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Wrong implant after cataract operation
Before my cataracts' operation I used eyeglasses for driving and none for reading since I had extremely sharp vision. After the first cataract with regular implant operation (distance), the doctor admitted that I would need a new implant with more graduation since my TV/driving vision was not sharp, in fact, it was bothersome without glasses.
After waiting a couple of months with no improvement whatsoever I elected to have a second opinion. The new doctor did not recommend a new implant on the same eye, and performed the cataract/implant operation on the other eye resulting on 20/20 vision where I would not need glasses for tv/driving; however, now I cannot read the newspaper or even 14 pica without glasses. So now I have to wear sun glasses for day driving and non-glare clear for evening driving/tv/inside stores. For short distance, glasses all the time, including the computer (intermediate vision glasses). If I had know this would have been the end result of the cataracts operation, I would not have gone through either one.
The second doctor would like to correct the near vision problem with an implant/lens over the implant in the (now?) dominant eye (the eye where the cataract/implant operation was performed by the first doctor).
Apparently Medicare will also pay for this "correction." Is the above the best solution to my problem? I am a writer/artist and I am very distressed about having lost my short-distance vision. Without glasses I cannot even read 16 pica and it has been a month since the second operation. Thanks for your help.
After waiting a couple of months with no improvement whatsoever I elected to have a second opinion. The new doctor did not recommend a new implant on the same eye, and performed the cataract/implant operation on the other eye resulting on 20/20 vision where I would not need glasses for tv/driving; however, now I cannot read the newspaper or even 14 pica without glasses. So now I have to wear sun glasses for day driving and non-glare clear for evening driving/tv/inside stores. For short distance, glasses all the time, including the computer (intermediate vision glasses). If I had know this would have been the end result of the cataracts operation, I would not have gone through either one.
The second doctor would like to correct the near vision problem with an implant/lens over the implant in the (now?) dominant eye (the eye where the cataract/implant operation was performed by the first doctor).
Apparently Medicare will also pay for this "correction." Is the above the best solution to my problem? I am a writer/artist and I am very distressed about having lost my short-distance vision. Without glasses I cannot even read 16 pica and it has been a month since the second operation. Thanks for your help.
Prior to precdures I needed glasses for driving, computer and reading - nothing too drastic - +1 for driving, +2 for computer and +3 for close reading. I had Lentis Ls 313 lenses - right eye 2/2, left eye 2/16 - and am quite unhappy with the results. Initially the right eye seemed OK, near (reading & computer were not great) but appearently this is to be expected, but distance was A week or so after the left eye near vision did improve and I could read and use the computer without glasses, although not very comfortably, but I persevered. However my near vision now seems to be deteriorating - it's almost like the right eye (set for distance) is fighting against the near vision of the left eye. I have also got quite bad double vision - I did have this before the surgery (both my optician and the optician at the Clinic where I had the surgery said it was due to astigmatism), but it is considerably worse since the surgery. I am now having to see a consultant to see what can be done and there is talk of Botox injections in the eye muscles or surgery - neither of which I really want. It is almost as if one of the lenses has moved - had anyone else had a similar experience - if so, can the lens be put back in the right position? It's very difficult to talk to the consultant who actually carried out the procedures as now everyone is waiting for the results of the consultation about the double vision, but I think they are two separate issues - also should I have had a toric lens in the eye with astigmatism? I'm really quite dejected about the whole thing and rather wish I hadn't had this done, it seems I will at the very least have to wear glasses - and different ones for near, middle and distance - exactly what I wanted to do away with by having the surgery. Has anyone any thoughts???
