Abrupt cataract surgery during ICL surgery,now I am so depressed
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I am 25 years old. I've been wearing glasses since childhood with both myopia and quite a bit of astigmatism. Now that I've reached my mid-20's I decided to undergo vision correction surgery and decided to go with the ICL implantable lens surgery. The surgery was scheduled for yesterday and something unexpected happened during the process: my doctor said he suddenly discovered cataracts in my right eye around the periphery of my lens and he asked me if it was okay to undergo instant cataract surgery,just like that! I was lying down helpless with my eye already numb and feeling dizzy and said yes,since I large. He said that from what he sees he suspected I will have to undergo cataract surgery in less than 10 years time and it was better for me to do it now since then I wouldn't have to undergo surgery again. For my other left eye he just performed the ICL surgery as scheduled. After the surgery I found that for my right eye which underwent catarct surgery, I could see almost clearly for some distance but virtually nothing up close; reading a book is unimaginable for me at the moment. The doc said this was something that comes with cataract surgery and that it will improve over time, especially if I get used to seeing closeup with my other eye. But this is a total disaster for me! I am only 25, and I hadn't felt ANY issues of cataracts affecting my vision whatsoever. I only found out that cataract surgery involves replacing your natural lens with another one and that different types such as single or multifocal lenses exist, AFTER the surgery had finished by googling. All I wanted was a perfectly simple ICL surgery,not some surgery that takes out my perfectly working natural lens thanks to which I now can't read anything up close and it isn't even reversible.
Okay enought with the ranting..Will someone here be able to tell me if this problem of not being able to read up close with my cataract eye will likely improve over time, especially considering my young age? I'm guessing the lens I got implanted is the monofocal one with sight set to distance,since I can't see anything up close. Any other tips or suggestions will be appreciated..I am a web developer and use my laptop alot so I am very worried...Thanks in advance
0 likes, 25 replies
ingrid63168 yulie93
Posted
yulie93 ingrid63168
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Shrimpie yulie93
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michael74313 yulie93
Posted
Hello - let me tell you my story along with some suggestions for you. Like you, I'm also a software developer and I know exactly how you feel because I felt that way after the first eye was done. I had planned cataract surgery (I'm in my mid 50's which is still somewhat young for cataract surgery). Anyways, after my doctor did my first eye set mono focal lens for distance I too had a terrible time seeing things up close. I was really worried. So my doctor suggested that for the second eye, we set it for distance but he also advised to go in slightly biased to near (1/2 diopter in). By doing "mini-mono vision" I would have a much better ranger of vision. I think, usually, in about a week, you get about 90% of what you're going to get but there are many options still. After he did the second eye, both eyes working together see fantastic. I see up close as well as mid-range and distance. Because my eyes are set to mini-mono vision, both eyes work together and I see better at all ranges with both eyes than any one eye individually.
With all that said, I will say that before surgery, I was very near sighted and I needed glasses for anything mid range or distance and even then it was getting more difficult to see (due to the cataracts). Before surgery, I could see things around 5-7 inches from my eyes (when reading). Now, since I don't want to use reading glasses, I usually hold items around 16-20 inches away. So, it's a matter of reprogramming your brain to hold things a little further away to read unless you want reading glasses. Over time, it just gets easier. I just could not believe how much easier it got (for both eyes) when he set the second eye 1/2 diopter in from distance. Some have it set as much as 1 diopter in but I would not advise going more than that since there's an error factor. Also, I'm not sure how close you sit to the laptop or the computer. It's not good to sit too close as it can cause dry eyes over time.
Your situation is a little more tricky because you are a lot younger which means over time they are going to have better inter ocular lens. The problem today with the multi focal lens is many complain of night vision halos and glares and the contrast is not as good as a mono focal lens. So, it's hard to say whether to hold off on the second eye or not and a "lens exchange" is a more involved procedure. For me, after the first eye was done, my eyes were so out of whack (full mono vision) I wanted the second one done even though the cataract in the second eye was not too bad.
You should find out if you have a mono focal lens, what kind it is and what it was set to (distance, mid-range, etc). You still have many options. First, I don't know how long ago you had the surgery and it can take up to six weeks or more for full healing. If you are still not happy then it's possible to do a "laser tweak / lasik" on your cornea to bring your vision in more so you can see better up close. So, all is not lost. A lens exchange is another option but that's a lot more involved than a simple laser tweak. You could also try reading things further away as I have done (I used to always hold things around 5-7" from my eyes. It was like second nature and that "sweet spot" was just so ingrained. Now I pretty much have reprogrammed my brain to hold things further out. There are many options for you - no need to panic but I do know the anxiety your feeling.
Take it slowly and I would not rush to do the second eye until you have researched all your options. There's no way to know what awesome lenses they will have in the future and it's more involved to do a lens exchanged than when doing it the first time around. But, your eyes will adjust. I honestly wonder if my cornea has naturally adjusted somewhat because I've been reading without reading glasses for around 8 months now.
