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part of cataract left in eye following surgery

I had cataract surgery a three weeks ago and I had a Acryfof Toric lens implanted. At my post op appointment, I complained to my Dr. that I was seeing wavy lines. Upon examination, he discovered that a part of the cataract was still in my eye! I asked how often this happens, and he said," very rarely." He decided to remove the remaining cataract immediately in his office using numbing drops. He said " you'll feel some pressure." The numbing drops didn't work! It was like a torture chamber and I couldn't stand it! After I started moaning, he stopped. I told him I didn't feel pressure, I felt intense pain! After he examined me again, he said he had gotten 75% out but that 25% remained. He scheduled another appointment for the following week to see if the remaining piece of cataract would dissolve by itself. It didn't. My husband came with me for the next appointment and the Dr. decided to take the reaming part out under anesthesia. After my very first surgery, I was seeing better and had removed the lens from my glasses. After the third procedure at the surgery center instead of getting better vision, I got worse. I went from 20/25 to 20/80! The Dr. said I had some edema in my eye. This is not the outcome I had anticipated! I asked him why my vision got worse instead of better and he replied..."it happens." He said he'd set me up with another Dr. if I would like another opinion in case me missed something. . It has been 2 weeks since the third procedure. My next appointment is in 2 weeks. Have you ever heard of anything like this happening? It has been a nightmare!
12 Responses
233488 tn?1310696703
MEDICAL PROFESSIONAL
1. Part of the cataract is always left in the eye and that is the capsular sack that holds the IOL in place.
2. In your case some "nucleus" (hard) or "cortex" must have been left in the eye. Nucleus doesn't disolve so it must be cortex.
3. Try to remove cortex in the office is a stretch and it does happen that some is left behind but it is generally done in the operating room with anesthesia.
4. All that manipulation could cause the cornea to swell (edema).
5. There is a chance that things will still turn out good for you. See what the consultant thinks

JCH MD
Avatar universal
Thank you for your help. Your response answered some questions I had. My internist is making an appointment for me to get a second opinion. My eye has not improved since I wrote to you.
233488 tn?1310696703
MEDICAL PROFESSIONAL
Good luck. Hopefully the consultant can shed some light and perhaps a solution to your problem
JCH MD
7439659 tn?1390842306
I had my 2nd cataract surgery done last week. The first one (left) went well, the second one (right) not so much. My vision has only improved somewhat ... I still have all the symptoms I had before the surgery ... yellowish haze, dim, grainy and blurry. Plus the focal distance is off between the L & R eyes (meaning objects in the left eye seem a little further away than in the right eye). To me it's as if some (maybe 50%) of the cataract was not removed. Does this occur often? Can the doctor see if there is cataract still in there? Can the remaining cataract be safely removed? ( for some reason when I first tried posting this it, ended up in a different discussion so I apologize if you see both the posts).
Avatar universal
Yes, an ophthalmologist can look at your eye and see if there is a clouded remnant of your old cataract still in there.  As Dr Hagan stated before, it's possible that the capsular 'bag' that your old lens was removed from could be clouded.

Have you had a followup with your cataract surgeon, other than the day-after-surgery visit?  If so, did you describe the problem that is still happening with your right eye?  What did the doctor say?

If the problem is a clouded capsular bag, there is a laser treatment (YAG laser capsulotomy) that may be able to help.  But it's premature to discuss any treatment until the cause of the remaining vision impairment is identified.

It's also possible you have some issue with your retina such as an epiretinal membrane or scarring; this can cause blurring and a disparity in size between objects viewed between the right and left eye.  If your cataract was severe, your doctor may not have been able to see much detail on your retina before, since the cataract would have been in the way.   I don't know if an epiretinal membrane or scarring can cause a color difference ('yellowish haze') or dimming, though.

You should return to the cataract surgeon with a written list of all of the vision problems you see with your right eye, and ask for the doctor's opinion of what is causing them.  

Since you are having symptoms you should probably not wait for weeks for your next followup visit - call and go back as soon as you can, if you have not already done so.  Please let us know what you find out.   Good luck!
7439659 tn?1390842306
Thank you so much for the quick response ... yes I have an appointment scheduled for late next week but I plan to call tomorrow to see if they can move it up for me. I agree that I don't want him to use the YAG without first being sure the cataract has been completely removed or if there is some other issue. I've been doing as much research as I can before seeing him (such as this site) to help me make an informed decision when I'm there. I will definitely post a followup after I see him. Thanks again for the input.
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