Prior to precdures I needed glasses for driving, computer and reading - nothing too drastic - +1 for driving, +2 for computer and +3 for close reading. I had Lentis Ls 313 lenses - right eye 2/2, left eye 2/16 - and am quite unhappy with the results. Initially the right eye seemed OK, near (reading & computer were not great) but appearently this is to be expected, but distance was OK A week or so after the left eye near vision did improve and I could read and use the computer without glasses, although not very comfortably, but I persevered. However my near vision now seems to be deteriorating - it's almost like the right eye (set for distance) is fighting against the near vision of the left eye. I have also got quite bad double vision - I did have this before the surgery (both my optician and the optician at the Clinic where I had the surgery said it was due to astigmatism), but it is considerably worse since the surgery. I am now having to see a consultant to see what can be done and there is talk of Botox injections in the eye muscles or surgery - neither of which I really want. It is almost as if one of the lenses has moved - had anyone else had a similar experience - if so, can the lens be put back in the right position? It's very difficult to talk to the consultant who actually carried out the procedures as now everyone is waiting for the results of the consultation about the double vision, but I think they are two separate issues - also should I have had a toric lens in the eye with astigmatism? I'm really quite dejected about the whole thing and rather wish I hadn't had this done, it seems I will at the very least have to wear glasses - and different ones for near, middle and distance - exactly what I wanted to do away with by having the surgery. Has anyone any thoughts???
Thanks a lot for a very informative response. Right now I am using several glasses for different purposes. In the evening, my eyes tired, I have to use a different set for the computer. For the newspaper, with artificial light I need more graduation (I still have not ordereded the prescription glasses). Artificial tears (with/without) do not help the tiredness, burning sensation.
Today is the 42nd day after the second eye operation and I can say that, if anything, my vision (LD/SD) is slightly worse than four days after the operation although I was told that there could be an improvement after a month and a half. With Medicare/Supplemental insurance I went to "the best places" for both eye operations. I need an impartial evaluation to see what would be best to correct/reverse what's been done. It is very difficult to accept that while before I could see long distance objects without glasses (needed for driving!) and I could read the smallest of prints without glasses, that now I cannot read even pica 18 without. My particular situation has not come up as yet but I will follow your leads. I can only be on the computer for so long. (I have had to withhold editing of my second book (180 pages) until I feel comfortable reading. Thanks again for sharing your valuable experience with me.
Today is the 42nd day after the second eye operation and I can say that, if anything, my vision (LD/SD) is slightly worse than four days after the operation although I was told that there could be an improvement after a month and a half. With Medicare/Supplemental insurance I went to "the best places" for both eye operations. I need an impartial evaluation to see what would be best to correct/reverse what's been done. It is very difficult to accept that while before I could see long distance objects without glasses (needed for driving!) and I could read the smallest of prints without glasses, that now I cannot read even pica 18 without. My particular situation has not come up as yet but I will follow your leads. I can only be on the computer for so long. (I have had to withhold editing of my second book (180 pages) until I feel comfortable reading. Thanks again for sharing your valuable experience with me.
Please understand that I am NOT advocating explantation, and particularly not any additional surgery at this point. I am recommending that you now educate yourself thoroughly regarding your options, your expectations, and particularly your expectations in light of what is reasonable.
I am merely a patient (although one who has taken anatomy and physiology classes). However, I have received implants for cataracts that were swiftly destroying my vision. Utlimately, no glasses helped, and since I am a craftsperson, this was a dreadful situation.
After due consideration, measuring my eyes seven ways from Sunday, taking into account that for most of my life I had been 'far-sighted' with a commensurately 'short' eyeball, that I had smallish pupils, that my retinas were healthy, and that I had realistic expectations, my surgeon chose a mutlifocus lens for me, namely the ReStor D1.
My outcome was utterly superb, and although I was perfectly prepared to wear readers, they turned out not to be necessary.
This virtually perfect outcome seems to be rather unusual, and I attribute it to my surgeons's skill--and the fact that he is extremely thoughtful about choosing the best lenses for his patients.
However, before the surgery, I also did my homework, reviewing every respectable study I could find about lens implants that were relevant to my case. I had a metric ton of questions, each of which my surgeon patiently answered. I do believe this kind of dialogue is tremendously important for a good outcome.
Now, if I were in your situation, I would do several things:
Before even halfway entertaining the idea of an implant on top of an implant, I would read, read, read about explantation. There are a number of posts here by thoughtful patients who have undergone this procedure with success (I believe one is named JodieJ). Though any surgery has risks, and the outcome is never guaranteed, in selected cases, explantation and substitution can be done, and seem to be best done not too long after the original surgery. But it is up to the patient to do a great deal of research and become truly informed about what is involved.
You can search this board using 'explantation,' and I would also recommend a google search using a phrase something like 'scholarly articles iol explantation.'
