Aa
Restor hopelessness
Hello, I have a bit of a long story and I'm not really sure if there is a question but I'm hoping I can find some support and some hope with this post.
I'm 46 years old and all my life I was extremely farsighted with high astigmatism. My prescription was +10 farsighted give or take and +3.00 astigmatism give or take in each eye. My glasses always seemed to bother me even after getting high index lenses and I was always told that i was not a candidate for Lasik.
A little over 2 years ago I began having a lot of problems with getting my glasses to fit right so I was at the opticians at least once a day trying to get them to feel better. This was when I was told by an optician that there was a surgery called clear lens extraction and that I looked like i would be perfect for it. So I did research about the surgery and I found a doctor in my area that could perform it.
I went in for the consultation and was promised the moon and the stars. I was told that I was the perfect candidate for the surgery but that I would also need Lasik to "polish up" the end result. I was told once this was all done then I would only need glasses for reading, especially in dark places like a restaurant. All the risks and benefits were explained and I was told that it would change my life. Needless to say I had the surgeries and was given the Restor multifocal IOL.
In May of 2014 I went in for the first lens extraction and did the second one a week later in June. I couldn't believe how much better I could see. It wasn't perfect but it wasn't the utter blurriness I spent my life seeing. A month later I went in for the Lasik on both eyes and the results seemed so good. Once again, they weren't perfect but I was happy.
As time went on my vision seemed to be deteriorating very slowly. The halos and starbursts never went away and my vision slowly started blurring more and more. I continued to tell my doctor what was going on and he just kept saying that it would get better but it never did. Then more blurriness. The doctor told me not to worry I could still drive with my vision the way it is. Finally in November of 2015 I told the doctor once again that my vision was blurry and seemed off. He told me I had a little bit of scar tissue on the lens and that he needed to remove it with a laser and everything would be better. I had no idea at the time that he was talking about a YAG capsulotomy. I had never even heard of that but I went in thinking that he was just going to remove some scar tissue.
So I had the YAG done on my left eye and was told I might see some floaters for about a week but immediately after getting home I noticed that there was what can only be described as plastic wrap moving back and forth across my field of vision. I chalked it up to a floater and waited for it to go away, which it didn't. I went in a week later for my recheck with the optometrist in my doctors office and at this time I learned that I had gotten a YAG. OK. This is not how my doctor explained it to me but I had to accept it. I told to optometrist about the floating "plastic wrap" and he told me he could see it but that it would be a bad idea to have it removed but only a talented surgeon would be able to do it. Excuse me? Only a talented surgeon? Are you saying that the surgeon who did these surgeries on me wasn't talented? He then told me to give it a few months to see if it would go away. It still hasn't.
Since that recheck, my vision has deteriorated even more. I have blurriness at all distances and I could not even see my television. Readers worked for seeing anything within 6 inches to 1 foot of my face but nothing else. I went to see 2 other ophthalmologists. One of them told me that I could see well enough and to get used to it. The other one recommended having limbal relaxation incisions to get rid of the astigmatism that I still had. During all this time no one would tell me what my vision was like. I would ask about my prescription and they would tell me it wasn't what it was supposed to be. The starbursts and halos also got worse.
I finally made an appointment to see the new optometrist in my doctors office to see about getting glasses. When I walked in for the appointment I was told by the receptionist that I needed to have a YAG in the other eye and they had to schedule me to see the surgeon. I asked them who decided that without even seeing me and they let me see the optometrist. I explained everything I had gone through and was told to get the YAG, even though my vision got worse after the last one. I asked if I could get glasses and was told I couldn't get them until at least 3 months after getting the YAG. I decided then and there that it would be my last appointment at that office. This was 2 weeks ago.
My quality of life has completely diminished and I have become depressed. The only time I could see somewhat well was wearing 2.75 readers sitting in front of my computer. Finally I made an appointment with another optometrist hoping that he could at least give me some glasses to provide relief. I was very lucky and found one who finally helped me. He was familiar with the surgeon I had gone to and told me I was not the first person he had seen with these issues. He told me that he would help me as best as he could and he did. I was able to get prescription glasses that have helped me to see much better. It's not perfect at all but it is better. I still have issues reading and even though I got a progressive lens I have to switch to the regular readers to see the computer or read anything. The multifocal of the IOL is so unpredictable.
I feel like this has been the worst thing I have ever done in my life. I just want to have the lenses explanted and have monofocals with glasses. I want to have a somewhat normal life again. I have no quality of life anymore. I am depressed all the time. I can't drive at night at all because of the halos and starbursts. Even daytime driving can become difficult because I see the halos during the day also. I cry most of the time. I'm not eating and sleeping well. I spend most of my time thinking about or dwelling on this issue. I feel like no one out there can or will help me and I will be this way for the rest of my life.
