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bad cataract surgery
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bad cataract surgery

I'm really saddened about my  right eye sight after cataract surgery. I only went to my eye doctor to get contacts, he said that I had a number 2 cataract and that I should have surgery. I never had hazy or blurry vision and have only needed glasses the last ten years...I'm 59 years old. My vision before the surgery was distance sph +0.75  cyl +0.50 axis 175 reading addition +2.50
                            after surgery sph -1.00   cyl +25    axis 026 reading addition +2.50
I get terrible headaches now when I try to go with out glasses. He addmitted that it was about a diopter off of what we had discussed but that the main objective was to get rid of the cataract (he doctor owns the surgery center). I want to know if this is normal and what can be done to get my vision back to my original perscription? ALSO.. a very big concern is why do I have black vision on the upper outside corner of my vision? It gets worse when I look at something up close. I keep thinking that I am going to bump into something. They did a peripneral vision test and said that it was OK but I can tell that it's not OK at all. Could the implanted lens be too small,could it be scar tissue? I'm sorry that this is such a long questioin but my work requires very close up sight and now it has been wrecked and I just don't know what to do. Thank you for any help or knowledge that you can give me about this problem. Dee
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233488_tn?1310696703
Hello Dee

This is a message to all readers. If you don't have visual difficulties and are getting along just fine with your vision and a surgeon suggests cataract surgery  GET A SECOND OPINION. Our practice likes to say "we don't like to operate on happy people".

1. You need a second opnion in the worst way with a competent eye surgeon not in that practice. Use the Find An Eye MD feature at www.aao.org and search a "refractive surgeon". First you need to find out why you have that black area.  When you schedule the second opinion on the phone tell them you need a visual field exam scheduled at the same time.

2. After finding out what is wrong with your eye you may be a candiate for LASIK on your operated eye to reduce the refractive error from -1.00 to "plano" or 0.00  It's likely your problem with glasses is matching a nearsighted cataract surgery eye with a farsighted non operated eye. The problem is called aneisometropia and part of it comes from unequal image size (aneisokonia).

Please let us know what the second opinion shows. This is VERY important to follow through.

JCH IIIMD
14 Comments
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Avatar_n_tn
There are a few mysterious effects of putting an intraocular lens which ultimately has a higher refractive index than the natural lens.  This group can generally be classified as "pseudophakic dyschromatopsia" which bothers a relatively small number of astute observers after cataract surgery.  Temporal darkness is one of the harder phenomena to explain but you are not alone.  Provided that your visual field test is normal and your dilated fundus exam reveals no pathology in the retinal periphery, I would be reassured that you will notice this phenomenon less and less as time goes on.

Regarding the headaches, can you achieve satisfactory vision with glasses or contacts?  It would be worth a serious try before doing anything more permanent.  Also what about the vision in the other eye?
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I'm going in today for a visual field test. When I looked on the website aao.org to find a refractive surgeon...the doctor that did my surgery came up. I  had and have heard good things about him. I immediately went to another surgeon following my surgery on June 19th, and the other doctor didn't really say anything but said to come back in November which I canceled because I can't afford it. The doctors are friends, I'm from a fairly small town. My doctor is going to try monocular contact lenses on me.
Thank you so much for your info.
Dee
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I do have a new lens in my glasses which does help my headaches. I just did not HAVE TO wear my glasses before the surgery except for real close up work...now the minute I wake up I have to reach for them.
My other non operated eye perscription is sph + 1.00 cly +0.25 axis 004  reading addition + 2.50.
Can you tell me what vision would be like if an implanted lens was too small?
Could the black sight be from scar tissue?
My surgeon and I had discussed the fact that I would not have to wear glasses for close up work but he said 'you sometimes have to give up something to get something so I might have to wear glasses for driving'...how often does the wrong lens get implanted? Who should pay for the lasik surgery to get the operated eye back to plano or 0.00?
Thank you so much, I'm off to the eye doctor
Dee
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233488_tn?1310696703
As we have discussed many times picking an IOL to leave a person "plano" is not an exact science. You will be responsible for the LASIK if you chose to go that route. In some cases such as yours you and your surgeon can petition your health insurance to cover since your eyes don't  work together. Sometimes they will cover it.

