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drastic vision fluctuations post cataract surgery prior RK paient

I had cataract surgery 4 days ago. The day of my follow up appointment I had excellent sight. Probably 20/25. Day 3 sight began deteriorating to possibly around 20/250 or so where it seems to have bottomed out. No real pain, just feels like mild eyestrain. My vision does improve looking through pinhole. I am a former 1991, RK paient that had complications 2 corneal perforations in that eye. Eventually needed stiches.I also have MGD, and severe dry eye. Cauterized tear ducts and was in sclerals prior to surgery. I am reluctant to go to emergency room due to Covid concerns for what may nothing. Is such a rapid fluctuation abnormal in my case?
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233488 tn?1310693103
Because you have just had surgery you will need to communicate with your surgeon or the person taking call for him/her.
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IThank you. I was just weighing pros and cons of the emergency room waiting area. I went to Emory  on Friday night but got spooked after seeing how crowded it was. No pain and my vision has stabilized , so after speaking with the on call resident I opted to wait be seen Monday morning . I wasn't really expecting to be able to see very well initially given my history, so I was totally shocked when I had such good vision initially .I was just wondering if it was typical in RK.  I can now read without readers ,but can't see at a distance. My left eye is OK for distance so I think it's what the Dr was probably aiming for.
I know it's very hard to get the correct measurements for RK patients.
I will have to be refitted for sclerals regardless for my dry eye.
I did my residency at Emory Dept of Ophthalmology. One of the best in the country. Conversely a cornea surgeon George Waring MD was a big early proponent of RK and did lots of them. As we know know RK is a disaster,  scarred irregular, often unstable corneas and regression to hyperopia and the scarred cornea radiates lights at night. In our practice we often use the new Light Adjusted IOL for patients with previous RK.    Recovery from cataract IOL surgery in RK is never predictable. Good luck
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