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Great Results with Aspheric IOL

I had my cataract surgery last week (July 8) and just wanted to post my experience for those who are waiting to go....

The B & L Softport AO aspheric lens was implanted in my right eye.  I could close my eyelid immediately after surgery, so I did not receive a bandage, just the plastic shield.  I could see out of the eye right away except I was seeing double for a couple of hours due to the eye being paralyzed to hold it still for surgery.  By evening, my distance vision was AMAZINGLY clear with the newly implanted lens (no glasses) and very clear for reading at the computer and in hard copy with drug store reading glasses.  The contrast of white page to black text was greatly improved.

I was originally petrified to have it done, but the surgery really was a 'piece of cake' especially since I had them give me an extra bit of that 'relaxing' medicine!  I was awake during surgery but didn’t feel a thing, just saw some bright colored lights, which didn’t bother me a bit, and heard the soft whirring of the doctor’s tool.  After I got home, my eye felt scratchy and hurt a little off and on for the rest of the day, but the drops helped.  

Next day, I woke up seeing great and no pain at all, just some flickers of light now and then from what seemed to be the edge of the lens on the side where the incision was made.  (The flickering went away in a few days.)  The eye was checked at 20/40 (legal for driving with no glasses).

I had my optometrist remove the right lens from my glasses and I drove to work the third day and worked the whole day at the computer using the reading glasses.  

It is a joy to read again.  And I can see the leaves on the trees at a great distance!   I can see better at a distance with the new IOL with no glasses than with the other eye with glasses.  I can now see the alarm clock in the morning with no glasses (couldn’t before) and I can read much better with the new IOL and reading glasses than I can with the prescription glasses on the other eye.

I am glad I chose to go with the aspheric standard lens and not the Crystalens, because the doctor had told me I probably would still have to wear glasses anyway (I am extremely farsighted) and I am used to wearing glasses with progressive (multifocal) lenses, which I will continue to do.

My left eye has a bit of cataract, not really too bad, but I will probably have it done.  I do not have much of the unbalanced feeling that they talk about because I am an alternator (only focus with one eye at a time) but I feel just a little unbalanced when tired.  I will see how the right eye does for a few more weeks before deciding.
17 Responses
711220 tn?1251891127
MEDICAL PROFESSIONAL
Thanks for the follow-up,

Dr. O.
Avatar universal
I'm glad to read about your excellent outcome.  You did your homework and made the best choice for your situation.
Avatar universal
Congratulations!  Sounds perfect!  I knew you'd write an excellent account as well.  Thanks!
Avatar universal
Well, not quite perfect....  Late yesterday afternoon (day 9) I was looking up at the sky and I noticed what I perceived to be faint shadows of dust or specs or tiny dark bubbles on about the top 1/3 of the new IOL.  I did not see this when I looked other places, just looking at the blue sky.  At first I didn't think much of it because of other small visual  distrubances that had been temporary, but I checked this morning and afternoon (day 10) and it was still there, and I saw it again when I looked up at a screened fluorescent light and then at a white wall.  I called the doctor's office and they had me come right in and get checked.  The doc who was there said that I had mild secondary cataract.  I was floored to learn that this could be starting so soon.  I guess if it continues to develop, it is easily fixed with the YAG laser, but I was hoping to avoid YAG treatment because I've read that if you have to have it, it can put you at some risk for detached retina later on.   But I am glad that the specs were not floaters.
Avatar universal
Hi, Glad4Help -- I'm happy to hear of your experience.  I hope the secondary cataract can be corrected without risk.

I had my first eye done sooner than expected when I wrote last.  A slot opened up for July 16, so I took it, and I will keep my appointment on the 30th to have the second eye done.  I have a conference in mid-August and I teach school right after Labor Day.  This lucky break gets me all done before those events.

My surgery was comfortable, once I resigned myself to losing a body part.  (I'm not kidding.  The day before the surgery, I actually did fret that it was my last day in the body I had been born with.)  Only one oddity to report from the surgery itself.  I had studied up so much and watched YouTube videos of the operation, that I was as on top of the procedure as I could be.  I actually saw the shadow of the instrument enter and make the neat circular cut called the capsular rhexis.  It was all blurry lights after that, of course.

