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a question about corneal oedema and astigmatism
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a question about corneal oedema and astigmatism

Last month I had cataract surgery on both eyes (only the right eye had cataract, but I had both eyes done so I could have them both at plano and so not have to wear glasses anymore). My left eye was -5.5 sph, -0.5 cyl and right was -7.5 sph and-1.0 cyl (right had been -5.0 before the cataract).

I had the right eye done first, but found the speculum too painful to tolerate. They put more topical anaesthetic on the eyeball to try to fix this, but it was still too painful, and in the end, they were literally pouring it in. Finally I could bear the speculum, and the op went ahead.

When the anaesthetic wore off, I was in terrible agony for hours. Further, though I'd been told my vision would only be 'a little hazy' after the op, it was completely blurred, and took a couple of days to recover.

When I saw the surgeon, he said that all this was due to the fact that so much anaesthetic had been poured onto my eyeball, it had caused the cornea to become oedemous, and said that for the left eye, the anaesthetist would use a different technique. With the next op, I was given some topical anaesthetic and then some injected into the eyeball. When the anaesthetic wore off, the discomfort was hardly even noticeable, and when I took the tape off my eye, my vision was very sharp. Next day, it was absolutely perfect.

I'd had -1.0 dioptre of astigmatism in my right eye, and my surgeon had said that, rather than insert a toric IOL, he'd attempt to reduce the astigmatism surgically during the operation by the placement of the incision made to insert the IOL. Well, though my left eye is now near-perfect (plano with -0.25 astigmatism), my right eye is definitely less sharp, and is +0.50, still with -1.0 astigmatism (though the axis is now different).

My question: could the cornea have become oedemous by the time the op was about to begin, and if so, could this have made any surgical attempt at reducing my astigmatism prone to error? Thanks.

"My question: could the cornea have become oedemous by the time the op was about to begin, and if so, could this have made any surgical attempt at reducing my astigmatism prone to error?"

Yes, unlikely.

It sounds related to the amount of anesthetic eyedrops used. Also, you possibly had a corneal abrasion from your intolerance to the speculum. It's very hard to predict this possibility, and when I predict it then I use an injection anesthetic like your left eye. Once you right eye has healed more and the edema resolved, you can ask your doctor "what is the residual astigmatism" and can it be corrected with laser vision correction? Best wishes,
Timothy D. McGarity, M.D.
Thanks your that advice, Dr McGarity. It's now around a month since the op on my right eye (I had it done on May 14th). The astigmatism reading of -1.0 was from an eye-test I had last week.

Should all of the edema have resolved by now? (ie: is the astigmatism I have now likely to be the 'final figure', or is there still time for it to improve?) Thanks.
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