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night blinding starbursts after cataract surgery
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night blinding starbursts after cataract surgery

I have almost blinding starbursts in both eyes at night.  In 2007, I had a trabeculectomy and a cataract surgery on my right eye.    I was told recently that I have a cataract in left eye.  My doctor says the starbursts in my left eye should be worse than my right eye since the cataract is still there.  But that is not the case.  I think the right eye is worse.  Why would I even have starbursts in my right eye after the cataract has been removed.? A Alcon Acry Sof lens model SA60AT was put in my right eye after the cataract was removed.   I have read that some of those had deformaties and scratches on them caused by the packaging and that could cause problems for those who received them.  That may not have anything to do with me but, even so how come a company can get away with their product getting damaged and then damaging someones eye?  I feel like I am getting the run around concerning the starbursts.  It is almost scary to drive at night but my doctor does not even address that point.  Is there an explanation for the starbursts in the eye that has been operated on?  And can anything be done to correct it?  
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284078_tn?1282620298
Please get a second opinion and ask how the implant looks.  It is very premature to start blaming it on a defective implant when you have no evidence if that is the case.  THere are defintely much more common causes of your symptoms.  Often astigmatism is a major factor as well as corneal problems and posterior capsule opacity.  A corneal topography would shed light on the astigmatism question.  A new doctor can tell you if any problems are present with the implant.  YOu might need to wear glasses to reduce glare and astigmatism.  Good Luck.

MJK MD
15 Comments
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Avatar_n_tn
I have the identical lens placed in the left eye. I do not have problems with the other eye as that cataract has not been removed.  I have had multible problems since I had the cataract removed 19 months ago and that Alcon lens put in.  My Large PVD has almost settled to the bottom and knife like pains in the upper lid is sporactic now BUT the surgical eye is still extremely fuzzy/distorted.  I feel there is a problem with the lens, whether wrong power or another....I sent my records to Alcon....and I called them also.  You may want to call their toll free number in Ft. Worth.  I am in need oif having the right cataract removed but will not do anything until I KNOW what is going on with the left eye.  I wish you better eye days ahead.
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Avatar_m_tn
I have an article that says that the company knows that these lens get damaged in the packaging.  Why has not anyone tried to check into this?  I did not mention the whole scenerio of what happened to me in this surgery that I  speak of.  I was turned over to a Ophthamologist who specializes in Glaucoma, which I had in the right eye.  As soon as I went to this Doctor, she wanted to perform a trabeculectomy on my eye.  She explained the procedure to me and I told family and friends about it.  They all were excited that perhaps my vision would improve.  I told them, no, glaucoma cannot be reversed because it kills the nerve endings, but it can be arrrested and that was the preventative purpose for the surgery.  Now I am not stupid and I like the details, however she not only did a trabeculectomy  but also removed a cataract on the same eye during the same surgery without verbalizing to me before hand (i have seen the records and I did sign forms saying she was doing a cataract surgery as well but she never told me about this, therefore, I did not read all the paperwork and missed that humongus fact.    I did not become aware of this until the follow up visits after the surgery, when the doctor told me my sight in the center would be better as time past because she removed a deep seated cataract.  I was shocked but also certain that everything went well so I was glad.  She told me soon after that a film had grown over it and she could easily laser it off later (which was done by different doctor later).   However after about two and a half months I started ot have severe pain in my eye and come to find out she had left a sponge dipped in MMC in my eye.  It began to surface and looked like an abcess (abscess) surrouded in beet red sclera.  It was under the upper lid to the right of the iris.  She looked at it in her scope for another three months while I was in severe pain.  My sister's eye doctor, who talked to me over phone but did not see me,finally suggested I go see a reknowned Dr in Boston.  I did and he immediately knew what it was, a sponge, and  performed two surgeries to get it out and patch me up.  