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
lin59 yulie93
Posted
Also, what this doctor did was really horrible (I'm not surprised though), but there was a good chance you would have developed early onset cataracts with ICLs anyway (I personally know people it happened to). Also, you did sign an informed consent, but you can try contacting an attorney to see if there's a case of malpractice here.
lin59
Posted
The right thing for this doctor to have done though is call off your surgery so you could have decided what to do, since ICL's can be removed, leaving your eye's natural lenses intact, and now you no longer have your eye's natural lenses (plus cataract surgery shouldn't be done until someone's vision is so bad that they can no longer legally drive and I'm sure he would have seen the cataracts during your pre-op exam in that case). I think maybe you should try for a malpractice lawsuit.
lin59
Posted
I re-read that you did get an ICL in one eye (I was skimming before). I hope you don't have any problems with it, but if you do, at least it can be removed.
miguel20862 yulie93
Posted
monofocals are the most popular choice because their less risky in terms of quality vision and generally just regarded as being “safer” among all the other type of multifocal/edof premium iols because of their simplicity which is a good thing. And more people seem to be unhappy about premium lens/multifocal lens then monofocals because they are expensive and tend to add additional unwanted side effects. I may end up choosing a monofocal over a premium multifocal lens because I’m a bit worried about ending up with permanent problems associated with those that seem to be very common. Although I’ am also worried about the thought of losing near vision with a monofocal but It’s a tough fix... I see a lot of comments on Facebook and here as well that people are very happy with monofocals and have quite a bit of range: maybe only have to rely on reading glasses for near. Perhaps that’s something that may improve for you over time. Please continue to share your experience! Best of luck
lin59 yulie93
Posted
I found a copy online of an example of a basic informed consent for ICLs (also known as "phakic IOLs"
. It's possible your informed consent also mentioned the possibility of needing to do refractive lens exchange (also known as clear lens exchange or the same thing as cataract surgery without cataracts or with mild cataracts) instead of the ICL procedure:
1. In most cases, the surgery will be accomplished with numbing drops, but in some cases the eye surgeon may elect to use an injection around the eye for anesthesia. Very rare complications from injections include damage to the eye muscles, perforation of the eye, and damage to the retina or optic nerve leading to loss of vision.
2. I understand that mild or severe infection is possible. Mild infection can usually be treated with antibiotics and usually does not lead to permanent visual loss. Severe infection, even if treated with antibiotics, could lead to permanent scarring and loss of vision that may require corrective laser surgery or, if very severe, corneal transplantation, blindness, or even loss of the eye.
3. I understand that I could experience damage to the iris (the colored portion of the eye) or develop a rise in the pressure in the front of my eye (secondary glaucoma). I may require another iridotomy or eye drops to control the pressure if this occurs.
4. I understand that I could develop a retinal detachment, a separation of the retina from the inside wall of the eye, which usually results from a tear in the retina and could lead to vision loss. Patients with moderate to high levels of nearsightedness have a higher risk of retinal detachment when compared to the general population. This risk level may be increased with implantation of the phakic IOL.
5. I understand that I may develop a cataract, or a clouding of the eye’s natural lens, which impairs normal vision, and may require removal of the lens, the phakic implant, and insertion of an artificial lens. Patients with high levels of nearsightedness are at higher risk for cataract development, and that risk may be increased with implantation of the phakic IOL.
6. I understand that I may develop corneal swelling (edema) and/or ongoing loss of cells lining the inner surface of my cornea (endothelial cells). These cells play a role in keeping the cornea healthy and clear. Corneal edema and loss of endothelial cells may result in a hazy and opaque appearance of the cornea, which could reduce vision. It is not yet known how much endothelial cell loss will occur and what effect the cell loss and phakic implant will have on the long-term health of the cornea. If too many cells are lost over time, I may need a corneal transplant.
7. I understand that I may develop glaucoma, which is an increase in the pressure of the eye caused by slowed fluid drainage. Glaucoma can lead to vision loss and may require treatment with long-term medications or surgery. Patients with high levels of nearsightedness are at an increased risk for the development of glaucoma, and that risk may be increased by implantation of the lens. The effect of the [phakic IOL] on the future risk of glaucoma is not known.
8. I understand that other complications could threaten my vision, including, but not limited to, iritis or inflammation of the iris (immediate and persistent), uveitis, bleeding, swelling in the retina (macular edema), and other visual complications. Though rare, certain complications may result in total loss of vision or even loss of the eye. Complications may develop days, weeks, months, or even years later.
lin59
Posted
And here's a list of possible complications from refractive lens exchange (also known as clear lens exchange) - the same complications as with cataract surgery that people have because they have no choice in the matter (and like I said, I personally wouldn't care if it says the risks are "exceptionally low" - I wouldn't do it unless absolutely necessary - and it also says this isn't even all the possible risks there are since it says the risks "include, but are not limited to"
:
RISKS OF REFRACTIVE LENS EXCHANGE SURGERY:
Since this surgery is essentially the same as cataract surgery, the same risks apply. As a result of the surgery and local anesthesia injections around the eye, it is possible that your vision could be made worse. In some cases, complications may occur weeks, months or even years later. These and other complications may result in poor vision, total loss of vision, or even loss of the eye in rare situations. Depending upon the type of anesthesia, other risks are possible, including cardiac and respiratory problems, and, in rare cases, death. Although all of these complications can occur, their incidence following RLE surgery is exceptionally low.
