complications after incorrect iol replacement.

I am 64 years old. 5 years ago I had cataract surgery on my left eye and everything went smoothly. Since I had very strong eyeglass correction the image size between the two eyes were now quite different. However I had no problems handling the difference and did not want to take a chance on doing the right eye as well in case of complications. With aging the image size differential became more difficult so I decided to go ahead with the right eye.

Everything went wrong. The IOL was completely the wrong power. I was able to get it corrected with glasses. By the way I never expected to be glasses free so I did not consider this be a problem. But I was getting strong light diffraction off the edge area of the IOL and this was very distracting. The ophthalmologist recommended the replacement of the IOL.

Then things went really wrong. Immediately after the surgery I had hazy vision. It did not improve with passage of time. This cloudiness occurs mainly in bright light. I took a piece if paper and cut a slit 1/8 inch wide and 2 inch long. If I look through this slit the haziness disappears and full contrast returns. I can rotate this slit 360 dgrees around the axis of the eye and there is no haziness at any angle.

  During the last visit he said that he thought the cause was that some cells got rubbed off resulting in the thinning of that area allowing in too much light. He said it was too risky to go in again and and put in a prosthetic to correct for the problem. When I asked him what was the solution he said there wasn't any.

He prescribed Alphagan P 0.15% and another appointment in 3 weeks. He said the Alphagan P was for diagnostic purpose. As you can imagine I developed a serious lack of confidence and went on the web to see what this drug was used for. I became very alarmed when I found out that the predominant use of this drug was for the treatment of wide angle glaucoma.

I can really use some advice to see if there is a solution. Obviously I will seek a second opinion but the problem is that this is a small city and all the ophthalmologists know each other. We all make mistakes and unfortunately it happened to me. I am not interested in pointing fingers, all I care about is if it is possible to correct this problem.

Any information will be greatly appreciated.




This discussion is related to Wrong Lens Questions.

[Joan M Pernoud, MD]

I am sorry this happened to you. Sometimes these things can happen even though the processes are all correct but it's easy to wonder when it is your eye its happening to.

Several thoughts:

1) The Alphagan is being used because it makes the pupil smaller and your doctor thought that might help....simulated the small slit scenario. It is also a glaucoma medicine. There might be a second reason and that is maybe your endothelial cells of your cornea are decreasing and sometimes that can be made better by lowering the eye pressure even if the pressure is normal. So, that was a good plan.

2) If your cornea is becoming cloudy from decreased endothelial cells, there are procedures to help that....transplantation of corneal tissue...but I am not sure if that is what you have.

I would give your surgeon a chance to do whatever can be done to help then get a second opinion if needed. Remember to bring a list of questions to your doctor so you feel satisfied and it helps avoid distractions that easily happen once you are in the doctor's office.

I would not worry about the ophthalmologists knowing each other. That doesn't mean the doctor giving the second opinion won't do his or her best to help.

[igardos44]

Thank you very much for your comment. It was very helpful especially your comment on the use of Alphagen P. Your advice is greatly appreciated and I will be patient and give my surgeon a chance as you suggest before seeking a second opinion. Again thank you very much.

[Dalubaba]

lessor iridotomy was done to prevent damage to my right eye as i was prone to glaucoma. After lessor therapy i developed intense pain. I was given pillocarpin to reduce pressure and analgesic. I was asked to continue pillocarpin indeffinately.
however other ophthalmologist stopped pillocarpin after 18 moths as trh pressure remained normal.
At present pressure is normal.But episodic blurring one or twice in a month for one or two days.I am asked to take nutritional treatment for dry ARMD.
Now the question is Am i suffering from ARMD or some form of Glaucoma? Should i start pillocarpin? As you have suggested in your above posting that drug to reduce tension may be given ever if the pressure is normal..At present I am using magnifying glass to read.Will it help if i resume pillocarpin. I am checking myself for amsler grid.At present i can clearly see the dot and the squares clearly. no distortion of lines.Please guide me.
.

[KellyComfort]

Quite frankly:  If I were you I would set up a second opinion, forget letting that doctor working on you any more.  your trust is broken and your faith is probably gone. You are under no obligation to tell the next surgeon who did the original surgeries and I wouldn't.  It is a fraternity and it is sad to say that this fraternity sticks together, sometimes despite the fact that they know there has been a diservice.  I am willing to take the possibility, liklihood even, that Dr. P. will not be happy with that statement, but the facts are facts.  I have seen the works of surgeons that HAD NO BUSINESS CONTINUING TO PERFORM SURGERY and it is tough to say anything because of professional codes. Get another opinion.

[JodieJ]

I agree with KellyComfort.  I'd get a second opinion, preferrably from a board-certified cataract/refractive specialist.