My experience as of three days has been very much like yours.  I had my right eye implanted for distance with an Alcon AcrySof IQ.  At first I had halos around bright lights, but as my pupil returned to normal, these have gone away.  My doctor says that I made a good choice in not going with Crystalens.  She says that I have a somewhat larger eye, so the larger lens (Alcon = 6mm / Crystalens = 5mm) means that I am less apt to experience edge effect.  My pupils are almost equal in size today, so I'm eager to try night driving.  Using the drops and sleeping with the shield have been no problem.

Like you, I will probably need YAG laser treatment, because the doctor says that while she removed all of the cataract deposits that she could, she suspects that I still have some remaining at the back of the lens capsule.  (I don't know if I have the terminology right, but that's the general idea.)

But also like you, I am thrilled with the improved vision.  Distance detail is stunning, colors are brighter and more subtle, and the sense of the world as an endlessly deep 3D environment is almost like make-believe.  I wonder how long it has been since I have seen the world this way.  This won't improve my game, but I bet I find my golf balls faster.

So, now I have to decide what lens to put in the second eye.  My doctor has really earned my trust, so I'll probably go with her recommendation.  I'll report my results here in early August.

Good luck, all.
David
Avatar universal
I am hoping to hear a report from a one-cataract patient who chose to retain good near vision with a near-vision IOL, rather than going for distance correction in the one cataract eye only.  I am frozen with indecision. I wonder if someday, cataract patients will be able to "try on" IOLs in advance.
Avatar universal
I'm sure that by you know the precise statistics from every study ever done, but from my limited reading a YAG is nothing.  In fact, it's about as nothing as it gets.  I'm still expecting to need one just because I am "young" (51) and therefore at higher risk of posterior subcapsular opacification.

I'm sorry that you have to fret longer, but I know that everything will soon be perfect.

Meanwhile, almost perfect is way better than with the cataract, and I guess you had to get to this point to get to the end point.  When is the next step?
Avatar universal
mmmmpppp,

Thanks for your vote of confidence but, in truth, I know very little of the statistics and feel very ignorant about all this... and I appreciate all your comments.  

Dr K. also assured me the YAG "... is very safe, very easy and the risk of retinal detachment is about 1 in 1000 which is extremely low." (See my post titled "PCO after 9 Days??").  He also advised me to see my own surgeon again and I requested an appointment today.  The "dust" or "bubbles" or whatever it is is still there today but I am also still seeing to read very well.  So we will see....  

What I can't understand is that this "debris"  I am seeing moves when I move my eyes and the doc's PA told me the lens and capsular bag stay stationery so, in that case, it seems that it wouldn't be on the lens.

I am thankful for this forum and the opportunity to get questions answered here.  These docs are great!  So many times I later think of the questions I should have asked when I was in the doc's office.
Avatar universal
Yes, wouldn't it be great if one could "try on" the IOL in advance.

I only focus with one eye at a time and although my lens strength changed dramatically with the new IOL, I do not feel as unbalanced as some report with an extreme correction in one eye only.  I went from +6 far vision to what I think would be 0 with the IOL in my right eye, which is the one I favor for reading.  My brain just seems to go to whichever eye sees better for the distance at the time.

If I had known it would turn out this way for me, I think I could have even gone toward a more nearsighted correction in the new IOL.  But don't forget, I am used to focusing with only one eye.  Anyway, I was too scared to try a monovision scenario.  I could see relatively ok prior to sugery and, if I had it to do over again, I think I would have tried monvision contact lenses for a while to see how it would go.  But the surgery was scheduled and I went ahead.

As it is, just having better farsighted vision is great because I am used to being farsighted and wearing glasses.  And I am reading VERY well.  

I hope you can find some posts from people who were nearsighted before surgery and then were farsighted after and, also someone who stayed nearsighted.   I wonder why they don't usually put nearsighted people back to being nearsighted, like they are used to??
Avatar universal
Glad4help,

I'm probably smoking something here, but your story reminds me of what I was told at one point about my situation.  Namely, that because I had a very advanced PSC cataract, I should expect that there would be staining from the cataract on the back of the capsule (I think it was the capsule) that would not be removed by the cataract surgery.  I was told that I would probably need a YAG three months later to take care of it.  This was all to be no big deal in and of itself, but especially so because I'd probably need the YAG at that point anyway due to the likelihood of Posterior Capsular Opacification given my youth (and beauty?).