The Doctor who left the sponge in  also left a stitch over the trabeculectomy bleb which is still there to this day. On top of all this, I have this horrible difficulty driving at night as well as I seem to "miss step" sometimes and risk losing my balance on steps and such. Now that I learn that many Doctors do not even like to use this kind of lens she put in. as well as, some of them get damaged in the packaging and on top of that, I was never briefed on anything about cataract surgery, I am beside myself over this Doctor. I quit seeing her when I discovered what it was and I do have a lawyer because i had to spend a lot out of my own pocket flying to Boston, staying in hotels and all to have it removed.  But it is all questionable what the outcome will be.  But now add to all this the lens and starburst problem and I'd like to sit down and have an honest conversation with the Doc, but I don't think it would be mutual.  It is almost too much to believe.  So now I have a cataract in the other eye which my current doctor is going to talk to me about at length next visit.  She also has provided for me a thick packet about all the ends and outs of the cataract surgery and types of lens etc.  Not a word of any of this from the Doctor who did my right eye.  This is the kind of stuff that should not happen.   It just seems to go from bad to worse.  And I now have to make a very hard decision about going thru with the cataract surgery on my left eye.  On top of all of this, I keep getting switched from Doctor to doctor, I think because I do have a lawyer and I don't think they are giving me the full picture of what they really know is going on in my eyes.  On top of that, they have been reluctant to do anything else to the right eye because so much has been done to it already.  I asked about replaceing the lens and one doctor advised against it for the reason I mentioned.  But when my night vision is so bad, what do I really have to lose?  Incredible! Calling Alcon seems like a good idea.  ( I also have what I describe as a kalidascope, sort of swirly, effect going on during the day in my right eye which I think has to do with how the light is refracting on the lens.  )
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Avatar_m_tn
I did not see Dr. Kutryb's comment before i posted my last one.  I just read his comment.  I do wear glasses and I have asked about 5 different Opthmologists about all this and not one has mentioned any of what you suggested I ask about.  That certainly seems odd when they are common solutions or problems. And I had this surgery in April of O7 over two and a half yeas ago so I am not sure how any of this could be premature.  I have asked that they check the lens out and if there is a problem with it.  I have not had one thing you mentioned suggested to me by any one of these doctors.  I went to Boston and that Doctor recommeded I go to a Doctor in the same town the one who left the sponge in practiced in. I was hesitant so I went to another practice.  The head doctor there saw me and turned me over to his asscociate.  Neither one was interested in discussing my past problems or looking at the sponge site without me asking them to do so.  I finally decided to go to the Doctor that was suggested.  He saw me once and turned me over to his Associate.  She saw me for several months and turned me over to a new partner.  None of them have even hinted to me what you have suggest. Needless to say, I have been very frustrated.  
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Avatar_m_tn
I also agree that it is a stretch that it might be caused by packaging. I guess in light of all i have been through, I am being a little facetious. However it is not a stretch that something has caused this and some by now should have given me some kind of clue as to what the problem is caused by or what a solution might be.
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574673_tn?1234129578
I am not a physician, only a patient such as yourself who was also seen in Boston by a reknowned surgeon to explant a Restor lens that was the wrong prescription and also had many of the typical Restor issues. So my problem was different, however I would recommend having any further surgeries done either by the Boston doctor, or at another world recognized teaching/reasearch eye hospital. There are at least ten of them in the US. It is true that there are out of pocket expenses to fly etc, but your vision is precious and not worth taking any further chances with.
Good luck and best wishes
londonbridge
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Avatar_m_tn
I agree my eyesite "IS" precious.  Do you see how fast the doctor's answer once I tell the whole story.  I will certainly think about what you said about having the Doctor in Boston perform a surgery, if it comes to that.  As a matter of fact, I will contact him again and see what he says.  He sort of was quick to turn me over to someone locally that he recommended and he of course turned me right over to his associate, who turned me over to the Dr. I am seeing now. Thanks for the suggestion.  