I'm sorry that this post went on for so long. I guess I'm just hoping there are others out there who can give me suggestions or advice or who have gone through the same thing.
I'm 46 years old and all my life I was extremely farsighted with high astigmatism. My prescription was +10 farsighted give or take and +3.00 astigmatism give or take in each eye. My glasses always seemed to bother me even after getting high index lenses and I was always told that i was not a candidate for Lasik.
A little over 2 years ago I began having a lot of problems with getting my glasses to fit right so I was at the opticians at least once a day trying to get them to feel better. This was when I was told by an optician that there was a surgery called clear lens extraction and that I looked like i would be perfect for it. So I did research about the surgery and I found a doctor in my area that could perform it.
I went in for the consultation and was promised the moon and the stars. I was told that I was the perfect candidate for the surgery but that I would also need Lasik to "polish up" the end result. I was told once this was all done then I would only need glasses for reading, especially in dark places like a restaurant. All the risks and benefits were explained and I was told that it would change my life. Needless to say I had the surgeries and was given the Restor multifocal IOL.
In May of 2014 I went in for the first lens extraction and did the second one a week later in June. I couldn't believe how much better I could see. It wasn't perfect but it wasn't the utter blurriness I spent my life seeing. A month later I went in for the Lasik on both eyes and the results seemed so good. Once again, they weren't perfect but I was happy.
As time went on my vision seemed to be deteriorating very slowly. The halos and starbursts never went away and my vision slowly started blurring more and more. I continued to tell my doctor what was going on and he just kept saying that it would get better but it never did. Then more blurriness. The doctor told me not to worry I could still drive with my vision the way it is. Finally in November of 2015 I told the doctor once again that my vision was blurry and seemed off. He told me I had a little bit of scar tissue on the lens and that he needed to remove it with a laser and everything would be better. I had no idea at the time that he was talking about a YAG capsulotomy. I had never even heard of that but I went in thinking that he was just going to remove some scar tissue.
So I had the YAG done on my left eye and was told I might see some floaters for about a week but immediately after getting home I noticed that there was what can only be described as plastic wrap moving back and forth across my field of vision. I chalked it up to a floater and waited for it to go away, which it didn't. I went in a week later for my recheck with the optometrist in my doctors office and at this time I learned that I had gotten a YAG. OK. This is not how my doctor explained it to me but I had to accept it. I told to optometrist about the floating "plastic wrap" and he told me he could see it but that it would be a bad idea to have it removed but only a talented surgeon would be able to do it. Excuse me? Only a talented surgeon? Are you saying that the surgeon who did these surgeries on me wasn't talented? He then told me to give it a few months to see if it would go away. It still hasn't.
Since that recheck, my vision has deteriorated even more. I have blurriness at all distances and I could not even see my television. Readers worked for seeing anything within 6 inches to 1 foot of my face but nothing else. I went to see 2 other ophthalmologists. One of them told me that I could see well enough and to get used to it. The other one recommended having limbal relaxation incisions to get rid of the astigmatism that I still had. During all this time no one would tell me what my vision was like. I would ask about my prescription and they would tell me it wasn't what it was supposed to be. The starbursts and halos also got worse.
I finally made an appointment to see the new optometrist in my doctors office to see about getting glasses. When I walked in for the appointment I was told by the receptionist that I needed to have a YAG in the other eye and they had to schedule me to see the surgeon. I asked them who decided that without even seeing me and they let me see the optometrist. I explained everything I had gone through and was told to get the YAG, even though my vision got worse after the last one. I asked if I could get glasses and was told I couldn't get them until at least 3 months after getting the YAG. I decided then and there that it would be my last appointment at that office. This was 2 weeks ago.
My quality of life has completely diminished and I have become depressed. The only time I could see somewhat well was wearing 2.75 readers sitting in front of my computer. Finally I made an appointment with another optometrist hoping that he could at least give me some glasses to provide relief. I was very lucky and found one who finally helped me. He was familiar with the surgeon I had gone to and told me I was not the first person he had seen with these issues. He told me that he would help me as best as he could and he did. I was able to get prescription glasses that have helped me to see much better. It's not perfect at all but it is better. I still have issues reading and even though I got a progressive lens I have to switch to the regular readers to see the computer or read anything. The multifocal of the IOL is so unpredictable.
I feel like this has been the worst thing I have ever done in my life. I just want to have the lenses explanted and have monofocals with glasses. I want to have a somewhat normal life again. I have no quality of life anymore. I am depressed all the time. I can't drive at night at all because of the halos and starbursts. Even daytime driving can become difficult because I see the halos during the day also. I cry most of the time. I'm not eating and sleeping well. I spend most of my time thinking about or dwelling on this issue. I feel like no one out there can or will help me and I will be this way for the rest of my life.
