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No clear near, far or any distance vision after cataract surgery. What went wrong?

Hello again.

First of all to thank the doctor for his answers and help, means alot.

My question:
As a part of a trauma to the eye, i developed a cataract.
Being myopic(-2), doctors told me i had two options, IOL for near or far vision. I picked near vision bcs it felt more natural to me and with desire of being able to read.
I had cataract surgery and YAG laser done.
Problem:
I got no clear far, near or any distance vision in operated eye. Target set by my doctor was -2. Now i have -1.5 for far, but also +2 for near and astigmatism on top of it, that i didnt have before. Im not able to read at any distance. With glasses, my vision is now ~90% as doctors said.
As i understood before surgery, i should have been able to see near without glasses, at least enough to read, but now i have to wear both near and far distance glasses.
Also, without glasses, my poor vision in operated eye is affecting my good near vision in healthy eye, making letters bit more blurry, and adding to a need for glasses.

Did something go wrong, or something like this just happens?
Most importantly, is there something more i can do about this? What are my options, if any, now?
What can i expect in the future?

Tnx.
2 Responses
233488 tn?1310693103
MEDICAL PROFESSIONAL
Please read this article carefully. Then repost any questions that remain unanswered.  LINK    http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
7 Comments
Tnx for answer doctor.
I did read it before posting, but perhaps i didnt understand fully.
What seemed most relevant for my case was "..and -3.00 which has great vision for tiny detail at reading distance 13-14 inches", or "..distance and -1.25 or -1.50 for the "reading eye." In good lighting they often can read without glasses".
Only thing i could understand is that i should have gotten -3.00 for 13-14 inches reading, and that even perhaps with -1.5 i should be able to read, but its not possible for me. Its too blurry.
About astigmatism, i didnt have it prior to surgery, nor i have it now in my healthy eye, which is myopic with -2 for far.

My goal is just to get to good enough vision to be able to read, and i have no problems with wearing glasses for far.

So in the end im not sure about my options or which one would be best one.
Replacing IOL?(My current is monofocal of power 18D)
LASIK surgery? What can i expect from it?

Is there anything else?
What is your glasses RX for both eyes     It will look like this   + or -   SPHERE      + or -  CYLINDER        AXIS  in degrees     ADD
Also list your vision with the glasses on.
I will just type whats written on my report, bcs i dont rly understand any of this. Hope that will be ok. Ill also note im from Europe.

fc OU:-2.25

AR OD:+0.25=-1.75/150
       OS:-2.25

VOD: sa -1.25/150 =0.9
VOS :sa -2.25 dsph =1.0
VOD: close vision sa add +2.00=jeger 3/2    PD= 60/62 mm
TOD:10 mmHg
TOS:12 mmHg

Hope this is it.
FIrst of all you have had trauma to your eye.  That may account for the astigmatism you have in the RE (1.5 diopters)  that is a lot more than you would expect from routine cataract surgery on an uninjured eye.  Small incision cataract surgery may cause about 0.25 to 0.50 astigmastim in the axis of the incision.  So likely the astigmatism is from your injury.   Second you can see great (decimal vision 0.9 or about 20/20 minus  metric 6/6 minus) you just need glasses.  Your profile says you are 28. To the unoperated eye does not need bifocals but the operated eye being monofocal needs a plus 2 add.   If you don't have your glasses on and you look at something farther than 6 meters your operated eye will likely be clearer than your unoperated eye.

I would certainly not do an IOL exchange. Not likely to help you.  Most likely you just need to start wearing glasses more. You can see how you do with wearing a pair of glasses with no line progressive bifocal on the RE .  That is hard for many people to adjust to.  You can take your glasses off and just use your LE for near wearing just distance RX in both eyes no add for RE.  Lasik surgery is not a good choice for your RE because you will still not be able to read at near without glasses because LASIK makes you less myopic nor more.
So, that means, this is probably the best it can be.
Im disappointed, bcs by what i was reading online and by what doctors told me, i did expect it better. Reading without glasses, looking at distance with. But now i just have to accept it.


I also wanted to thank you doctor, for taking time to answer and for advice. Meant alot to me, and im sure no less to other people you help in this community.
I'm sorry you are disappointed. Your expectations were too high, especially after trauma, and because your young age your other eye doesn't need bifocals and doesn't have a cataract so they are not 'matched"  You should be  more grateful.  You could be blind in that eye.
You are probably right. I will, as someone here said, have to adjust to and accept whats my "new normal" now. When you reach your maximum, its probably best thing anyone can do.

You helped me with decisions, you provide alot of information for patients, and im thankful for that.
All the best.
233488 tn?1310693103
MEDICAL PROFESSIONAL
Same to you also
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