After due consideration, measuring my eyes seven ways from Sunday, taking into account that for most of my life I had been 'far-sighted' with a commensurately 'short' eyeball, that I had smallish pupils, that my retinas were healthy, and that I had realistic expectations, my surgeon chose a mutlifocus lens for me, namely the ReStor D1.
My outcome was utterly superb, and although I was perfectly prepared to wear readers, they turned out not to be necessary.
This virtually perfect outcome seems to be rather unusual, and I attribute it to my surgeons's skill--and the fact that he is extremely thoughtful about choosing the best lenses for his patients.
However, before the surgery, I also did my homework, reviewing every respectable study I could find about lens implants that were relevant to my case. I had a metric ton of questions, each of which my surgeon patiently answered. I do believe this kind of dialogue is tremendously important for a good outcome.
Now, if I were in your situation, I would do several things:
Before even halfway entertaining the idea of an implant on top of an implant, I would read, read, read about explantation. There are a number of posts here by thoughtful patients who have undergone this procedure with success (I believe one is named JodieJ). Though any surgery has risks, and the outcome is never guaranteed, in selected cases, explantation and substitution can be done, and seem to be best done not too long after the original surgery. But it is up to the patient to do a great deal of research and become truly informed about what is involved.
You can search this board using 'explantation,' and I would also recommend a google search using a phrase something like 'scholarly articles iol explantation.'
Thanks for your interest and reply.
When I complained to the first doctor after the operation in the originally better long distance eye (left eye) that my vision was not clear or 20/20 as he had claimed, he examined the eye in question and indicated that I might need an implant with more graduation in that eye. Days passed and my vision was bad on that eye so I went to a new doctor to get a second opinion before subjecting myself to a new operation.
On the subject of the first eye the second doctor said "I would not recommend that" referring to having another implant on the operated eye. Upon discussing the second eye operation with this doctor I had mentioned that I wanted to keep some short vision since I painted and wrote books and, at that currently I could read the smallest of prints without glasses. I was told then that after the cataract operation I would still need glasses for the computer (I could live with that).
After the first eye operation (LEFT EYE) five months ago here is the situation with the originally better long D eye (the new doctor verified it was the dominant eye).
a. I cannot drive using that eye only; b. I cannot read without magnifying glasses; c. without glasses I have double, blurred vision starting with 18 pica; d. below 18, not distinguishable.
After the second eye operation (RIGHT EYE) 37 days ago here is the situation:
a. The operating doctor said I have 20/20. b. I could possibly drive using the right eye only; c. I can better focus and see clearly for watching TV with this eye (I do use both all the time for everything, though).
AS TO SHORT D., same as with the left eye, except that this right eye (originally the one with excellent short vision) is slightly worse for reading 18 pica and above than the left eye.
To recap, a. I do not need prescription glasses for driving using both eyes; b. I do need tinted non-prescription glasses for inside stores or with light tint for night driving if glare bothers me. c. I do need glasses for the computer; d. Some times more than others my vision feels bad (heavy, not too focused) without reading; e. I can "guess" pica 18 and above with both eyes without glasses but anything below that is blurred or unintelligible. Again, lots of people operated over 15 years ago and more recently have proven to me they can read the newspaper without glasses.
The second doctor said that he believed Medicare would pay for a lens over the implant (or implant over the left eye implant, the dominant eye) and that his office would call me to confirm. I have read on the internet that replacing an implant is not advisable but that an implant over another is a better solution. This supposedly would improve my near vision for reading, etc.
Your opinion and qualifications/experience, please. Thank you.
When I complained to the first doctor after the operation in the originally better long distance eye (left eye) that my vision was not clear or 20/20 as he had claimed, he examined the eye in question and indicated that I might need an implant with more graduation in that eye. Days passed and my vision was bad on that eye so I went to a new doctor to get a second opinion before subjecting myself to a new operation.
On the subject of the first eye the second doctor said "I would not recommend that" referring to having another implant on the operated eye. Upon discussing the second eye operation with this doctor I had mentioned that I wanted to keep some short vision since I painted and wrote books and, at that currently I could read the smallest of prints without glasses. I was told then that after the cataract operation I would still need glasses for the computer (I could live with that).
After the first eye operation (LEFT EYE) five months ago here is the situation with the originally better long D eye (the new doctor verified it was the dominant eye).
a. I cannot drive using that eye only; b. I cannot read without magnifying glasses; c. without glasses I have double, blurred vision starting with 18 pica; d. below 18, not distinguishable.
