Crystalens post op complication questions

[CBCT]

I am a 56 year old female who had problems driving at night.  I now have Crystalens AT50AO implanted in both eyes.  OD=18.50.  OS=19.00.

OD history  --  Presurgery -1.50 x -1.87 x 109 ; Two weeks post surgery -1.25 x -.75 x 130;  Five weeks post surgery Selective Yag capsulotomy and posterior capsulotomy.  Eight weeks post surgery -.75 x -.75 x 130  VA = 20/70.  Mid distance vision is good, distance vision is not.

OS history -- Presurgery -3.25 x -.25 x 162 ; Ten days post surgery -2.50 x -1.25 x 15 ; Five weeks post surgery Selective Yag capsulotomy and posterior capsulotomy.  Seven weeks post surgery -2.50 x -1.50 x 10.  VA = 20/400.  Close vision at 6" is superlative,  mid and distance vision are awful.  Both eyes are sensitive to light and have cobweb-like filmy floaters.  Right eye has clumped cobweb-like filmy floaters that pass like a cloud.

Under care of Ophthalmologist and Optometrist. Could not drive for three weeks.  Got distance glasses which allowed me to drive.  Yag improved right eye only.  Have not yet picked up glasses prescribed in last script cited above.  Next Ophthalmologist appointment is in two weeks (one month after OS Yag) Both Ophthalmologist and Optometrist recommend patience and ultimately LASIK as the solution.  I have seen both several times since my surgery.  They are attentive, but I don't feel that I am getting straight answers about the extent and cause of my refractive surprise or the lack of accomodation on my left eye.  

What are your thoughts about this refractive surprise?  What are your thoughts about the decision to perform the Yag.  Do you agree that LASIK is the appropriate route?  What questions do you suggest I ask at my next appointments?

Thank you for your consideration.  

[Timothy D McGarity, M.D.]

LASIK will help cure the "refractive surprise" as will the glasses and a tincture of patience. A trial of Toric contact lenses would help to simulate the LASIK and gauge wether your accommodative reaction will improve. With uncorrected nearsightedness you are trying to accomodate. I don't implant the crystalens but many that do recommend yag capsulotomy. So I think that part is fine. The are multiple reasons for refractive surprises  literally textbooks on this subject. I wish you the best.
Tim

[CBCT]

Thank you for your prompt response.  I understand how a toric contact would correct for astigmatism and simulate LASIK, but how would it gauge accommodative reaction improvement?  At this point, I have no accommodation in my left eye.