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Avatar_m_tn
Would any of you like to comment on my posts now that i have elaborated on my situation?  Sincerely, Peglegsrib
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Avatar_n_tn
I feel your pain. I feel your frustration.  I feel your anxiety...BUT, we will never find an eyeMD that will make a commitment to what could be going on with our eyes since surgery. I heard this is Global with EyeDoctors...This came from an EYEMD tech.  I made the wrong choice in doctors when I had surgery.  I am trying to work on the good eye now to carry me through.  I asked in an earlier post (12-26) if one can have another mfg. lens placed in the good eye when the bad eye has an Alcon Lens.  Not one of these doctors here answered me.  I wish you better eye sight....
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Avatar_m_tn
Lenoir, I also read here or somewhere else on line, I will go to find it again, that most Drs. agree that they wuold not recommend the type of lens that was put in my right eye.  I was not given a choice, nothng about cataract surgery was discussed with me.  I think it is pathetic that not one Dr. has the nerve to discuss this now with me.  I have always been taught that it is just as wrong to omit doing the right thing as it is to commit the wrong thing. oh well.  
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Avatar_m_tn
there is a comment by me in Feb. 08 in related discussions above this post called "sponge in eye."  I have explained more about it in a second post by me earlier tonight under "sponge in eye."
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Avatar_m_tn
my explaination did not get posted under sponge in eye.  Basically, that post in feb 08 was a few weeks after the sponge was removed.  I did not know at the time that the cataract surgery was going to back fire on me also.  I had to get a film lasered off it a few months later and then I began to notice some wierd visual occurances.  Now it is obvious, that the type of lens that i was given causes very frequently night driving problems.  And now I have them severely.  To the point that I really do not know the next steps to take.  I sort of do, but I will have to give this whole thing a little more thought and some more prayer.  Like someone told me, my eyesite is precious.  
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Avatar_m_tn
1) You have glaucoma bad enough to need a trabeculectomy.  Your eye is not healthy, it wasn't before the surgery.  You have had a combined trabeculectomy/cataract surgery, apparantly a wound revision to remove a sponge, followed by another revision.  That is 3 incisional surgeries on one eye.  That is alot.  You may need to revise your expectations, your eye will not see like you did when you were 20, and it probably would not have with a perfect surgery.
2) If indeed someone left a sponge under your conjunctiva, that is very unfortunate, and a reason to obtain counsel, esp if they did not bend over backwards to fix the problem.  You post that "she left a stitch in my eye", as if it were a bad thing.  The trabeculectomy flap is closed with stitches, they will always be there.  Some people close the conjuntiva with a nylon stitch which does not dissolve.  It can be removed, but doesn't necessarily need to be.   You feel like it should be removed, why did the world renowned surgeon in Boston not feel so?
3) You stated "I like details".  You signed the informed consent for cataract extraction.  In this era of malpractice lawsuits I find it hard to believe your surgeon did not mention what she would be doing for 33% of the time you were in the OR.  You agreed to a major part of the operation.  
4) You stated you needed a laser to remove a membrane after cataract surgery.  That is common, and occurs in 18-25% of the people who have an uncomplicated cataract surgery.
5) You stated "most doctors would agree that the SA60 lens should not be placed in your eye".  I would disagree.  A monofocal lens should be placed whether Alcon or not.  Alcon has the lions share of the IOL market and I would conservatively estimate over a million SA60, MA60 or SN60 lenses have been placed.  If these lenses were so bad we would know about it.  
6) Reasons not to explant the right lens:  First, you have an open posterior capsule from the laser (done to remove the film) so lens exchange would necessitate a vitrectomy and there may not be a good place to reimplant a second lens.  Second, you have had 3 surgeries on that eye.  If the trabeculectomy is working you run the risk of making it stop working, your pressure goes up, and you lose vision from glaucoma.   You ask what do you have to lose, the answer is your eye, $$ if further surgery is needed to repair damage from a complicated lens exchange, time away from work if you end up with a retinal detachment, bleb failure, etc...
