Blurred vision and shadows after lens replacement

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i had lens replacement surgery a week ago.  Before surgery my distance vision was very good but I couldn't read a thing without glasses. Since surgery I can read the smallest of print but can't see further than a couple of metres before everything goes out of focus. I also have a shadow at the corner of both eyes so feel like I'm wearing blinkers. Has anyone had the same experience and if so does it improve at all without the need for further surgery. Any advice appreciated. 

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  • Posted

    My surgery was in February. I had reasonable near sight and 'good' distance. Now everything is blurred, distance is terrible and for reading I cover the operated eye and use my old glasses

    I think the lens size has been miscalculated and the wrong lens put in. I am seeing another ophthalmic surgeon at another hospital hopefully to get my sight restored

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    • Posted

      That doesn't sound good. Unfortunately I have had both eyes done and am wondering if they got my prescription wrong.  I'll see what they say when I go for my check up. Hope all goes well for you and you get sorted. Keep me posted. 
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    • Posted

      It sounds as if you have a secondary cataract if your vision was good immediately after surgery.  Most doctors want to give the eye 6-8 weeks for the eye to heal before removing a secondary cataract. This procedure is minor compared to what you went through before.
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  • Posted

    Your expecations are perhaps unreasonable.  It is not unreasonable for your eyes to take a few months to settle down just from the trauma of the surgery.  Also, you make no mention of the type of lens that you had inserted?  Were they plano lenses?  Were you near-sighted or far-sighted before the surgery?    
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    • Posted

      I have been fitted with the symfony multi focal lens.  I had presbyopia so couldn't read anything but distance was never a problem until now.
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  • Posted

    It sounds as though the lens power may have been off and left you nearsighted, myopic. Unfortunately there isn't an exact formula for calculating the lens power required, the formulas are merely estimates based on statistics of the eye measurements of past patients and what lens power worked for them. They work well for most people, but they can be off for a minority of patients. After surgery however it is possible for the lens to shift position a bit during the initial healing process, which can make you more or less myopic, which is why they tend to wait a few weeks before determining whether to prescribe correction. So it is possible your vision will get a bit better... or worse. Unfortunately its likely the case that you were left too myopic.

    If you are myopic, they can either correct it using glasses/contacts or laser correction, or a lens exchange to a better power lens. 

    The shadow is likely what they refer to as a dysphotopsia (if you wish to google it), which people's brains usually tune out over time so its likely nothing to worry about. It is best to have the doctor try to be sure what the cause is though to make sure that is the issue, rather than say the lenses not being positioned right and needing to be repositioned. In the rare cases where it doesn't go away over time, they sometimes consider a piggyback lens or lens exchange. 

     

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    • Posted

      I have been left with an astigmatism something I didnt have before. It is difficult walking on uneven ground, as on woodland paths or in my allotment as the ground appears to move. I have to close my op eye for safety. 

      I also have a cloud with black spots in on the right side. These are not floaters as they have remained in the same place since the op. 

      My sight is so bad I have been told not to drive until it is corrected

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    • Posted

      i have googled dysphotopia and it seems there are mixed reviews, some say it settles over a few months and some say a couple of years or never without intervention
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    • Posted

      I think it depends on the type of dysphotopia. My sense is that you get used to positive dys.  but not so easiy negative dys (which is what I think you have).
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    • Posted

      Each person is different, the articles by surgeons that I've seen suggest that most see dysphotopsias go away within the first few weeks/months, with a minority taking years, and some never without treatment. Its not something that can be predicted unfortunately. Any treatment option involves some risk so people tend to try to see  first if they adapt, unless the problem is too disruptive of their lives. Its also best to confirm with the surgeon that is what the issue is, vs say the lens being positioned wrong (which seems unlikely) or something else. btw, I also have Symfony lenses, and although some descriptions lump them in with multifocals, they are considered to instead be in the new category of "extended depth of focus" lenses. In my case one eye was right on target, plano, 0D, while the other was unfortunately left just slightly farsighted, hyperopic, +0.5D, which reduces its near vision a bit.   I get enough near vision from my plano eye that I hadn't bothered with a laser tweak for the hyperopic eye, ideally I'd have that eye be slightly myopic, -0.5D to give a bit more near without much impact on distance.
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    • Posted

      Sorry to hear about the spots, I don't know what that could be offhand if they aren't floaters. I vaguely recall someone may have posted recently about spots that were related to a retinal issue, perhaps they were there before but you just couldn't see them until after your cataract surgery cleared your vision. If your current doctor can't explain them, you might consider getting a 2nd opinion, perhaps from a retinal specialist if that might be an issue.