I'm sorry that this post went on for so long. I guess I'm just hoping there are others out there who can give me suggestions or advice or who have gone through the same thing.
Thank you.
Is the cloudiness normal? It seems to only be slightly better today. Just wondering if I should contact my doctor about it.
Is the cloudiness normal? It seems to only be slightly better today. Just wondering if I should contact my doctor about it.
1 Comments
Any concerns should be communicated to your surgeon.
I know it has been awhile since I posted on this thread but I wanted to give an update.
I found an awesome doctor close to me and after initially trying to treat my issues conservatively, we opted for remove and replace.
I had one of my lenses replaced on Monday and the surgery went very, very well. I'm still a little inflamed and I have some stitches but there has been only slight pain from the eye block which is almost gone.
I do have some cloudiness in the eye that I did not experience with the first surgery 2 years ago and I am wondering if that takes more time to go away with a remove and replace surgery.
I found an awesome doctor close to me and after initially trying to treat my issues conservatively, we opted for remove and replace.
I had one of my lenses replaced on Monday and the surgery went very, very well. I'm still a little inflamed and I have some stitches but there has been only slight pain from the eye block which is almost gone.
I do have some cloudiness in the eye that I did not experience with the first surgery 2 years ago and I am wondering if that takes more time to go away with a remove and replace surgery.
1 Comments
Thank you for the follow up which is always very helpful. Please come back in a month or so and let us know how you're doing. Best of luck.
thanks
5 Comments
Well, I went to see the specialist yesterday and I want to think that I'm getting somewhere but it is still a very frustrating time.
After ANOTHER very thorough exam, I saw the Doctor who told me I was suffering from dry and and rosacea of the eyelid. I knew about the dry eye, but the rosacea was new. He gave me all kinds of directions to follow and recommended eyelid scrub, omega-3 supplements and Retaine eyedrops. I was very glad that he was treating me for the dry eye, but that is not what I went there primarily to discuss.
After the directions on how treating the dry eye I asked him if I could be very blunt and went on to tell him of my issues and how miserable things are for me. I explained the starbursts and halos and the fact that I see them even during the day. I also explained the blurry vision. At this point he told me that he still wanted me to try the things he recommended for at least 2 months and to come back and see him. He then stated that there were a lot more risks involved in doing an explant/exchange that there were for the original surgery, but if there was really no improvement in 2 months then we would talk about doing the surgery. I also made sure to ask him if he had done explant surgery and he said he had. Can anyone tell me what the risks are? I've seen different answers to this question and I would love to know the specifics.
I guess this is a positive thing but it's still frustrating that I am going to have to live like this for a minimum of 2 more months.
Is this a good thing, or is there a chance that the doctor is just trying to stall me because he doesn't want to do the surgery at all. I don't want to think this way but I can't help it.
Thanks again for listening and responding.
After ANOTHER very thorough exam, I saw the Doctor who told me I was suffering from dry and and rosacea of the eyelid. I knew about the dry eye, but the rosacea was new. He gave me all kinds of directions to follow and recommended eyelid scrub, omega-3 supplements and Retaine eyedrops. I was very glad that he was treating me for the dry eye, but that is not what I went there primarily to discuss.
After the directions on how treating the dry eye I asked him if I could be very blunt and went on to tell him of my issues and how miserable things are for me. I explained the starbursts and halos and the fact that I see them even during the day. I also explained the blurry vision. At this point he told me that he still wanted me to try the things he recommended for at least 2 months and to come back and see him. He then stated that there were a lot more risks involved in doing an explant/exchange that there were for the original surgery, but if there was really no improvement in 2 months then we would talk about doing the surgery. I also made sure to ask him if he had done explant surgery and he said he had. Can anyone tell me what the risks are? I've seen different answers to this question and I would love to know the specifics.
I guess this is a positive thing but it's still frustrating that I am going to have to live like this for a minimum of 2 more months.
Is this a good thing, or is there a chance that the doctor is just trying to stall me because he doesn't want to do the surgery at all. I don't want to think this way but I can't help it.
Thanks again for listening and responding.
The risk of IOL exchange (you do not want to remove the Restor and not put in another IOL though a spherical monofocal or topic would be better option) WIthout IOL you would have terrible vision without thick unsightly "aphasia" glasses. Back to risks same as first surgery: infection, bleeding, retinal detachment, vitreous loss, capsular tear, swelling of the macula or cornea, double vision, droopy eye lid, need for glasses, worse case loss of eye.
The risk of IOL exchange (you do not want to remove the Restor and not put in another IOL though a spherical monofocal or topic would be better option) WIthout IOL you would have terrible vision without thick unsightly "aphasia" glasses. Back to risks same as first surgery: infection, bleeding, retinal detachment, vitreous loss, capsular tear, swelling of the macula or cornea, double vision, droopy eye lid, need for glasses, worse case loss of eye.