7) To you and Lenoire118, you caught us.  All eye doctors (outside of Boston of course) are trying to blind you.  If you are not happy with your current provider it is very easy to get your medical records and find someone more to your liking.
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Avatar_m_tn
First let me say it is so kind of you to respond. I will start from the top.  I went to an ophthmologist for my eye issue.  Never had any problems prior.    He did field vision test in office and he sent me for various other test to rule out cancer and more serious things, while he went on a two week vacation. He said he would call me when he got back. He called me and a friend encouraged me to tell him then that my eye was worse and i needed to see specialist.  He sent me to one and I was in her office that afternoon.  She checked my eyes and without explaining she had me drink a sulfer drink.Finally she explained that the pressure in my eye was 69 and I could go blind in hours. The drink brought pressure down.  I asked why other doctor did not know.  She said nothing.  Two years later, I went and got copy of the field vision test that the first doctor did in his office the one time I saw him.The print out report that  was generated in his office through his field vision machine said right there as plain as day "indicative of glaucoma."  Even though he went on vacation a nurse had to put that in my file.  I would expect it would have been a good idea to read it also. And I think it would have been a better idea to call me back in to treat me immediately for glaucoma, since their test said I had it.  Who knows what the pressure was that day, but I it sure could have been arrested two weeks earlier if some one had done their job.  As it was, i was immediately put on drops and had laser surgery by the second Doctor and my pressure has been around 17 until the third doctor that I was referred to, because the second doctor was folding her practice, did the cataract and trabeculectomy surgery.  Now it is around 15. By the way, glaucoma does not run in my family.  My glaucoma was induced by medicine.  I was taking a particular medicine for restless legs and was given a muscle relaxer for a week after pulling a muscle in my back.  The second doctor told me she was pretty sure that the combination caused my iris to relax and fall back and block the normal channels that the fluid in the back of my eye escapes from, thus causing the pressure buildup, followed by a tremendous loss of vision in that eye.  So none of this has been because I am no longer 20.  On to the third doctor, the one who did the trabeculectomy and cataract surgery and left the sponge in my eye.  (When I say,I  like details, I did not say I study to know everything about the surgeries.  I know people who can't tell you the first thing about anything they have or anything about the treatment they are getting or what.)  And she and other doctors told me they would normally take the stitch out but it was not necessary and because all the things that had happened, they were not going to.  And yes, I did sign paper work that said I was having a cataract surgery, but when the forms are in a clip board, and I have been told that I am having  a trabeculectomy, then I did not read every word.  I trusted her!  Even after everything else.  I left out the part about her on call doctor refusing to see me and going to a second opinion.  On a particularly bad day, the pain was so bad I called her office to see if i could come in, but she was out of town.  I had an appointment but felt I needed to see someone cause the pain can mean another glaucoma attack and loss of more vision.  I called back a few hours later to ask what they would suggest.  They gave me the name of her oncall doctor.  I called and acutally talked to him describing  the pain and all and he told me I could wait to see her the next day!  Still worried about possible loss of mrore vision, I called her office back to say i was going to have to go to patient first and they said go to ER instead cause they have better equipment. ER checked pressure and it was good, gave me something for pain but did not know why the pain.  Next day in her office she said she was sorry her oncall doctor did not see me.  A few weeks later again in severe pain I went to second opinion at the Second practice I had been to.  The doctor who saw me said she would have to call the doctor who did the surgery and discuss some things with her while i sat there.  I  looked at her and asked how that could be a second opinion then. She did not respond. But when she came back she said that I needed to go back to Doctor who did the surgery.  When I saw her next she point blank told me that if she thought her patients needed to get a second opinion, she would tell them.  I could not believe my ears.  But whether you believe it or not, I am not a person that tries to make waves with Doctors.  I have always respected them and trusted them with my care.  