Wrong implant?

[JAC1953]

I had an IOL implant  SA60AT power 20.0 D put in my left eye one and a half years ago after cataract surgery and my vision is terrible....My vision before the surgery was 20/40 and I only had minimal blurring from the cataract. After the surgery, my vision was tested by several doctors and it was 20/200 to 20/400 depending on who tested. A doctor also did the TAG procedure on me to no avail. I have been wearing a single contact in the eye ever since. The contact is a night and day 5.75. With it I can see during work hours , but driving at night is full of streamers and halos around street lights and headlights. Could I have gotten the wrong implant? I have never worn glasses until the cataract surgery and this is driving me crazy. I have the beginning of a cataract in the right eye and I am terrified to have it done. Is this a fluke? Are the tests to measure which implant you get that subjective? What can I do ? Two doctors have advised against implant exchange but I am only 50. I tried glasses but they were very strong and I had double vision with them . HELP.  JAC1953

[Winker22]

I suffered a blunt ocular trauma. First surgery repaired retina tear, it did not detach. Removed traumatic cataract. Retina tests show 20/20. Second surgery IOL sutured in. Vision no better than when all injuries were still present and before surgeries. Doc tried to push glasses but refractive error too great. No glasses could help. No known cornea damage.

Doc not talking.

Why did my vision not improve any?

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

1. It is important to know whether its 3 diopters of myopia (-3) or hyperopia (+3).
2. Either way that has no astigmatism. Find out from your present surgeon what is your refraction in the operative eye it has three parts a plus or minus sphere plus or minus cylinder and axis in degrees
3. Get your vision in that eye with the glasses (refraction test).
4. Also inportant to know if your other eye is a -15 also and whether it has a cataract and will need surgery soon.
5. Repost that information here and I can give a much better answer.
6. Consider setting up a second opinion soon.

JHC MD

[lydiah511]

I was wondering the same about my IOL.  I was at -15 w/ GP len.  I had cataract syrgery 2 wks ago and have an IOL of 3.0 diopters now.  My vision is blurry near and far.  Now my doctor tells me I have an astigmatism-which I did not have before the surgery.  He told me to have lasik or get another GP lens to get 20/20, and to remove the astigmatism.  Is there anything wrong here Doc?.

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

If you were left +5.75 diopters short of plano (zero) which is the ideal target for a far-sighted person on the first they then you were seriously mismatched.  The present day state of the art will leave people +/- 0.50 of target post op refractive error 95% of the time and probably 75% of the time +/- 0.25 of target.

Lasik does not work well for hyperopia.

I would suggest you find a different surgeon and see at least two cataract/refractive eye surgeons.

Likely you will need and IOL exchange.

JCH MD

[JodieJ]

One additional suggestion:  Please, please, please find a different surgeon when you need to do your second eye.  Your best bet for another opinion about your first eye would be an experienced, board-certified cataract/refractive ophthalmologist.

[JAC1953]

Thanks for the quick responce the power of the contact I'm using is + 5.75. And  I'm seeing pretty clearly with it. When I said I had TAG procedure I meant YAG. I hear implant exchange is much more risky after YAG.  What kinds of eye problems  would make the implant not work correctly? Could it be the shape of the eye?

-JAC1953

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

The problem is  that even with a contct lens (is that a plus or minus 5.75) you are not seeing normal. A wrong IOL power would not do that so there must be some other problem with your eye.

The power of the IOL is off because it is highly unlikely that the surgeon was trying to live you almost 6 diopters away from neutral. Even if your were extremely mypopic we usually try and make the cataract surgery eye neutral or no more than -2.50 myopic.

See a retina surgery to evaluate your reduced vision and a cornea/refractive Eye MD to consider either lasik or IOL exchange.

JCH MD

JCH MD