Spell check make some changes Should be "aspheric". And "aphasia" glasses. And "topic" IOL not topic
Spell check make some changes Should be "aspheric". And "aphasia" glasses. And "topic" IOL not topic
Just a bit of an update on my situation.
I went to my optometrist and was able to get the lenses for my glasses remade to a single vision lenses and I am able to see a little better. It is not the optimal situation and I have to change glasses to read but at least I am able to see much better.
My appointment with the cornea/refractive specialist is a week from Friday. Hopefully he will be able to help me. I will update about that appointment after it happens.
Thanks
I went to my optometrist and was able to get the lenses for my glasses remade to a single vision lenses and I am able to see a little better. It is not the optimal situation and I have to change glasses to read but at least I am able to see much better.
My appointment with the cornea/refractive specialist is a week from Friday. Hopefully he will be able to help me. I will update about that appointment after it happens.
Thanks
The deal with sooner the better is that IOLs are put "in the capsular bag" where over 3-4 months adhesions form that hold it in place. It is possible for a skilled an experienced surgeon to break these adhesions, remove the old IOL and put a new IOL into place. If the capsule is open from a yag. viscoelastics can be used to hold the vitreous back. quite often the need to remove an IOL is not apparent at 3-4 months so its not unusual to have an IOL that's been in the eye for over a year operated on successfully.
1 Comments
Dr. Hagan, thank you so much for all your answers and advice. I think you're a great person to take time to answer all our questions and concerns. You have helped to calm some of my fear and anxiety and I truly appreciate it.
I forget to ask anyone's opinion about exchange after 2 years. I have read that sooner is better but what is the consensus on getting it done after such a long time?
It's ok for thinking I had floaters, I went back and looked at my post and realized I didn't make it completely clear what exactly it was that I had.
Re: "I find it difficult to imagine any surgeon would place a regular multifocal (not a toric) in someone with that much astigmatism without correcting it (unless that shift all happened after surgery, which seems odd), and the farsightedness is also defeating the whole point of the Restor, its likely leaving your distance vision poorer since its well inbetween the focal points."
I completely agree with you. I got a copy of all my medical records from my surgeon and the last refraction showed that one eye was +1.00 and the other eye was +1.25 for farsighted but there is no record of the what the astigmatism was. All the records seem off and when I asked about it the OD at my surgeons office would not give me an answer.
Re: "I am curious if single vision glasses (or contacts) might be a better choice than progressive glasses since that might actually let the Restor lenses actually work for you to provide more near."
I was just thinking about this earlier and I decided that I'm going back to the new OD that I have to see if he can put me in a single vision lens. I wanted to see if I would get used to the visual disturbance from the progressive lens and I am seeing that it is not happening. Luckily I have a 30 day no questions asked on the lenses and can go back and get a change without more money out of pocket.
I have been trying to do research on surgeons who do explantation but have found very few in my area. My new OD told me that the doctor I'm seeing at the end of this month has done explanation before but is not sure how many he has done. He also gave me the name of another doctor at Duke who he said was a "legend" in these types of issues. I think he will be my next step after this months appointment.
As I said before I just want to not feel so hopeless anymore and move past this. I know I can't live the rest of my life this way.
Re: "I find it difficult to imagine any surgeon would place a regular multifocal (not a toric) in someone with that much astigmatism without correcting it (unless that shift all happened after surgery, which seems odd), and the farsightedness is also defeating the whole point of the Restor, its likely leaving your distance vision poorer since its well inbetween the focal points."
I completely agree with you. I got a copy of all my medical records from my surgeon and the last refraction showed that one eye was +1.00 and the other eye was +1.25 for farsighted but there is no record of the what the astigmatism was. All the records seem off and when I asked about it the OD at my surgeons office would not give me an answer.
Re: "I am curious if single vision glasses (or contacts) might be a better choice than progressive glasses since that might actually let the Restor lenses actually work for you to provide more near."
I was just thinking about this earlier and I decided that I'm going back to the new OD that I have to see if he can put me in a single vision lens. I wanted to see if I would get used to the visual disturbance from the progressive lens and I am seeing that it is not happening. Luckily I have a 30 day no questions asked on the lenses and can go back and get a change without more money out of pocket.
I have been trying to do research on surgeons who do explantation but have found very few in my area. My new OD told me that the doctor I'm seeing at the end of this month has done explanation before but is not sure how many he has done. He also gave me the name of another doctor at Duke who he said was a "legend" in these types of issues. I think he will be my next step after this months appointment.
As I said before I just want to not feel so hopeless anymore and move past this. I know I can't live the rest of my life this way.
