explant lens post cataract surgery

[cassyjones]

How safe is it to have a lens removed and replaced with another after cataract surgery?  I currently have the tecnis Multi focal tecnis lens and have multiple problems with my vision.  My surgeon told me "you need to decide if you will keep this lens now".  I am not feeling like I have enough information to make a decision.  I plan to see him in few days and have questions to ask. I am looking for input from professionals and patients on this procedure.  I also have clouding in the capsule, which complicates the decision as well and also a corneal abrasion, which is partially, healed since the lens implant 4 months ago.

[cassyjones]

  I do have clouding and I have not agreed to the YAG  procedure because of the uncertainty.  The halos I expected, the star bursts were not expected and are more bothersome, but only at night.  Glare is also a problem, especially florescent lighting.  My surgeon tells me I have a corneal problem, that was not there before the cataract surgery. I do also have recurring pain and some swelling under that eye that ranges from a tolerable ache to intense enough to take a pain reliever.  I have mentioned this since the 2nd week after my surgery in  October. He tells me it is not associated with the surgery, but I did not have it before the surgery.
I am not aware of what macular edema is, or epiretinal membrane.

[Doreen Fazio, M.D.]

Obtain a second opinion regarding the explantation.  Usually this is performed when the patient is unable to adapt to the multifocal vision, and continues to have significant problems with glare/halos and decreased contrast sensitivity.  Delay any YAG posterior capsulotomy to open the cloudy membrane behind the implant, since an open capsule will make an intraocular lens (IOL) exchange more difficult and risky.  All other possible causes of decreased vision should be evaluated and addressed before deciding on IOL exchange:  corneal surface problems, macular edema, epiretinal membrane.