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replace implanted cataract lens
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replace implanted cataract lens

A week ago I had cataract surgery.  I made it clear to dr. that I wanted to maintain near vision and don't need distance vision because I have that in my other eye.  Having near and distant vision has worked very well for me throughout my life.  I have double vision and wear prisim glasses without correction to drive.  The dr. put a lens in that gives me distant vision and I have lost near vision.  Can I get this replaced to restore my near vision?  Also, my double vision is worse because my brain doesn't know which eye to use.

Thank you,  Mary
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517208_tn?1211644466
Dear itsmemaryc,

I would recommend that you speak with your eyeMD. The lens can be replaced and is usually easier the first month.  There are risks to this and there are other alternatives to removal such as glasses, contact lenses, and laser vision correction.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
18 Comments
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Avatar_f_tn
Am I correct in assumming that you now have distance vision in boith eyes?  If this is the case maybe just getting glasses for reading.would take care of the problem. So many complications can happen when you have surgery.  I would not want to have another surgery if the problem can be corrected without it.. This is just my opinion.  I had distance monofocal lenses put in both my eyes and I see everything beautifully.  I just need glasses to read small print.  It is great not to have to wear glasses all the time. Your eyes were used to seing in monovision. I used to wear monovision contact lenses. My brain has adjusted to not having monovision and I believe yours will also..
I am not familiar with double vision.  I know it should be corrected and can also be caused by cataracts.  Talk to you eye care doctor and discuss these issues with him to come up with a solution. If you are not happy with the surgeon that removed the cataract get a second opinion.
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Avatar_f_tn
If you are not contact lens intolerant, get a contact lens to give you near vision.  (Try 1-day Acuvue moist--very comfortable.)  Most optometrists stock disposable contacts, so you should be able to get some contacts today.  I don't believe that you can get new prism glasses made in an hour, but you can try.  (Maybe someone can make them by the end of the day--let them know that this is an emergency.)

It's my understanding that an IOL exchange is not difficult during the period soon after surgery.  You will want a surgeon who is experienced doing this procedure.  Get an appointment with your surgeon within the next few days.  Let him/her know that having distance vision in both eyes causes double vision, which impairs your ability to function in your daily life.  If s/he is not experienced with exchanging IOLs, then have him/her set up a referral for you.  (Or call the ophthalmology department at a major medical center and talk to the secretary of the senior staff member who specializes in cataract surgery.  Ask for a referral to an experienced surgeon who can see you soon.)  

  
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757137_tn?1347200053
Yes, you can do this, that, or the other thing, but the important thing is that your doctor made a mistake and should be held responsible. It is not your responsibility to correct the error - bu this. He has made plenty of money out of your surgery. You are entitled to have it done correctly.
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Avatar_f_tn
Making IOL power predictions is (unfortunately) not an exact science, and no surgeon can guarantee that s/he will hit the refractive target.  And even if my outcome were very unsatisfactory, I wouldn't necessarily want my surgeon to attempt to "fix" it.  I'd much rather have the "fixing" done by the most experienced surgeon in town.  
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Avatar_f_tn
I certainly would not go back to the same surgeon. I agree with Jodie J ,Find a new very experienced surgeon. for the best care you can get.

Good Luck
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757137_tn?1347200053
So sue him for malpractice and go to a better surgeon to have it done right. Wouldn't you sue someone who cut off the wrong leg?
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Avatar_f_tn
I think that it's important to have realistic expectations about cataract surgery outcomes.  Results are never guaranteed, and any surgery involves risk.  Most people do end up within .5 diopters of their targeted refraction.  People who are very nearsighted/farsighted or those who have had previous refractive surgery might end up outside this range.  Just because the surgical outcome isn't perfect is not a reason for a lawsuit.  I wouldn't trust a surgeon who promised perfection.