Thanks for that information. It does give me a little bit more hope for my situation. The hardest part is the wait to see anyone. The appointment that I have for May 27th was made a month ago. It's very hard to keep hope and be optimistic about my situation when I have to live this way for what seems like forever.
1 Comments
I should note that I above I was defending multifocals in general as a good option for many, but obviously there are a minority of patients who have trouble who should get a lens exchange to improve their situation. Those who get multifocals should only do so knowing there is a small chance they might be in the unlucky minority that will decide they need a lens exchange.
As the doctor suggested, you might search for a surgeon that has done more IOL exchanges. The issue with having had a YAG is that usually when they remove an IOL after a YAG, the capsular bag where the lens is usually placed will likely not remain intact. They get fairly comparable results placing an IOL outside the bag, its merely a less common thing to do and it requires a different IOL (they prefer 1 piece IOLs for placement inside the capsular bag, but 3 piece IOLs for placement outside the bag).
I will note that re: "I went to the optometrist and my astigmatism is +1.50 and +1.75 in my eyes and the farsightedness is +1.00 and +1.50."
I find it difficult to imagine any surgeon would place a regular multifocal (not a toric) in someone with that much astigmatism without correcting it (unless that shift all happened after surgery, which seems odd), and the farsightedness is also defeating the whole point of the Restor, its likely leaving your distance vision poorer since its well inbetween the focal points.
I am curious if single vision glasses (or contacts) might be a better choice than progressive glasses since that might actually let the Restor lenses actually work for you to provide more ner.
I haven't researched the connection between refractive errors like you have and halos, but I'd have to suspect that if your vision is that far off that issues like halos would be more disturbing.
Sorry for thinking you were referring to floaters before, your first post made it sound like you might have been describing a floater.
As the doctor suggested, you might search for a surgeon that has done more IOL exchanges. The issue with having had a YAG is that usually when they remove an IOL after a YAG, the capsular bag where the lens is usually placed will likely not remain intact. They get fairly comparable results placing an IOL outside the bag, its merely a less common thing to do and it requires a different IOL (they prefer 1 piece IOLs for placement inside the capsular bag, but 3 piece IOLs for placement outside the bag).
I will note that re: "I went to the optometrist and my astigmatism is +1.50 and +1.75 in my eyes and the farsightedness is +1.00 and +1.50."
I find it difficult to imagine any surgeon would place a regular multifocal (not a toric) in someone with that much astigmatism without correcting it (unless that shift all happened after surgery, which seems odd), and the farsightedness is also defeating the whole point of the Restor, its likely leaving your distance vision poorer since its well inbetween the focal points.
I am curious if single vision glasses (or contacts) might be a better choice than progressive glasses since that might actually let the Restor lenses actually work for you to provide more ner.
I haven't researched the connection between refractive errors like you have and halos, but I'd have to suspect that if your vision is that far off that issues like halos would be more disturbing.
Sorry for thinking you were referring to floaters before, your first post made it sound like you might have been describing a floater.
My doctor never gave me this kind of information. i wish he had, maybe I would have been able to make a much better informed decision.
At this point I'm of the mind that with the blurriness, halos, and starbursts during the day and at night that I would prefer an exchange to a monofocal I just don't know if there is anyone who will do it for me because I've had a YAG in my left eye.
What I do know is that I have no quality of life anymore. The visual disturbances are interfering with all aspects of my life. I think of almost nothing else during the day and can't wait for the day to end so I can go to bed and not have to look at anything. Getting up in the morning has become a chore.
I'm sorry to sound so bad and I have read some of the success stories here on the boards, but I still feel hopeless.
Thanks again for listening.
At this point I'm of the mind that with the blurriness, halos, and starbursts during the day and at night that I would prefer an exchange to a monofocal I just don't know if there is anyone who will do it for me because I've had a YAG in my left eye.
What I do know is that I have no quality of life anymore. The visual disturbances are interfering with all aspects of my life. I think of almost nothing else during the day and can't wait for the day to end so I can go to bed and not have to look at anything. Getting up in the morning has become a chore.
I'm sorry to sound so bad and I have read some of the success stories here on the boards, but I still feel hopeless.
Thanks again for listening.
1 Comments
The yag capsulomy is not an insurmountable problem for IOL exchange. Anytime a person says "I have no quality of life anymore" a surgeon that does this type of surgery would likely feel removing the present IOL and puttingin a monofocal IOL was appropriate. It is important to find a surgeon that specializes in post operative problems as its rare to have to do and many surgeons that have done thousands of putting in IOLs have not exchanged IOLs.
Yes I was happy at first because instead of seeing a giant blur everywhere I looked, I could see things without glasses for the first time in my life. I had been wearing +10 lenses since I was 15 months old so to see anything, even if there was some blurriness was the most amazing thing ever. I was also happy because I kept being told that the vision would improve, it never did. I have had the blurriness and the halos since day 1 but decided to be happy and optimistic. I think at this time the optimism has gone away because of the fact that it feels like no one was listening to me.