THE RISKS OF RLE INCLUDE, BUT ARE NOT LIMITED TO:
1. Complications of removing the natural lens may include hemorrhage (bleeding); rupture of the capsule that supports the IOL; perforation of the eye; clouding of the outer lens of the eye (corneal edema), which can be corrected with a corneal transplant; swelling in the central area of the retina (called cystoid macular edema), which usually improves with time; retained pieces of cataract in the eye, which may need to be removed surgically; infection; detachment of the retina, which is definitely an increased risk for highly nearsighted patients, but which can usually be repaired; uncomfortable or painful eye; droopy eyelid; increased astigmatism; glaucoma; and double vision. These and other complications may occur whether or not an IOL is implanted and may result in poor vision, total loss of vision, or even loss of the eye in rare situations. Additional surgery may be required to treat these complications.
2. Complications associated with the IOL may include increased night glare and/or halo, double or ghost images, and dislocation of the lens. Multifocal IOLs may increase the likelihood of these problems. In some instances, corrective lenses or surgical replacement of the IOL may be necessary for adequate visual function following RLE surgery.
3. Complications associated with local anesthesia injections around the eye include perforation of the eye, destruction of the optic nerve, interference with the circulation of the retina, droopy eyelid, respiratory depression, hypotension, cardiac problems, and, in rare situations, brain damage or death.
4. If a monofocal IOL is implanted, either distance or reading glasses or contacts will be needed after RLE for adequate vision.
5. Complications associated with monovision. Monovision may result in problems with impaired depth perception. Choosing the wrong eye for distance correction may result in feeling that things are the “wrong way around.” Once surgery is performed, it is not always possible to undo what is done, or to reverse the distance and near eye without some loss of visual quality.
6. Complications associated with multifocal IOLs. While a multifocal IOL can reduce dependency on glasses, it might result in less sharp vision, which may become worse in dim light or fog. It may also cause some visual side effects such as rings or circles around lights at night. It may be difficult to distinguish an object from a dark background, which will be more noticeable in areas with less light. Driving at night may be affected. If you drive a considerable amount at night, or perform delicate, detailed, “up-close” work requiring closer focus than just reading, a monofocal lens in conjunction with eyeglasses may be a better choice for you. If complications occur at the time of surgery, a monofocal IOL may need to be implanted instead of a multifocal IOL.
7. If an IOL is implanted, it is done by a surgical method. It is intended that the small plastic, silicone, or acrylic IOL will be left in the eye permanently.
8. If there are complications at the time of surgery, the doctor may decide not to implant an IOL in your eye even though you may have given prior permission to do so.
9. Other factors may affect the visual outcome of RLE surgery, including eye diseases such as glaucoma, diabetic retinopathy, and age-related macular degeneration; the power of the IOL; your individual healing ability; and, if certain IOLs are implanted, the function of the ciliary (focusing) muscles in your eyes.
10. The selection of the proper IOL, while based upon sophisticated equipment and computer formulas, is not an exact science. After your eye heals, its visual power may be different from what was predicted by preoperative testing. You may need to wear glasses or contact lenses after surgery to obtain your best vision. Additional surgeries such as IOL exchange, placement of an additional IOL, or refractive laser surgery may be needed if you are not satisfied with your vision after RLE.
11. The results of surgery cannot be guaranteed. If you chose a multifocal IOL, it is possible that not all of the near (and intermediate) focusing ability of your eye will be restored. Additional treatment and/or surgery may be necessary. Regardless of the IOL chosen, you may need laser surgery to correct clouding of vision. At some future time, the IOL implanted in your eye may have to be repositioned, removed surgically, or exchanged for another IOL.
12. If your ophthalmologist has informed you that you have a high degree of hyperopia (farsightedness) and/or that the axial length of your eye is short, your risk for a complication known as nanophthalmic choroidal effusion is increased. This complication could result in difficulties completing the surgery and implanting a lens, or even loss of the eye.
13. If your ophthalmologist has informed you that you have a high degree of myopia (nearsightedness) and/or that the axial length of your eye is long, your risk for a complication called a retinal detachment is increased. Retinal detachments can lead to vision loss or blindness.
14. Since only one eye will undergo surgery at a time, you may experience a period of imbalance between the two eyes (anisometropia). This usually cannot be corrected with spectacle glasses because of the marked difference in the prescriptions, so you will either temporarily have to wear a contact lens in the non-operated eye or will function with only one clear eye for distance vision. In the absence of complications, surgery in the second eye can usually be accomplished within 3 to 4 weeks, once the first eye is stabilized.