Problems following Cataract Surgery and YAG laser posterior capsulotomy

[russell1945]

I should start by saying I live in the UK so hope you can still answer my question. I am a 68 year old male and have worn spectacles and/or contact lenses from my teenage years because I suffered from myopia and astigmatism. Around 2008, I began to notice that my distance vision was deteriorating such that I couldn't recognise faces from any sort of distance and couldn't follow a golf ball on TV without sitting very close to the set. When I was taking eye tests, the optician was finding no change in my prescription. Finally, he decided that I could possibly have developed cataracts. In 2009, I went to a local National Health hospital (which is free in the UK) to have my eyes examined. The consultant said that although I had mild cataracts, I also had Fuchs Dystrophy. I did nothing further until 2012 when I decided to use my company private health care scheme to see a private consultant. I was diagnosed with myopia, astigmatism, cataracts and Fuchs Dystrophy. The consultant decided to do a cataract operation as he said my Fuchs Dystrophy was relatively mild. He also recommended torric lenses which he said would remove some of my astigmatism but not all. I was asked to choose between having better distance vision or better close range vision and I chose distance vision. The consultant was very optimistic that I would not need any spectacles for distance although I obviously would need spectacles now for reading and computer work. I should say that before the operation I could read without spectacles as long as I held the newspaper or book close to my face and I could use a PC without spectacles also. The result of the operation was very disappointing in that I very quickly realised that I would need spectacles for distance and reading/PC. Not only that but where previous to the operation I had no sensitivity to light, I was now very sensitive to bright light but also could not read unless I had bright light behind me. Also, the colour definition and contrast had decreased dramatically and my vision was very cloudy. I did find an improvement in my astigmatism in my left eye but not in my right eye.  The cataract operations were done in January and February 2013. I had many checkups following the surgery but the consultant wanted my eyes to "settle" and arranged to see my again in October 2014 to see if a corneal transplant was needed. However, in August 2013 I retired from work and, therefore, could no longer use my company private health scheme so I then resumed as a national health patient at my local hospital. I had an appointment with a different consultant at the hospital a couple of months ago and he confirmed the diagnosis of the previous consultant i.e. that my Fuchs Dystrophy was relatively mild and after after examining my eyes that I needed YAG laser posterior capsulotomy. This was done a week ago and I was told my vision would be cloudy for a day but would then be improved or not as the case may be! Sadly, not only has my vision not improved but it has got worse, particularly in the area of contrast and is now so bad that I am getting headaches because of the strain of trying to read a newspaper as I see everything as grey instead of black unless the typeset is bold! So, I've now had 2 operations and all they have succeeded in doing is making my vision worse. I know that the last alternative will be either a DSEK, DSAEK or DMEK corneal endothelium transplant depending on the proceure used by the surgeon but I'm beginning to fear that having another operation as any further deterioration would be catastrophic! I guess my question I would ask is whether what has happened to me is unusual or is there anything I can do to ensure a satisfactory outcome or is it totally in the lap of the Gods? I'm not worried about wearing spectacles but would just like to be able to see reasonably clearly.


This discussion is related to bad cataract surgery.

[russell1945]

Many thanks for the reply.

[Ray T Oyakawa, MD]

I would suggest a second opinion in the private sector.  

Dr. O.