I don't have any floaters after the YAG. I have a big piece of the capsule hanging down into field of vision and the doctor told me to ignore it and see if it went away but it still has not gone away.
As far as the need to have a 2nd YAG surgery, I've seen 5 doctors, and only 1 of them told me I needed a YAG and it was the one in my original surgeons office. I was actually told I needed the YAG by the receptionist before I even saw the optometrist. I hadn't been in the office for a recheck for 4 months, how could they know anything about needing a YAG when they hadn't even seen me? Then when i went I actually saw the optometrist she told me that the previous optometrist noted that there was no opacification on the other eye when I was in 4 months previous. When I mentioned this my new optometrist, he looked and told me that there was very little opacification on the capsule and it was not interfering with my vision. So it does make it look like what Dr. Hagan said, that they have some kind of co-management agreement going, otherwise why would I be told I needed YAG before even seeing a doctor.
There is a lot of astigmatism left in my eyes and I don't know why the surgeon did not give me a toric lens or correct the astigmatism. There is also residual farsightedness there too. I went to the optometrist and my astigmatism is +1.50 and +1.75 in my eyes and the farsightedness is +1.00 and +1.50. This has been a slow degeneration of my vision since the surgeries last year and none of the doctors I have seen have any explanation for it. I got glasses last week to help with the vision but they are also disorienting. I got progressives but I still have to switch to different pairs of readers depending on what I'm doing. I have great distance correction with the glasses but nothing else.
As far as the halos, they have been bad since day 1, but once again I was told over and over again that they would get better and they haven't. I do wonder if they seem like they are getting worse because I'm noticing them more or not but I do know that they are becoming somewhat debilitating. I can even see them during the day.
I do feel sometimes like I was a little naive going into this whole thing. I thought i did all the research and learning that I could before decided that I wanted to do this. I know ultimately this was my choice. However, the choice does not seem to be working for me and I just want some help trying to see better again.
Thanks for listening.
I don't have any floaters after the YAG. I have a big piece of the capsule hanging down into field of vision and the doctor told me to ignore it and see if it went away but it still has not gone away.
As far as the need to have a 2nd YAG surgery, I've seen 5 doctors, and only 1 of them told me I needed a YAG and it was the one in my original surgeons office. I was actually told I needed the YAG by the receptionist before I even saw the optometrist. I hadn't been in the office for a recheck for 4 months, how could they know anything about needing a YAG when they hadn't even seen me? Then when i went I actually saw the optometrist she told me that the previous optometrist noted that there was no opacification on the other eye when I was in 4 months previous. When I mentioned this my new optometrist, he looked and told me that there was very little opacification on the capsule and it was not interfering with my vision. So it does make it look like what Dr. Hagan said, that they have some kind of co-management agreement going, otherwise why would I be told I needed YAG before even seeing a doctor.
There is a lot of astigmatism left in my eyes and I don't know why the surgeon did not give me a toric lens or correct the astigmatism. There is also residual farsightedness there too. I went to the optometrist and my astigmatism is +1.50 and +1.75 in my eyes and the farsightedness is +1.00 and +1.50. This has been a slow degeneration of my vision since the surgeries last year and none of the doctors I have seen have any explanation for it. I got glasses last week to help with the vision but they are also disorienting. I got progressives but I still have to switch to different pairs of readers depending on what I'm doing. I have great distance correction with the glasses but nothing else.
As far as the halos, they have been bad since day 1, but once again I was told over and over again that they would get better and they haven't. I do wonder if they seem like they are getting worse because I'm noticing them more or not but I do know that they are becoming somewhat debilitating. I can even see them during the day.
I do feel sometimes like I was a little naive going into this whole thing. I thought i did all the research and learning that I could before decided that I wanted to do this. I know ultimately this was my choice. However, the choice does not seem to be working for me and I just want some help trying to see better again.
Thanks for listening.