After the second eye operation (RIGHT EYE) 37 days ago here is the situation:
a. The operating doctor said I have 20/20. b. I could possibly drive using the right eye only; c. I can better focus and see clearly for watching TV with this eye (I do use both all the time for everything, though).
AS TO SHORT D., same as with the left eye, except that this right eye (originally the one with excellent short vision) is slightly worse for reading 18 pica and above than the left eye.
To recap, a. I do not need prescription glasses for driving using both eyes; b. I do need tinted non-prescription glasses for inside stores or with light tint for night driving if glare bothers me. c. I do need glasses for the computer; d. Some times more than others my vision feels bad (heavy, not too focused) without reading; e. I can "guess" pica 18 and above with both eyes without glasses but anything below that is blurred or unintelligible. Again, lots of people operated over 15 years ago and more recently have proven to me they can read the newspaper without glasses.
The second doctor said that he believed Medicare would pay for a lens over the implant (or implant over the left eye implant, the dominant eye) and that his office would call me to confirm. I have read on the internet that replacing an implant is not advisable but that an implant over another is a better solution. This supposedly would improve my near vision for reading, etc.
Your opinion and qualifications/experience, please. Thank you.
Although I understand the first part of your post, which describes the failure of your first implant, I do not quite understand this part:
"...The new doctor did not recommend a new implant on the same eye, and performed the cataract/implant operation on the other eye resulting on 20/20 vision where I would not need glasses for tv/driving; however, now I cannot read the newspaper or even 14 pica without glasses."
Are you saying that with the second implant you did in fact---for a while at least--have 20/20 vision, but that your sight in that eye has now gone bad as well? Or do you mean that the second doctor promised 20/20 but you did not get that?
"...The new doctor did not recommend a new implant on the same eye, and performed the cataract/implant operation on the other eye resulting on 20/20 vision where I would not need glasses for tv/driving; however, now I cannot read the newspaper or even 14 pica without glasses."
Are you saying that with the second implant you did in fact---for a while at least--have 20/20 vision, but that your sight in that eye has now gone bad as well? Or do you mean that the second doctor promised 20/20 but you did not get that?
Thanks for your reply. Before I had the cataracts' operation I had talked to several people who had the age-related cataract operation over fifteen years ago and all of them can read without eyeglasses. I never expected perfect near vision but, at least to have the same quality of vision that everyone else around me enjoy with the Medicare-provided lens implants. I guess too little time, if any, is spent with the patient to discuss his/her activities to see what would be the best implant combination or to tell the patient in clear terms what is to be expected. Of the friends/family membeers that I have talked to, the oldest one is a ninety-five year old lady who can read smaller and news print without glasses Others with recent operations also can read the newspaper without glasses.
From what I understand you see any possible correction effort as risky including the offered solution of an implant over implant. A month after the operation I cannot see who is on the phone's caller ID, the readings on the stove's knobs or the newspaper. I expected that perhaps I would have to wear glasses for computer-reading, but not for everything! Something went wrong with the implants and I have now lost my near excellent near vision.
From what I understand you see any possible correction effort as risky including the offered solution of an implant over implant. A month after the operation I cannot see who is on the phone's caller ID, the readings on the stove's knobs or the newspaper. I expected that perhaps I would have to wear glasses for computer-reading, but not for everything! Something went wrong with the implants and I have now lost my near excellent near vision.
MEDICAL PROFESSIONAL
The purpose of cataract surgery is to make you see better with glasses. An effort is always made to give the best possible vision without glasses especially with paying extra for refractive "premium" lens.
These columns are full of people that have had extremely severed complications with cataract surgery and cannot see good with or without glasses.
Especially for monofocal IOLs your expectations are unreasonable. When you need to see as well as possible wear glasses. Anything more surgical is fraught with risk and expense and being no better or even worse off.
JCH MD
These columns are full of people that have had extremely severed complications with cataract surgery and cannot see good with or without glasses.
Especially for monofocal IOLs your expectations are unreasonable. When you need to see as well as possible wear glasses. Anything more surgical is fraught with risk and expense and being no better or even worse off.
JCH MD
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