Seeing part of IOL

[sandy50]

I did not receive a Rezoom lens, but see part of my IOL from 4 to 10 o'clock.  Depending on the light (flourescent is the worse - it causes flickering off the edge), the edge of the lens that I see quivers and pulses in and out.  It is extremely annoying and distracting.  The only time I don't see it is when I look directly at the Sun.  It has been five and one-half months and I don't know if I can live with it.  The problem is that I had YAG because of a wrinkle in the capsule (a different Opthalmologist performed the YAG and said that he thought it would help my visual symptoms) and from what I've read it would really be risky to have the lens replaced now.  I'm very angry, because I was never told that this was a possible risk of having cataract surgery.  


This discussion is related to Frustrated.

[John C Hagan III, MD, FACS, FAAO]

As usual JodieJ's advise is right on the money and that is an entirely reasonable formulation of a plan.

JCH MD

[JodieJ]

I can certainly understand your anger, anxiety, and frustration.  But please don't give up hope.  As Dr. Hagan has indicated (above), it's possible to do an IOL exchange post YAG (and it's not even a "high risk" operation!)  But you'd want to get the very best surgeon in town to do it--someone who is experienced with cases like yours.  The question is: how do you find this surgeon?  You probably don't want to pick a doctor from a directory at this point.

If there is a teaching hospital (connected to a medical school) in your area, you might try calling the ophthalmology department and explaining your situation to the clinical coordinator.  Ask which of the senior faculty specializes in cataract/IOL and set up an appointment with him/her.  (Or perhaps they can refer you to an experienced surgeon in private practice.)  Don't accept an appointment with a resident or a fellow.  

Another possibility would be to get a referral from either of the two surgeons you saw previously.  Tell them that you're terribly bothered by the dysphotopsia, and you'd like their help in referring you to the area surgeon who is most experienced at doing an IOL exchange post YAG.  It would be great if they were willing to set up an appointment for you, since you'd probably be seen sooner.

I'm not an eye care professional, but I've read that your best bet for eliminating dysphotopsia would be a round-edged silicone IOL from a different manufacturer than the lens you have now.  But I'm sure that your surgeon can advise you about that.

Perhaps Dr. Hagan or other community members have additional suggestions for you.  

  

[John C Hagan III, MD, FACS, FAAO]

1. Never look at the sun.
2. Your complaint falls into the catagory of "dysphotopsia) which is very common after ReZoom IOL.
3. You should see another eye surgeon for a second opnion about your problem. Its likely the IOL is not decentered and that you are not seeing the edge but having dysphotopsia or seeing "temporal darkness".
4. Ask the second (or third if necessary) consultant about replacing the IOL with a monofocal aspheric IOL. While more difficult and problem prone with an open posterior capsule than with closed capsule it is still not a high risk operation (remember NO OPERATION IS RISK FREE).

jch md