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cataract lens calculation

had cataract surgery 2 days ago on left eye due to vitrectomy done for macular hole last year, 2 hours after surgery Dr examed my eye & aske if i ever had lasik,  I had lasik 15 years ago, she said she would have calculated lens differently for cataract, what does this mean,  my eye kind of blurry, she mentioned possible exchanging lens or laser,  my next appointment is in two weeks, can this be corrected, would my insurance pay,
4 Responses
177275 tn?1511755244
177275 tn?1511755244
177275 tn?1511755244
Well neither you nor your surgeon should suddenly learn of your lasik surgery AFTER  the surgery. You should have told them and they should have asked. Most eyes that have had macular hole surgery do not recover perfect 20/20 vision so it might be that the difference in IOL power will not be enough to consider IOL exchange.  Generally insurance is NOT going to cover IOL exchange if glasses will correct the problem.
thank you for your reply.  I know I had told them about my lasik and have a friend witnessed who had accompanied me, also told a nurse and gave her some tips on lasik but somehow they fail to document it.  After my vitrectomy my best eye result was 20/30 and sometimes 20/40,  2 hours after cataract i was at 20/50, could this improve since it was only measured 2 hours after surgery.  I am not expecting 20/20 and know I always will have some distortion because of vitrectomy but at least what i was before which was 20/30 or 20/40.  Dr also mentioned she could do laser,  could laser help, should i consider that, could it be risky considering my eye history,  
First some helpful information:  your age? and do you wear glasses for your other eye?

The visual recovery is not usually known till about 3-6 weeks post op.  LASIK is not a good option for people with macular pathology (like you have)
I am 60 female and my other eye is 20/20 and don't wear glasses, just reading glass, also on the left eye that i had cataract, i see lots of moving  like water/wave in the bottom and left side,
my vision is wired and things seem smaller that what i used to see,
The water/wave are common and are generally reflexes coming from the incision. Generally they are gone 4-6 weeks post op. My wife had cataract surgery about 4 months ago and had them in both eye. The difference in size probably related to your new way of seeing through a IOL.  Compare the size at distance in both eyes.  They should be about the same.  Macular pathology often causes abnormal size and shape (metamorphopsia)  
what would be my best option, should i consider lens exchange after post op recovery, is it safe to exchange lens,
Generally wait 6 weeks to see how much your vision recovers and how they are working together. I would suggest you get at least 2nd opinion before doing IOL exchange they can be more difficult than the first surgery and the chance to make you "happy" given your other eye has good vision and needs glasses just for near and the other eye has macular pathology is low.  You will need to reduce your expectations for the eye with macular pathology.
thank you, Merry Christmas
Hope all works out well for you. Merry Christmas to you and yours also.
Dr. Hagan - can't you tell that someone had lasik just by looking at their eyes? Also, am I correct when I said a special formula is necessary to do cataract surgery on someone after having had lasik? I got that information just from researching it online.
No it is not always possible to tell someone has had lasik.  It can only be determined looking carefully with high magnification with the slit lamp exam.   Yes a modification of the IOL calculations is used if a patient has had lasik.
OK thanks.
You are welcome and good luck
Avatar universal
If you had lasik, the cataract surgeon needs to use a different formula to calculate the power of the IOLs for your cataract surgery. The formula used is also different depending on whether you were nearsighted before lasik as most people are or farsighted before lasik, so if you don't have your medical records from the lasik surgery to give to your cataract surgeon, you need to let your cataract surgeon know whether your were nearsighted or farsighted before the lasik was done.
It's really terrible that she didn't double check this information before your surgery. I had lasik and cataract surgery after and my results turned out great. I'm pretty sure your surgery will need to be redone and I personally wouldn't have lasik done to correct it, but wait and see first as Dr. Hagan suggested.
Also I am almost positive either insurance would pay for it to be redone or your cataract surgeon should do it for free in my opinion, since it sounds like it was her mistake. Good luck!
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177275 tn?1511755244
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