2 Comments
I stand by my experience and discussions that for MOST people at this point (5/11/16) that the visual results will be better with aspheric monofocal and toric IOLs than any multifocal including those currently used in Europe by not USA. Notice this brochure on RESTOR https://www.myalcon.com/products/surgical/acrysof-iq-restor-multifocal-iol/restor-25/activefocus-data-support.shtml
Look at the figure: Simulated retinal images using a Badal optometer (3 mm pupil)5 That is a good simulation by the manufactuer of RESTOR of the quality of vision. If someone is willing to accept the degraded quality of the acuity chart at distance top two lines RESTOR +2.5 and +3 compared with the bottom monofocal ultra sharp distance then you might consider. This is an excellent representation of the trade off monofocal/toric IOL vs any "all in one IOL"
Look at the figure: Simulated retinal images using a Badal optometer (3 mm pupil)5 That is a good simulation by the manufactuer of RESTOR of the quality of vision. If someone is willing to accept the degraded quality of the acuity chart at distance top two lines RESTOR +2.5 and +3 compared with the bottom monofocal ultra sharp distance then you might consider. This is an excellent representation of the trade off monofocal/toric IOL vs any "all in one IOL"
Using an optical bench simulation of what 1 eye sees is of course an oversimplification. If someone looks close up at a tv with 4k resolution they will see it has better image quality than an HD tv, but many people sit far enough away from their TV that they wouldn't actually be able to tell the difference in real usage conditions. Its hard to say how much of a difference is visible when the lenses are placed in a real eye, or how much practical difference that makes. Also I suspect other multifocals may have better quality distance vision than the Restor.
More importantly, that simulated image is for 1 eye, often binocular vision leaves people with greater visual acuity than 1 eye alone and lets the brain tune out visual artifacts that are different in each eye. So it isn't clear what a simulation of the resulting image for 2 eyes would be. With multifocals people are often going to use binocular vision at all distances, whereas if they go with monovision with a monofocal they are relying more heavily on 1 eye for distance, so the difference in distance vision won't be as much as such images suggest. (granted they would wear glasses to correct monovision to put both eyes at distance, but I don't know how many people bother if they see well enough with monovision).
Even if the distance vision is better, even if someone might theoretically notice a difference between say 20/12 vs. 20/15 or 20/20 distance vision, many might not really care about that small difference if it means better vision nearer in that they use more often
The issues are partly convenience, and partly what people's vision will be at the distances they use most often (which isn't usually far distance) and the sort of correction (if any) they'd likely be wearing.
Many of the visual tasks people engage in are at intermediate distance, which won't be as clear with 2 monofocals set for distance compared to trifocals, lower add multifocals outside the US, and the Symfony & Crystalens usually, and for some intermediate ranges the low add bifocals in the US will be better.
Using only a small amount of monovision with monofocals improves their intermediate a bit, but then is relying more on just 1 eye vs. 2, and a large amount of monovision helps more with near than distance.
For some intermediate tasks some people with monofocals might not mind wearing readers, like for computer work for the crispest vision. However for many social tasks, household tasks, and errands people may not bother (or they may use off the shelf readers, which if they have monovision will leave them still only using 1 eye). Visual quality with monofocals set for distance at the intermediate distance people use often may be lower quality much of the time, if they aren't wearing correction.
Before I had cataracts I wore multifocal contacts to get a wider range of vision, and if I'd had monofocal IOLs I'd likely have tried that, and the image quality I suspect wouldn't be as good as a premium IOL.
Some people will use progressive glasses if they have monofocals to try to get a wider range of vision, but others don't like those (I didn't, I preferred multifocal contacts) and for much of the visual range you can have a narrow window into the best focus.
More importantly, that simulated image is for 1 eye, often binocular vision leaves people with greater visual acuity than 1 eye alone and lets the brain tune out visual artifacts that are different in each eye. So it isn't clear what a simulation of the resulting image for 2 eyes would be. With multifocals people are often going to use binocular vision at all distances, whereas if they go with monovision with a monofocal they are relying more heavily on 1 eye for distance, so the difference in distance vision won't be as much as such images suggest. (granted they would wear glasses to correct monovision to put both eyes at distance, but I don't know how many people bother if they see well enough with monovision).
Even if the distance vision is better, even if someone might theoretically notice a difference between say 20/12 vs. 20/15 or 20/20 distance vision, many might not really care about that small difference if it means better vision nearer in that they use more often
The issues are partly convenience, and partly what people's vision will be at the distances they use most often (which isn't usually far distance) and the sort of correction (if any) they'd likely be wearing.
Many of the visual tasks people engage in are at intermediate distance, which won't be as clear with 2 monofocals set for distance compared to trifocals, lower add multifocals outside the US, and the Symfony & Crystalens usually, and for some intermediate ranges the low add bifocals in the US will be better.
Using only a small amount of monovision with monofocals improves their intermediate a bit, but then is relying more on just 1 eye vs. 2, and a large amount of monovision helps more with near than distance.
For some intermediate tasks some people with monofocals might not mind wearing readers, like for computer work for the crispest vision. However for many social tasks, household tasks, and errands people may not bother (or they may use off the shelf readers, which if they have monovision will leave them still only using 1 eye). Visual quality with monofocals set for distance at the intermediate distance people use often may be lower quality much of the time, if they aren't wearing correction.
Before I had cataracts I wore multifocal contacts to get a wider range of vision, and if I'd had monofocal IOLs I'd likely have tried that, and the image quality I suspect wouldn't be as good as a premium IOL.