You know - something else, you said you can see "almost clearly" at a distance. I'm wondering if you had a Toric mono focal lens put in (if you have an astigmatism). If the lens shifted slightly then that can affect your vision at all ranges. I had that problem with my first eye, but it only shifted a little bit. If that happened to you and yours shifted more than a bit then your vision might be blurred at all ranges. I believe that can be fixed either surgically by moving the IOL or by a simple laser tweak on the cornea or with glasses or contact lens.
Perhaps others have more input and advice but you'll have to provide us with more information on what you've got (toric lens? mono focal? set to distance? diopters? etc.) and when it was done. But, like you I was extremely worried for several weeks. Things got better when I noticed that at least I could (if I needed to) see clearly with reading glasses. Nowadays, I absolutely LOVE being able to just lean back in my chair about 3.5 feet from my ultra wide screen monitor and see it as clear as day. The point is, in this day and age if you have a really good doctor, they will make sure your satisfied and there are many ways to correct things if they don't get better in time.
Last bit of advice - make sure you have a great ophthalmologist.
michael74313 yulie93
Posted
Sorry - just noticed at the beginning of your post that you say you do have an astigmatism (as I also do or did). So, it's quite plausible that your doctor did use a toric mono focal lens. If so, then it's also possible that it did shift slightly and/or you had the astigmatism altered during the surgery (which can happen). But, with the "ora based surgery (which I don't know if your doctor did), helps to maximize your outcome (best focus).
Anyways, if that is the situation, then it can easily be corrected with glasses, contact lens, or a laser tweak. Let us know how long it has been since your surgery. I have two mono focal lens and the second eye was done 1/2 diopter in so that I get slightly better all around vision. At my last checkup a month ago, I was seeing 20/20 in my left eye and 20/25 in my right for distance and 20/30 for near (I could read an 8 point font). There is no way I could have done that If I had not held things further away for six months and read them without glasses. 98% of all my reading is without reading glasses. I think it just continued to get better over time because I resorted to doing it that way rather than quickly reaching for glasses.
You'll have to check with your doctor if you have a toric lens and if it shifted a bit. Or maybe you just have to wait longer for more healing. If it is very minor shift as was mine then if you get the second eye done right, both eyes could see great. But again, it just depends on your situation and your doctor. Good luck to you.
cora06849 michael74313
Posted
Michael, thank you for your wonderful detailed replies to Yulie's questions. I have learned more from reading your response, clearly expressed, than I have from many others.
I'm nearly 70, cataracts in both eyes, very near sighted and barely able to drive in sunlight or at night because of glare, it's even painful to go outdoors on bright days. Like both of you I treasure my near sight not just for reading but especially for handicraft. So much of what you said has clarified the options for me, and I'll be much better informed when I finally get to see someone to discuss my situation. Sadly my optician has not yet referred me (obviously she doesn't consider them bad enough) and I won't see her again for another 6 months.
Thanks again for your informative words.
at201 yulie93
Edited
I am very sorry to learn about your ongoing bad experience due to an unexpected cataract surgery.
I think that the surgeon just picked a lens with random prescription to use during your cataract surgery since he probably hadn't done the required measurements in the eye.
If he were really a honest surgeon, then instead of saying that:
".. this was something that comes with cataract surgery and that it will improve over time,,."
he should have said:
"Sorry that I had to take a wild guess at your IOL prescription (or out of the lenses at hand, I tried to pick the one which will work best for you) and that it turned out to be quite a bit off."
Any way, it seems that the only thing you can do right now is to wait about a week, get an actual prescription to judge exactly where your eye is (it will be close to what you will end up at, even though it will change slightly more over the next few weeks). You may be able to adjust that to the desired value with PRK or LASIK.
michael74313 at201
Posted
You know - something else I question is whether it's unusual for doctor to discover a cataract right in the middle of a surgery. I would think these things are easily seen during a routine exam. My doctor discovered mine years before I had surgery. He also said at that time it was not necessary to do any kind of lasik or PRK because I'm just going to need cataract surgery in the next few years. He was 100% right. Perhaps the original poster might want to seek a second opinion on his situation.
While at201 posts about correction with PRK or Lasik, I would just be 100% certain the doctor you choose is very experienced and has a great reputation.
Sue.An michael74313
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yulie93 at201
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Thank you for your response. Yes thats exactly how I felt after the surgery when the doc said it was 'something that comes with cataract surgery.' I hand no such information beforehand and had I known, I would definitely have put off the refractive lens exchange for later as I didn't even know I had cataracts let alone suffer any vision problems from it. I just did it because the doctor said something like 'well since you're already on the operating table and all..you might as well get rid of these cataracts..' Anyway what is done is done..it's sad because had I just gone with the ICL as originally planned I could have undergone refractive lens exchange much later in life when the cataracts ACTUALLY became a problem for me. Because ICL lenses are reversible - they can be taken out anytime. But for cataract surgery, your natural lens is now gone forever.
yulie93 michael74313
Edited
Thank you for your lengthy responses Michael. As for the operation date, it's only been two days so I probably shouldn't be making hasty conclusions as of yet..but I am just devastated that even now as I'm typing this on my phone I can only read with my left eye - my right eye which had cataract surgery is practically blind reading anything up close.