However since this whole thing, I cannot say I feel the same way. I saw her every two weeks for 8 months, 6 after the surgery and she failed to aquire. while looking at the thing under her high powered mags(you tell me what they are called!) while I was in severe pain for those months. I also never said I wanted to have  lens replacement!  I said they are known to cause starursts and I think that when my pressure has been down to 17 for over a year and I have had so much done to it, a good doctor would do just what you said, She should have discussed the cataract surgery with me and perhaps as you indicatem left well enough alone. I was not bragging about the world renowned doctor,  Fortunately, my sister who is a nurse, suggested I tallk to her friend who is an opthamologist in the philly area.  He spoke to me on a few occaisions and finally felt as if my doctor was in over her head, thinking after 12 years of practice she could handle anything and knew everthing,and he suggested  I go to the world renowned doctor as he called him.  I am just thankful that he suggested it.  I had a sponge with MMC making a whole in my sclera, causing a sever case of nodular scleritis, and it had become necessary to diagnose the sponge as soon as possible. Going to another doctor, accomplished this.  But he also did not want to continue to see me and had very little else to say about the whole orderal.  And I don't think these other doctors are trying to cause me to go blind, but i do think none of them have the guts to get involved because of possible lawsuit.  Nice!!!!!!  You see it however you want to, but you are the one who is off base. Granted you don't have all the facts, but one thing I have learned through all this, as my husband reminds me, Doctors are not God, and I do not have to fear them. As a matter of fact some of them are downright dishonest. when they have messed up.  
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Avatar_m_tn
I wrote my last post in the wee hours of the morning and I did not read it over, so for clarification I want to correct a couple of things.
When I said " And she and other doctors told me they would normally take the stitch out but it was not necessary and because all the things that had happened, they were not going to," I meant to preface that with the statement that "not only did she leave a sponge in my eye but she also left a stitch in my eye." (in reference to the person who said the lens is closed with a nylon stitch.  As a matter of fact, I received more information from "allsurgeryiscomplicated" than anyone else since the surgery.  All I can figure is they fear being involved in a lawsuit.) And No, the DR, who left the sponge in my eye has not done a thing to rectify the situation.  And what kind of a Doctor would tell a Patient that she will let the patient know when they need a second opinion?  I have an answere for that--- " A Doctor who would fail to tell you ANYTHING about a cataract surgery they were going to perform on a patient."  I am sorry but I do not think that having me sign a form saying I am having a cataract removed is sufficient care or even standard care before performing a cataract operation.  I knew NOTHING about it. From what I read, Doctors go over all the ins and outs about it beforehand.  

next  correction
I said "I had an appointment" when I meant to write "I had an appointment the next day." (but was in so much pain I just needed to see someone that day.)

Final correction
I  wrote "she failed to aquire."  What I meant to write was the thought that she failed to give me a proper diagnosis after all this time.

You know, even Doctors can make huge blunders.  But when they do, like the rest of us, it is always best to take responcibility and correct the problem.  Apparently she is too proud to do so.

The bottom line with me is that for whatever reason, I developed Glaucoma in my right eye and through it all, a Doctor then left a sponge in my eye.  And since then, I cannot get much information from the Doctors I see concerning my eye now.  So I have had to resort to the internet to find answers and then bounce all this off people here to try to figure what are my options now.  I am glad I came here because now I know I need to be certain that any decision to  have a cataract surgery on my other eye is going to be a serious decision and I am going to have to live with the results.  This time though, it will be my decision based on the information my new Doctor gives me and Things I have learned here. ( I have the packet for cataract surgery and we will discuss it next visit, unlike what transpired with the "Sponge Doctor." )  So, even though some of you might think I am a nut case, I am better informed than I was.) so thanks!  (by the way before all this began in my eyes, I would not have believed there were "nut case doctors" also, but now I am sure of it!

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