Implants are not "too small" they have expandable arms (haptics) that like an elastic waistband is get longer/shorter as need in your eye.

JCH III MD
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Avatar_n_tn
Thank you for your responses.
Just to keep anyone posted that is interested...I'll continue my experience. I went back to the eye doctor...I'm beginning to not like him. Now he says that he never said the implanted lens is a diopter off of what he wanted. Fortunate for me, my girlfriend goes with me to appointments and when I told him that he did say it she also said he did. Now he says that all of a sudden I'm changing my mind on what I want because now I only want to wear glasses for reading. He said that I can't be fixed so I don't have to wear ANY glasses. I changed my mind because yesterday he said that if I can see up close without glasses then I would have to wear glasses for everything else. He says that he doesn't ever think I'll be happy. I told him that I was happy when I got a mailing from his office saying that it was time to make an appointment...I did because I wanted contacts. I had no complaint with my eyes other than possibly needing a little stronger reading lens. I don't have an enemy in the world and am known as a happy and pleasant person....and I would be a very happy person just to get my own vision back. I'm very upset about my vision and the way he treats me. I now have contacts...both for distance and will have to wear glasses for reading. The doctor also said that if people don't have to wear glasses after cataract surgery...they are lying....what is that about?! my own parents wouldn't lie to me. Man...I just don't know what to do. Dee
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233488_tn?1310696703
Some people do find with glasses after cataract surgery.  Of these some have good distance vision in one eye and good reading in the other. This is called monovision. It doesn't work for everyone. Some have had multifocal IOLs. Most of these need glasses for some tasks.  Some people hate glasses, don't mind their vision being blurry and just don't wear glasses in spite of the fact that they would see better with glasses.

Give your feelings towards you physician and the lack of communication and trust, you should probably consider finding a new ophthalmologist.

JCH III MD
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233488_tn?1310696703
Make that do "fine" with glasses after cataract surgery.

JCH III MD
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Avatar_n_tn
Thank you for your medical advice which prevented me from possibly making a grave error.

I need cataract surgery and went to a recommended ophthamologist
with 300 word description of how I used my eyes.  I expected him to read it and then recommend an implant.  He did not read my eye used description, seemed in  a hurry, but did have time to tell me that I should have the Rezoom multifocal implant.  Said that is what he would pick if he had need of an implant.  I was unsure and he had me watch a video where some golfer was hawking the multifocal.

When I told his assistant the movie was insulting and that as a chemist, I made decisions base on numbers and objective studies, they really had nothing that would help me make an informed decision.  In my description I indicated I had no vanity (too old),  did not mind wearing glasses, but wanted the clearest possible vision.
In the end I became angry, told the assistant I was not cow and expected the doctor to read my "use description" and then recommend the appropriate lens.  And that I could not be expected to make the choice because I was not an MD and lacked the expertise to evaluate and make the best choice.

After 8 hours of seaching I found your site (Thank God and you) and read you telling comment on the multifocal lens.  I had always planned to have a monofocal lens, but once he alerted me to the multifocal I was tempted and reluctant to give up the new idea.  After reading the many posts however, I became concerned and your comment, "the technology did not match the promise", was the final nail in the multifocal coffin.   I am now comfortable with the choice of the monofocal.  

Thank you so much for your integrity and forthright opinion.
You honor your profession

vduvy in California
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Avatar_n_tn
I had cataract surgery on my left eye on Nov. 28th. Today is Dec 13th. I have been back to my eye surgeon 3 times complaining of erratic flashing in the corner of my left eye.  His associate told me the implanted lens had shifted and I am seeing the edge of the lens. At today's visit my surgeon gave a diagnosis of "negative dis photopsia" I can't find any reference to this term . I find plenty of articles about "photopsia" but not the diagnosis he gave me today.Where can I get some information onf "negative dis photopsia"?
Jim, Jacksonville, Fl. (77 yr old male patient)
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233488_tn?1310696703
Look up this term (it has also been discussed on this site so use the search and archives) "dysphotopsia"

JCH III
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A related discussion, problem during surgery was started.
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