after cataract surgery:any success withglasses with wide divergence in diopeters

[miria]

I have  success with distance vision but have  extreme difficulty reading (near vision and intermediate) after cataract surgery with Restor lens in Sept. 09, and am fearful of doing the other eye which also has a cataract. Before surgery  I   used to be able to read with a very low Rx or not using glasses  (which I still can do in the other eye, that still has a cataract), but now can't read at all  with operated eye unless I have glasses.. I have become very fearful of a 2nd surgery, fear losing ability to read as I can now with  the unoperated eye.  The doctor says my eyes are too different to tolerate glasses, which is what would have been a preferred and safer route for me, than the doctor's advice 1.(pilocarpine to contract pupils- I had a severe allergic reaction and have continued pain 6 weeks later after using drops for 2 days though with high dosage of 4x daily, and have also read that the drops have a slight chance of effect of detached retina), 2. change lens ( but for what? Restor is supposed to be the preferred one for near vision), more surgery with possibly other poor outcome
3.  surgery to contract pupil permanently-- too radical and scary
Question- has anyone been successful with prescription glasses,and or contact lenses if eyes are 5+diopeters apart? What can happen if I try this?. Maybe I could try reading glasses/ contact lenses, a mix of both? I can now  read with over the counter glasses of 3 strength, but of course those glasses only correct for the operated eye and the other gets blurred. I can read with the unoperated eye,  (using my old glasses or no glasses)but not with  using both eyes together.

[JodieJ]

You might want to describe your ReStor problems on a new thread and include "ReStor" in the title.  You can also use the "Search This Community" feature to pull up recent threads about ReStor problems.

[JodieJ]

I wish that Dr. Hagan had commented--his professional opinion is worth a whole lot more than my non-professional speculations.  Are you able to read with your ReStor eye when you wear reading glasses?  If you can read, then I suspect that your ReStor is the wrong power.  This might account for your 20/30 distance vision (which is acceptable but not great, unless you have other conditions affecting your vision).  ReStor is only good for near vision if it's the correct power.  (Actually, any of the monofocal lenses can provide excellent uncorrected reading ability, but then you'd need glasses for distance vision.)

It's interesting that your near vision improves with pilocarpine.  But what are you supposed to do, keep using the drops forever?  Personally, this solution would not be acceptable to me.  Is your near vision supposed to improve in the future without the drops (or not)?  And what if you're truly allergic to pilocarpine in any concentration?  In your place, I'd much sooner have the ReStor explanted and replaced by a monofocal lens than have surgery to contract my pupil.  How would this surgery affect your night vision?

I certainly wouldn't recommend getting a second ReStor until/unless you're satisfied with your vision with the first one.  And I definitely wouldn't recommend a YAG at this time.  I'm guessing that you're about a -5 myopic, which is actually not considered to be all that severe.  I hope that your post gets responses from other people who have had similar problems with ReStor.

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

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[miria]

I've had several opinions. Distance vision very good- 20/30.
Surgeon- recommends laser YAG, all confirm opaque capsule, but all the other opinions say this isn't the cause of the near vision problem, will only get marginal relief, and precludes changing the lens which would be then very difficult

2nd opinion: pupil doesn't contract for near vision, pupil "too large". REcommended pilocarpine, 4x daily, 1 %, for 2 days  but then, the 2nd night, I had a severe reaction (tearing, red eye, lid swollen, pain). That lasted a week. The pain has continued  for 6 weeks; MD says it's still inflamed and now taking antiinflammatory drops (plus lubricating drops). He wants me to try again at a lower dose but I',m concerned that pain (spasm feeling and sudden sharp pains) have lasted so long. and worried about trying again. Also, I was very myopic and read of possible retinal detachment.  However,  I did get very good results for reading and internediate- from pilocarpine. I live in NY-- he is well-regarded as the Dr. FixIt for failures- people wait months for an appt, sees people from nearby states He is now "officially" my MD


3rd opinion- Restore lens too weak ((15.5.D). But none of the others said anything about  the lens being too weak

2  of the doctors recommended changing the lens, but if Restor is best for near vision, (isn't it?) what could I gain? I am frightened of creating more problems and also of a 2nd surgery, though cataract is advanced in other eye.I was told that the RX strength for glasses  for the uncorrected has doubled in strength  since a year ago, when I got glasses rewed. It was changes in the last year that made me reaLIZE i HAD TO CORRECT THE CATARACTS.
  But,I would rather  live with contacts or glasses as long as I can, rather than lose ability to read naturally in 2nd eye-- makes me feel very vulnerable. I am a voracious reader and a reading teacher.  I'm  now, frightened of any more procedures- redoing lens,  and 2nd surgery.

Jodie--I have followed many of your replies and respect your concern and observations

[JodieJ]

Most people do very well with a contact lens in their unoperated eye.  (It worked for me with more than a 5 diopter difference.)  You can wear reading glasses over the contact for intermediate/near vision.

What does your doctor say is causing your poor near vision with ReStor, and what does s/he propose doing about it?  How is your distance vision with ReStor?  It sounds like it would be worth getting a second (and maybe third) opinion about this from (an)other surgeon(s) experienced with ReStor.