      Astigmatism can be corrected via laser or a blade incision, or of course just with glasses or contacts. 

      In an eye with a natural lens there are actually 2 major sources of astigmatism: the natural lens and the cornea. Sometimes they have astigmatism in opposite directions that balance each other out so you don't have any noticeable astigmatism that needs to be corrected. In that case   when the natural lens is removed, the counterbalance is gone and you are left with astigmatism from the cornea. That might be what happened in your case.

      Sometimes they can't predict that well beforehand since there are actually 2 parts of the cornea that can have astigmatism: the front, anterior, and the back, posterior. In the past most measuring machines only dealt with anterior astigmatism since that is usually where most of it is and they didn't think the posterior astigmatism was enough to worry about. The   last few years they've realized there can be posterior astigmatism that is problematic that  they weren't measuring, so newer equipment will measure it, but  not all surgeons have the latest equipment to measure it.

      Also surgery itself can induce some astigmatism, but with modern surgery its usually small and not a concern (and they try to plan the surgical incisions to counterbalance any minor existing astigmatism rather than adding to it, but if they didn't measure the posterior astigmatism then they might have gotten that wrong).

       

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    • Posted

      As a retired nurse with 50 years experience, I took note of and researched the surgery and its risk before I had surgery. This was never mentioned as a risk. No mention of it was made at the hospital prior to surgery or I would have noted it. I am unable to see distances or near for reading.

      I am seeing another ophthalmologist at a regional eye hospital on Thursday and hope to have the lens replaced with the correct one.

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    • Posted

      I live in an area that has 2 eye centres, I went to the one that had the easiest transport to. Last November they carried out 900 cataract ops, they say they have the latest equipment. The one I am going to is the regional Eye Infirmary so hopefully they can correct. 

      I am using a 17' laptop. With post op eye I see with +300 zoom and glasses with new lens to read it with the other eye I have my normal glasses So for most things, TV or reading one eye is covered

       

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    • Posted

      If the issue of spots is a retinal one, that is a different speciality than cataract surgery and may  require different cataract surgery.

       Part of the issue in terms of astigmatism&lens power is that people's standards have risen over the years. Decades ago merely getting rid of the cataract was a "success" even if someone needed to wear correction afterwards, since the purpose of the surgery was to get rid of cataracts. Now people are expecting to not need glasses, but some doctors don't consider "needing glasses/contacts or laser correction" to be a "risk", even if many now expect that result.

      In terms of the astigmatism, unfortunately its treatment isn't yet an exact science because people's eyes heal differently. An incision can lead the eye to change its shape, but how much it changes can vary with each person, even aside from the issue of measurements of the astgimatism. They have approximate guesses as to what sort of incision will have what impact, but it varies by person.  Of course there is always the possibility of human error as well, a mistake. If you research "surgically induced astigmatism" you'll see that it used to be more of an issue back when cataract surgery required large incisions, but modern micro incision surgery doesn't usually induce much change, and as I said its usually planned to counterbalance the existing astigmatism if there is any (or not add much if there isn't).

      Some people mean different things by the latest equipment, its only the last few years that posterior astigmatism has become an issue  so even fairly modern equipment may not deal with it (if you research "total astigmatism" and/or "posterior astigmatism" and cataract surgery you'll  see discussion of the issue). In terms of the spherical power of the lens, you'll see recent argticles talking about advances in IOL power calculation since it is still a research topic, they select the right power lens for most people, but some people are unlucky and the power is off depsite their best efforts. (though again of course there can be human mistakes, e.g. the lens power they calculated isn't the one they ordered, or the one they placed in the eye).

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    • Posted

      oops, odd typo, missing words  in that first sentence. I meant a retinal specialist may require different scanning equipment than that used for cataract surgery, even if they usually do basic retinal scans prior to cataract surgery. I'm not familiar offhand with what they might have, I'm just a lay person who has done their research. (I'm not from a medical field, but I've been on the net for a few decades so I'm used to reseraching things).
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    • Posted

      i go back for my check up Wednesday so I'll see what they say about my prescription. I would like my distance to be clearer but not sure I'd want anymore surgery
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