See obliquely after cataract surgery

[smeyo]

I had cataract surgery on left eye in May 2010.
The surgeon implanted me an Alcon toric lens T5 to correct my astigmatism which was -2.75 before surgery. Now it is -0.5. My right eye has also -2.75, which I correct with glasses. Previous to cataract I had been myopic.
-8.0 diopter. Implanted toric lens is 10 D.
Since the surgery I see everything obliquely with the left eye. Similar to rhomboid – upper left side is about 10 degrees elevated and whole picture is tilted to the right. I did not see obliquely before the surgery. When I look with both eyes I see double. Not astigmatism like, but it is like when you put a rhomboid over a square.
Furthermore the toric lens magnifies quite a lot which makes it much worse. Now is the left –oblique- eye stronger than right eye. This is why I wear old glasses, which suppresses the left eye and makes my vision bearable. Otherwise I could not work. I work whole day at the computer. And I have a headache almost every day as the eyes try to adjust. I can not wear new glasses, it makes the oblique vision much stronger and I feel dizzy.
Does anybody have similar experience? Thank you in advance for your input.

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

No it won't be too late to explant. If the problem is not an off axis toric IOL, and the IOL is not turned or canted, and the problem not corrected with glasses then the most common cause would be irregular corneal astigmatism and you might want to have them try fitting a rigid gas permeable contact lens to see if that helps.

JCH MD

[smeyo]

Thank you very much for you reply, Dr. Hagan.
The surgeon who operated me said that toric IOL was implanted correctly, and was not the reason for my complicated vision. Further he said that it might be something wrong with the curvature of the cornea. But he could not tell exactly what was wrong.
They tried if prismatic glasses could help. There was no improvement. Now they want to make an experiment with contact lens – to make my vision a bit “foggy”.
I went to another eye clinic for a second opinion. Doctor told me that lens was implanted well but I should not get implanted toric IOL because my right eye is astigmatic and the imbalance between astigmatic and not astigmatic eye makes the a.m. difficulties.
I was told to come in 6 months for an eye examination to see if there will be any improvement. It will be exactly 1 year after lens implantation.
Won`t it be too late for a lens explantation?
Thank you for your advice.

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

Your toric is likely not in the right axis. Discuss with your surgeon. Consider a second opinion.
JCH MD