Cataract Post-Surgery Results

Posted , 11 users are following.

I had cataract surgery on my right eye on 10/24/2017 with a Tecnics toric monofocal IOL, standard blade surgery no femtolaser.

The vision in my right eye varied a lot for the first four weeks after surgery, some days rather blurry vision worse than 20/40 and a few days 20/25 or better. However the vision seems to be improving and stabilizing in the past two weeks since the post-surgery steroid and NSAID eyedrops were stopped.

Today is 6 weeks after the surgery and this morning my right eye vision was the best I've had so far - uncorrected it was better than 20/20, I could read the 20/15 and even the line below that (20/13) for short periods at 20feet distance.  I have been getting excellent distance vision the past couple weeks pretty stable, better than 20/25 all morning to early afternoon especially good outdoors in sunlight. 

However I've noticed my right eye vision degrades in lower light conditions such as driving at night - the signs on the freeway I have to be about half the distance away to read clearly compared to my left eye corrected with eyeglasses that seems to stay about 20/20-20/15 even under the night driving conditions.  But in good lighting especially in the morning the right eye is getting close to equal with my left eye's excellent corrected with eyeglasses vision.

I went to an optometrist at 4 weeks after surgery and got this distance eyeglasses Rx:

OD(right) = PLANO  -1.0D cylinder  115 axis

OS (left)  = -0.50D  -1.75D cylinder 177 axis

I believe the right eye's astigmatism that was measured at about -1D cylinder a couple weeks ago may have decreased at least in the first half of the day, it may be varying from morning to night.  So the eyeglasses I ordered with the above Rx may not to be updated again in a few months since my eye still seems to be healing and improving more.  I should get the new eyeglasses delivered later this week so it will be interesting to see if they improve my right eye's vision later in the day and evening to what I'm getting earlier in the day in good lighting.

 

1 like, 73 replies

Report

73 Replies

Next
  • Posted

    Glad to hear that your surgery worked out well.

    Please let us know how your new glasses work vis à vis different lighting conditions.

    Best wishes for the Holidays & New Year!

    Cheers!

    Report Reply
  • Posted

    Glad to hear the result. Mine is on 12 th of December. My left eye was done in 2016 for far distance Zcb00, +23 D (don't understand the calculation). I haven't decided yet whether to have mini micro mono or the same distance as the left one. And I need to decide..soon. Lens is going to be the same tecnis. 

    Report Reply
  • Posted

    Thanks for posting the update!  You must have read my mind; I'm posting a "results-only" thread so feel free to repost a copy or condensed version.  How is intermediate (computer) and near (reading/phone)?  Do you plan to get progressive lenses?  When the time comes, are you still thinking of setting the other eye around -1.25 as you mentioned earlier, or a Symfony? I also noticed my surgical eye was dimmer in low light initially, but think it's improved.  I'll have to pay more attention. 

    Report Reply
  • Posted

    Very happy for you Hawk.  Nice to see your vision turn a corner and stabilize.  Your post should give others hope when things aren’t clear right away.  I think doctors are often misleading patients into thinking all will be great within 25 hours.  I recall I was told I could go back to work within 48 hours and even though my vision was pretty good within 24 hours - eye tired throughout the day and vision varied.  I recall reading that it takes uncomplicated cataract surgery 6 weeks for complete healing .

    Congrats - what a nice Christmas gift!

    Report Reply
  • Posted

    So far my right eye is getting what I expected for intermediate (2-3 feet) and near (<24"wink vision.

    Since my right eye ended up spot on for good distance vision at Plano, I need about +1D for clear text computer monitor viewing (2-3feet) and +1.25D or more for smartphone and +2D for near fine print reading.

    Thats what I've used before the cataract surgery when I wore contact lenses for distance vision, so its pretty much the same so far.

    I ordered a new pair of progressive eyeglasses with the new Rx I got a couple weeks ago and they are scheduled to be delivered by this weekend, so I will find out how well they work hopefully then.  I have a +2D add on that pair for the near/reading part.  I also ordered a separate computer vision pair that is a single vision (not progressive) set with +1D added to the new Rx values of both eyes.  The most interesting thing will be if the astigmatism correction for the right eye works well or if its changed too much in the past couple weeks - it might not matter for bright light conditions in the morning, but I hope it will improve my right eye vision in the evening especially driving at night.

    Report Reply
  • Posted

    The new pairs of eyeglasses that I ordered 2 weeks ago based on the new optometrist eye exam Rx taken 4 weeks after cataract surgery on my right eye arrived today. I had ordered 3 pairs, a progressive pair, a computer vision (2-3feet distance) pair, and a reading (near) pair.

    The Rx for my right eye after cataract surgery with a toric monofocal IOL was:

     0D sph  -1.0D cyl  x115

    The left eye lens of course worked fine for all 3 pairs. But the right lens correction was way off as I kinda expected since I had noticed my right eye's uncorrected vision had improved over the past 2 weeks. Rotating the right eyeglasses lens >45degrees did help but not completely, so probably the astigmatism axis has changed and the cylinder requires is probably smaller now. 

    So it ended up no better or slightly worse for the right eye than uncorrected, so I will be returning the pairs for credit for a future order.  I'll probably wait a few weeks to see if my right eye remains stable before having to get another eye exam Rx, maybe early next month.

    Though other than for night driving, the vision in my right eye has been good uncorrected for distance during the day and inside, so I could just use zero Rx and then use simple adds for correction for intermediate and reading. