Will cataract surgery help fix aniskonia in my non-operated eye?

[jerryc39]

Had a vitrectomy to repair detached retina about 10 months ago.  Needed cataract surgery post vitrectomy about 5 months ago.  Ever since gas bubble disappeared my binocular vision has been compromised.  After cataract was removed my visual acuity is 20-20 in that eye.  Problem is that the images are larger than in the unaffected eye.  Makes me feel dizzy and intoxicated all the time.  Depth perception is not great either.  My retinal surgeon and a local ophthalmologist seem to think if I have the good eye operated on than this might help my symptoms.  The ophthalmologist that performed the cataract removal is not sure this will help me.  So basically 2 votes for and 1 against from docs.  I only have a 1+ cataract in my good eye so that might be why the one who voted against feels this way.  What course would you take?  

[JohnHaganMD]

What is your glasses prescription? What is the vision in each eye with those glasses?   While you are furnishing that information read the posts by JodieJ who wrote many long and informative posts about difference in image sizes and treatment (aneseikonia and anesometrophia)

[jerryc39]

my contact lens in my good eye is -5.0  I am not sure what IOL in other eye is. Before detachment it was within .25 diopters of other eye.  After vitrectomy started cataract  progression I had to increase to -7.0 before surgery.

[jerryc39]

I have read some of Jodie's posts.  She talked about erm peeling surgeries and than using a combo of glasses and contacts.  I do have some ERM formation but my retinal surgeon does not feel it is enough of an issue to do surgery on.  I just am unsure about doing the cataract surgery on an eye that doesn't need it to see 20-25 or so.  If I was positive it would make eyes work together again I would do it in a heartbeat.

[JohnHaganMD]

So the unoperated eye is -5.00 and 20/20?  In the operated eye its not what power the IOL has it's what is the distance vision and what is the glasses to give it the best vision.  In other words what is the -5.00 trying to match up with.

[jerryc39]

yes unoperated eye  is nearly 20-20 wearing the contact.  Would you do the surgery if eyes are not working together?  Or is this idea not sound?

[JohnHaganMD]

I still need to know the glasses RX for your operated eye and the vision with them. Without that I can't answer your question.  

[jerryc39]

I don't wear any glasses or contacts in the operated eye.  Vision is about 20-20 after IOL placement

[JohnHaganMD]

Okay then your glasse RX (remember contacts are based on that) is -5.00 unoperated eye and 0.00 in operated eye.  Presumably you need glasses to read out of operated eye?   That is way too much imbalance to treat with contact on unoperated eye.   You could stop wearing contact and use operated eye for distance and unoperated for near. You could have lasik on unoperated eye and leave it somewhere between 0.00 and -1.00  or the riskiest would be do cataract IOL on unoperated eye. Remember you have had RD in operated eye so risk of RD in unoperated eye is high perhaps as high as 5-10% If you do cataract/IOL surgery on unoperated eye you increase risk of RD in second eye significantly.  You better get several opinions.

[jerryc39]

yes I do use reading glasses for reading.  My retina dr. used laser to prophylactically secure thinning areas of retina in both eyes when he did vitrectomy. Lasik might be a bit less risky than cataract surgery but I already have a 1+ cataract in that eye so eventually I would probably need lens replacement.  The last dr I saw seemed so sure it would work.  I am not so sure hence my hesitation.

[JohnHaganMD]

Well the options I listed are the only I see as possible.

[jerryc39]

Thank you for your responses.  Still not sure of what to do.  Do nothing and live with it or try surgery of some sort.

[JohnHaganMD]

Only you can determine how much it bothers you and thus create a risk/benefit for each of the possible options.

[jerryc39]

Very true.  I will ask the one dr. who was a no for his reasons he did not feel it would help.  Two eye surgeries is 6 months is plenty but having binocular vision again is a strong pull.

[JohnHaganMD]

Best of luck

[jerryc39]

Thank you

[JohnHaganMD]

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