As it turned out, my Dr. (not the one who told me all that) said that all the stain came out easily in my cataract surgery.

One Dr. had even told me that because I had a PSC cataract, I'd need a temporary lens put in first followed by a second surgery in which he would suction out the stain.

The Dr. who kept promising me the YAG (and wasn't going to charge me for it, by the way) assured me that it is a simple, very low-risk procedure.

And yes, Glad4Help, I have this theory that you are either a professional writer or that you are in some braniac profession, and that you research this stuff very thoroughly.
Avatar universal
Thanks for telling me about the staining.  I never heard of that before.  

I've been reading up on floaters and apparently they can show up as "bubbles" and specs as well as hair-like bits, so maybe it is floaters.  We'll see....
Avatar universal
I've had floaters all my life.  Mine look like little brown worms with joints and/or sperm-shapes.  They float freely at the slightest movement and move easily all over my field of vision.  If I am not looking at them, I never notice them.  I do look at them a lot, for no good reason.  I only found out that everyone doesn't have them this year as I was learning about cataracts.
Avatar universal
and to mmmmppp

I've had floaters all my life (described as per mmmmpppp like tubular "cells" or worms with joints) that move in response to eye movement), and now (post RD^2 and post vitrectomy+IOL) I have different types!

With the RDs, I had very dark, opaque round dots of all sizes that moved with my eye movement - presumably from blood released into the vitreous as it pulled on the retina, I'm guessing.  In the eye with the vitrectomy and IOL, I don't see these anymore, but when I look straight down vertically, I get a distinct cloudy blur now, but I wouldn't call that a "floater".
In my other eye (RD only), I still have the same old (from childhood) floaters, plus less distinct blobby gray patches that seem to move opposite my eye motion.  While no eye Dr. has specificially identified them, two Drs have guessed that this is from the partially detached vitreous "flopping" around inside the eye.  That seems to make sense to me as I imagine it waving like a flag inside the fluid in my eye.  In addition, some dark opaque thready floaters that appeared concurrent with the RD in this eye still remain - I assume these are blood or cells.  

I too have posterior subcapsular opacification in the eye that had the IOL post vitrectomy, but for now it's very tolerable, and i'm reluctant to have further procedures until it becomes necessary.  Right now, (one year post RD and 7 months post IOL) I see very nearly 20/20 corrected and glare, etc is only occasionally bothersome.  I too was very impatient to get "my old vision" back, but I am very very content as it is right now, knowing that it will likely get better when I proceed to the next step.  
Avatar universal
Thanks for the floater info.  Gosh, you folks have been through a lot!  I've only had two small floaters my whole life.  And matt's vitrectomy sounds like an ordeal.

My doctor's PA called back and said the doc would see me Fri am if I wanted but that the two doctors that checked me (I also had my one week checkup last Wed) did not see anything wrong and he trusted their judgement.  She said he thinks what I am seeing is floaters.  Since reading your accounts and others and realizing they can look different than just the jointed worms, I feel quite sure that this is what I am seeing.  And they are such tiny specs that maybe they cannot be readily seen??  The doc who looked at me last Friday seemed very thorough and it hasn't gotten worse so I will give it some time.

Thanks very much for your comments.  You were both very helpful.
Avatar universal
That's funny, my last post didn't stick.  Anyways, here is a site that shows floaters and other things.  Be sure not to miss the simulator controls for each type.

http://www.visionsimulations.com/
Avatar universal
Thanks for the link to the visual disturbances page.  There was some good info there.

I think the floaters in my eye are settling out a bit.... they don't seem quite as pronounced.  I am waiting a while to get my second eye done until I see what happens with the floaters.  

I had my one-month follow-up today and got my glasses Rx for the eye with the new lens.  It came it at 20/20 with a +1 Rx.  That's pretty great considering I could only get to 20/30 with glasses before!
Avatar universal

Nice!
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