cataract surgery wrong size lens got put in

Hi, my Mother just had cataract surgery on her left eye. Her near sight improved a lot, but far sight did worse than before. She also complained about too much light going to the eye. Well, when we went to see the doctor and he checked the eye sight it turns out the lens that was put in was miscaculated on doctor's behalf. Now the eye is not healed yet to redo the surgery soon, and will have to delay the right eye surgery as well. She is very uncomfortable at this point and next surgery date that we have is middle of Aug. Any ideas to help the comfort level in the mean time. Thanks.

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

Senstivity to light is not uncommon after surgery. One reason is that the cataract blocks light from entering the eye (like a pair of sunglasses inside the eye). When the cloudy, yellow-brown cataract is removed more light enters the eye and additional protection in the form of sunglasses, post-cataract sun goggles and a hat is often helpful.

Picking an intra-ocular implant power is not an exact science and even with the best of care and equipment under or over powered implants can be chosen for the eye. When this happens several options are available: correct the problem with glasses in addition to the implant, make corrections on the second eye (if the first eye was the one done) to 'balance' the eyes, remove the implant and put a different power implant in (implant exchange) or do LASIK or similiar procedure on the cornea to compensate for the implant power.

Your mother and her surgeon can decide on the best course of action. In the interim I can't make any specific recommendations to make her more comfortable. You might want to your mom's surgeon to discuss this with her again to be sure she has 'peace of mind'.

JCH MD

[JodieJ]

I'm wondering if some of your mother's discomfort could be due to the difference in image size between her eyes (a condition called aniseikonia), since the incorrect lens power has apparently made her left eye quite nearsighted.  This condition could make her binocular vision very uncomfortable.   Based on your post, I assume that her surgeon is planning on explanting the lens and implanting one in the correct power.  I've read that explanting an IOL is safer and more successful when done soon after the initial procedure.  That's why it astonishes me that your mother was given a surgery date more than two months away!  I suggest that you schedule another appointment with the surgeon ASAP and have an assertive (not aggressive), articulate friend/relative accompany you and your mother.  If there's no medical reason for delaying the explant surgery, perhaps your friend/relative can help your mother get a much sooner date for surgery.  You might also consider getting a second opinion from another doctor as to how to proceed at this point.  Best of luck!

[John C Hagan]

Jodie J is correct. As a generalization if we are going to exchange an IOL for power mismatch (whatever the reason) we do it sooner as opposed to later. I believe the rest of her suggestions are quite appropriate. I would clarify this ASAP.

JCH MD

[newflora]

I am confused.  My doctor told me that once you had a lens implant that they could/would not remove it and replace it with a different type.  The implication is that you have to live with your choice of lens once they were put in your eye.  But here it seems the lens is being changed.  

[John C Hagan]

Replacing, removing or exchanging an intra-ocular implant especially after it's been in the eye for a month or more is a "major" operation and in some cases more difficult than the original procedure. So it's only done in big problems where there is a large (say 4 diopter) mismatched power, where glasses or contacts will not correct the situation. For minor mismatched implants where the glasses prescription is only a little off what was predicted by the formula most insurance companies and medicare will not pay and the removal is not justified due to the risks.

JCH MD Eye physician & surgeons