Lasik surgery after cataract, after vitretomy

[tela44]

I had a vitrectomy done to repair a macular pucker. Then I had cataract surgery 5 months later. This is expected after that surgery. I opted to stay slightly nearsighted, just like my good eye so I would have balanced vision between the 2 eyes. This did not happen. I am 2 diopters apart in my eyelgass prescription. This causes slight double vision.
I discussed at length the vision I hoped for with the cataract surgery so I am surprised at the outcome. I have no idea what went wrong and of course no one will admit an error occurred.

Now I am considering lasik, PRK or whatever else they do to fix eyesight.

Has anyone else had this done?

[MrPresley]

I am going to see my optometrist this week for a referral to a cataract surgeon.  It's been a little over 14 months now since I had a vitrectomy/ERM peel in the affected eye and the time has come to address the cataract that formed afterward.  I saw the ophthalmologist (retinal specialist) who performed the vitrectomy and he's good with going ahead with it.  Will update as things progress.

[JohnHaganMD]

=

[JohnHaganMD]

Yes too bad she's moved on to different interests.  

[MrPresley]

I'll be going down this road eventually myself.  I had a vittrectomy/ERM peel about a year ago and the expected cataract formation in that eye is underway.

[JohnHaganMD]

If you are really interested JodieJ has written at length about this problem. You can access her postings using the search feature.

[chazas]

Her posts were very helpful to me. I recommend them highly.

[JohnHaganMD]

You have 2 diopters of unequal refractive error (aneisometrophia)  often people can adjust to this over time and I've seen people with 4 diopters difference wear glasses without problems. Your options would be an IOL exchange RE,  refractive corneal surgery (Lasik or PRK ) to reduce the myopia in the RE or wear a contact lens on the RE to help the image sizes be closer together.

[tela44]

Thank you for the information.

[JohnHaganMD]

What is your glasses prescription and your vision with the glasses on?  And only one eye has had cataract surgery? Which eye?

[tela44]

od -4.00 os-2.00, not sure if you need the cylinder/axis. My right eye had the macular pucker and cataract surgery.  The left eye has not had any problems.

[tela44]

I think my right eye with glasses on is 20/30 or 40, can't remember. The good eye is 20/20 with glasses.

[pinhole]

Sorry to hear about your situation. Double vision is really hard to cope with.

Has it been determined that the diopter difference is definitely the cause of yours?  What explanation for your double vision have you been given by your retina and cataract surgeons? And what is their recommendation for resolving the double vision?

Best wishes.

[tela44]

Retina surgeon says my brain and eyes need time to learn to work together. My cataract surgeon didn't really have an answer. I hear if they can correct the vision to 20/40 they call it a success. My double vision is slight so it doesn't stop me from driving but I don't enjoy reading much. A prism didn't help much when I tried adding that to my prescription.

[chazas]

2 diopters difference is hard to reconcile, you may adapt, but you may not.  I wouldn't think twice about getting a PRK or Lasik touchup if you dont.

[chazas]

Yes.  Same basic drill - had a detachment, then vitrectomy/gas bubble/scleral buckle, then vitrectomy to remove epiretinal membrane combined with cataract surgery.  I ended up with lots more astigmatism than I had before and more than 3 diopters off plano.  I suspect an error made in the IOL calculations at that time, but the buckle and high myopia do throw everything off too, so who knows.
Anyway, I had PRK to correct the error.  I ended up with reduced astigmatism and at about +.5 in that eye - not ideal, but a lot better than before.  I subsequently had cataract surgery in the other eye and ended up at -.5 in that eye, so only a diopter of difference.  Lots of complications between here and there but I'm basically seeing fine now with light progressive glasses.
The PRK was quite painful but the pain died down quickly.  It is difficult to wait while your vision settles down to see where you end up - the other main drawback of PRK.  But I'd definitely do it again, because leaving aside distortion from the ERM peel and big floaters from a PVD in the other eye, I have 20/20 stereoscopic vision now.