It's hard for me to imagine having the wrong leg amputated, but, yes, I'd almost certainly file a lawsuit in that situation.
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757137_tn?1347200053
Her doctor put  in THE WRONG LENS. What does that have to do with expectations?
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Avatar_f_tn
The lens is not the right power.  Predicting the correct power is not an exact science.  Predictions are made by plugging various eye measurements into one of a number of complex formulas.  These formulas are based on averages, and not everyone's eyes conform to the norm.  No cataract surgeon can guarantee "perfect" vision.  Usually if good vision can be obtained with glasses/contacts, cataract surgery is considered to be successful.
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Avatar_f_tn
Thank you all for the suggestions.  My surgeon is on vacation so I am in limbo until he returns.  I have made an appointment with another doctor in 2 weeks.  

Mary
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574673_tn?1234129578
I agree it is a good idea to go to another and very experienced surgeon. I had a similar with the wrong power Restor lens implanted causing much misery and I couldn't see very well at all with it. I had it explanted with a monofocal lens and am very happy. I considered the lawsuit route as well and consulted several very knowledgable lawyers. Malpractice suits are very hard to win especially if the patient ultimately can resolve the situation satisfactorily. I guess I would concentrate on seeing if you need to replace the lens and go on from there. Or see if there are corrections available for the near vision with glasses, contacts. Hope this helps. Hang in there. I know this is very frustrating.
londonbridge
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Avatar_f_tn
Thank you for your imput.  I am very interested in having this lens replaced.  I have been told that for some reason this probably can't be done.  I don't understand why.  Was this a very difficult procedure for you to go through?  Was it more difficult for you to recover or did they tell you it was a risky thing to do?  Did insurance enter into it?  I would not consider suing unless the doctor was drunk and made me blind.  

I live in Sacramento area.  Any suggestions for a good surgeon.  I can travel anywhere to get this done.

Thank you,
Mary Cuneo
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574673_tn?1234129578
Hi.
Many people have had their lenses explanted successfully and are happy with the results.  That is not to say it is not without risks because the IOL has to be surgically removed from the eye unlike the initial cataract surgery, where the lens is suctioned out with a laser procedure. (a non medical/technical explanation - just how I understand it to be).
However in the hands of a surgeon experienced with explants it can be done.
The recovery was the same as the first procedure i.e. not difficult, just use drops and go for rechecks. My insurance did cover the explant which helped.
I live in the Northeast so I do not know surgeons in your area. A while back this website listed some of the top research hospitals for eyes and you may consider one of those. I used MEEI in Boston.
You may want to spend some time with the double distance vision to see if you can adjust. It does take the brain time. Usually it is good to an explant sooner rather than later though. I did mine after six months and it was fine, but a surgeon can evaluate and tell you how difficult he/she thinks it would be to explant your particular lens.
Good Luck
londonbridge
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Avatar_f_tn
I did have the Restor lens explanted and exchanged for  a monofocal lens.  The Restor lens was a nightmare   Any surgery has its risks.  The procedure for me was no more difficult than having the first surgery.
You need to know the reason why the doctor said it cannot be done.  My first surgeon told me that once the lens was in, it was in for good. Thank goodness for this forum and after a second opionion, I found out that it could be done.  My results have been very good.
My insurance, by the way paid for the second surgery. You would have to get in touch with you insurance to see if they would pay.   One of the things Londonbridge advised me at that time was to be patient.  She was right. Hang in there, Mary!

disappointed 66
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Avatar_m_tn
I wonder if you would recommend I get Explant and Implant the same IOL based on followings:
Postop prescr. is reasonably good: -0.25DS x -0.50 x 170
Main complaint is Double Image/ghosting at all distances, Near and Close Reading can only achieve N10 due to Ghosting. 2 images just blur our the wordings...Qn: is if the IOL lens was defective (I suspect)and whether a new IOL exchange would solve the 'reflective' issue of Near/ Reading.

Alcon Boston live surgery 2010 on eyetube has a interesting video on a 80 year old lady who is wife of doctor went thr' 4 implants/explants....

http://www.eyetube.net/alconlivesurgery/2010/default.asp?v=drodef&q=medium
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Avatar_f_tn
When my doctor came back from vacation he tried several different contact lenses on me over a 8 day period.  He found the correct prescription and a week ago exchanged the original lens with the new prescription.  I am very happy with the outcome.  I don't know if my insurance will pay but doctor said there will be no charge.
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Avatar_f_tn
Glad to know that your story had a happy ending!
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