As for the type of IOL, I'm sure he used a traditional monofocal lens instead of toric, and corrected my astigmatism with limbal incisions. That's how he corrected astigmatism in my left eye which just had the ICL implanted as scheduled. As for the left eye, there are no plans to have cataract surgery in the near future because it was only the right eye which was starting to develop cataracts.
And yes, I do think it's strange that he only discovered the cataracts during surgery. When I asked him later why they weren't discovered beforehand,he said it was because during surgery the pupil was more fully dilated so he could see more clearly. What I suspect is then, if the degree of the cataracts was such that it could not be detected beforehand and only during surgery, it surely would have been mild or only just starting to develop - I cannot but keep asking myself, did I really need to get it out at this stage, since I was 'already on the operating table and all?' It seems to me that getting on with the normal ICL vision correction surgery for myopia and astigmatism would have been much better, even if it meant I would have to come back for cataract surgery some 10 or 20 years later.
Anyway, what consoles me is your experience that overtime your near vision got better...I desperately hope that would be the case for me too. Thank you
Shrimpie yulie93
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My lenses were made to order in accordance with measurement & diagnostic screening that was done by the laser vision hospital I went to
lin59 yulie93
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I'm way older than you and got standard non-toric monofocal IOLs set for distance in both eyes for my cataract surgery in August 2017 and September 2017. I can read all but the teeny tiniest print without glasses, plus I see fine to drive without glasses and see my car's speedometer without glasses. It definitely took around a month for my vision to get to its clearest reading vision though. I have also read about numerous other people who had the exact same result as me, so it's not a rarity, but instead it's the norm (I also found studies online to back this up).
The problems you are having are one of the reasons why I don't recommend anyone get any form of refractive surgery including LASIK, LASEK, PRK, ICL, RLE/CLE, Relex Smile, etc. (whether before cataract surgery or after cataract surgery - I know people who have serious permanent complications from these procedures that were done either before or after cataract surgery, but I know people determined to get these surgeries won't listen to any warnings, so I know I'm pretty much wasting my time writing this), aside from the possibility of ectasia, retinal detachment, chronic cystoid macular edema and various other possible permanent complications ranging from chronic dry eye to floaters, etc. that can occur right away or years later. In the case of ICL and RLE/CLE, artificial lenses installed inside your eye are never as good as your eye's natural lens.
michael74313 lin59
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Hi Nina - I don't recall what the doctor set your mono focal lens to. Mine were set to distance and the second eye to 1/2 diopter in. I definitely think one will get much better results with a mono focal lens if both are set from 1/2 to 1 diopter apart and with that little amount of mini mono vision, it should not affect depth perception much at all and should be very tolerable.
All those complications you mention are all the more reason one should really make sure they have confidence in their doctors. But, I would also tend to think (as it has been said) what we all read on these forums could be more of the minority given that most who are satisfied won't post at all or even look to the internet given the number of cataract surgeries performed every year. Most are VERY satisfied. But, I could also argue that most are in their mid-late 60's and their sight is probably awful and some could be considered blind. So any vision improvement is a welcome change.
yulie93 lin59
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Thanks for your response Nina. I'm glad to hear that your near vision improved over time after cataract surgery. It's really the only thing I can hope for since this surgery can't be undone.
lin59 yulie93
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You're welcome yulie.
lin59 michael74313
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lin59 michael74313
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And about possible complications, I personally wouldn't care how low the complication rate is supposed to be. I wouldn't take the risk of ruining my eyes with totally unnecessary refractive surgery after the things I have learned firsthand from people with complications from all types of eye surgery done solely to correct their vision and avoid wearing glasses or contact lenses. I say this because these people have complications ranging from chronic dry eye costing hundreds of dollars a month for eye drops to incurable pain and actual eye loss (before I read these stories, I also thought those complications were very rare, but they're not as rare as they're reported to be). Also, the doctor the person goes to doesn't matter either, since many of them went to "top" doctors and paid a lot of money for their procedures.
lin59
Posted
And even if the risk of complications is statistically "low" or even said to be "rare" I personally wouldn't want to risk my eyesight no matter how low the risk is supposed to be. The problem is most people don't even understand all the risks, but that's the fault of doctors for not explaining the risks clearly and in detail in the informed consent procedure and letting people make a decision in more than a split second as to if they want to go through with the surgery or not. Anyway, to each his own.