Some people will use progressive glasses if they have monofocals to try to get a wider range of vision, but others don't like those (I didn't, I preferred multifocal contacts) and for much of the visual range you can have a narrow window into the best focus.
re: "I feel like this has been the worst thing I have ever done in my life. I just want to have the lenses explanted and have monofocals with glasses. "
You described your initial results as: "Once again, they weren't perfect but I was happy. ", so it isn't clear how much of the issue is the lens choice vs. later issues. It sounds like the problems started with need for YAGs (which can happen with any lens), floaters after the YAG, which a lens exchange doesn't deal with, and the need for a YAG in the other eye and for astigmatism to be dealt with.
Multifocals do increase the risk of halos, and so it could be that a lens exchange is appropriate if they are causing you major problems. However since you were happy initially, I'm wondering if the halos weren't as bad at first and if they aren't primarily due to the multifocals themselves but instead due to your remaining other issues.
Astigmatism can be corrected with glasses/contacts, but an LRI is a minor few minutes procedure surgeons often do in their office (rather than an operating room), its not like cataract surgery since they don't do anything inside the eye so it isn't as big a production. Unless you have enough astigmatism to warrant a toric IOL (which sounds unlikely since you didn't have them), an LRI is useful even if you later get a lens exchange. It is the case that sometimes they can plan the incisions in a lens exchange to reduce astigmatism rather than having a separate LRI.
You described your initial results as: "Once again, they weren't perfect but I was happy. ", so it isn't clear how much of the issue is the lens choice vs. later issues. It sounds like the problems started with need for YAGs (which can happen with any lens), floaters after the YAG, which a lens exchange doesn't deal with, and the need for a YAG in the other eye and for astigmatism to be dealt with.
Multifocals do increase the risk of halos, and so it could be that a lens exchange is appropriate if they are causing you major problems. However since you were happy initially, I'm wondering if the halos weren't as bad at first and if they aren't primarily due to the multifocals themselves but instead due to your remaining other issues.
Astigmatism can be corrected with glasses/contacts, but an LRI is a minor few minutes procedure surgeons often do in their office (rather than an operating room), its not like cataract surgery since they don't do anything inside the eye so it isn't as big a production. Unless you have enough astigmatism to warrant a toric IOL (which sounds unlikely since you didn't have them), an LRI is useful even if you later get a lens exchange. It is the case that sometimes they can plan the incisions in a lens exchange to reduce astigmatism rather than having a separate LRI.
Dr. Hagan,
Thanks for your reply. I have seen a doctor at Duke already and he wanted me to get LRI surgery which I am not willing to do at this time. I was given the name of another doctor at Duke by the last optometrist I saw and was told that he would be able to help me, but I have an appointment with a cornea/refractive surgeon on May 27th of this month to see what he can do for me. He has a great reputation and his training and experience are top notch.
I agree that it's going to take a team of doctors to help me. I just feel very alone right now and I just need help coping I guess.
Thanks for your reply. I have seen a doctor at Duke already and he wanted me to get LRI surgery which I am not willing to do at this time. I was given the name of another doctor at Duke by the last optometrist I saw and was told that he would be able to help me, but I have an appointment with a cornea/refractive surgeon on May 27th of this month to see what he can do for me. He has a great reputation and his training and experience are top notch.
I agree that it's going to take a team of doctors to help me. I just feel very alone right now and I just need help coping I guess.
Unfortunately there are many posts like yours on this website. That is why I wrote this article and suggest you do also:
http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
Your handle suggests you live in NC. I would suggest you make an appointment at the department of ophthalmology at either UNC or Duke. I would start out with a cornea/cataract/refractive surgeon. It will take a team of ophthalmologists to get you back to a condition that you can tolerate.
In retrospective your interests have been poorly served. Many of these optometrists and ophthalmic surgeons have "co-managment" arrangement where they divide the surgical charges. Patients are often not told of this. It's legal but in my opinion not ethical. If a surgeon is not willing to co-manage then quite a few optometrists will not refer to them.
Duke and UNC are both first class ophthalmology programs and deal in post operative complications.
http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
Your handle suggests you live in NC. I would suggest you make an appointment at the department of ophthalmology at either UNC or Duke. I would start out with a cornea/cataract/refractive surgeon. It will take a team of ophthalmologists to get you back to a condition that you can tolerate.
In retrospective your interests have been poorly served. Many of these optometrists and ophthalmic surgeons have "co-managment" arrangement where they divide the surgical charges. Patients are often not told of this. It's legal but in my opinion not ethical. If a surgeon is not willing to co-manage then quite a few optometrists will not refer to them.
Duke and UNC are both first class ophthalmology programs and deal in post operative complications.
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