusting to them, and I get excellent vision at all distances.

But you'll probably be happier wearing a contact for most activities.  You can try out different powers to get the very best monovision correction for you.  Everybody's different, but 1-day Acuvue moist and Extreme H20 lenses have been the most comfortable ones for me.
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Avatar_n_tn
Hi JodieJ, sorry, just saw your post now, I haven't been on for a few days. You know you are the first person I've heard say that progressives are great! So perhaps I will give them a try. Although the multifocal contacts interest me as well. Ah well I'm seeing the optician this week - I'll see what he suggests. Will keep you posted!
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Avatar_m_tn
Somewhat in a similar situation as you.

I decided to go with distance (although i've just had one eye done so far).

I can't see anything close either. I was hoping to mimic the way I saw with my contact lenses in, but so far that's not happening. Even with +2.50 reading glasses I can't read my phone. With +1.50's I can see my computer, but my right eye doesn't need +1.50 to read my computer so everything is just kinda blurry and awkward right now.

It's been three days since the surgery and each day my left eye gets very slightly better. Hopefully I'm just a slow healer and all will get better soon.

It's been five years since your post, I hope you were able to adjust well :)
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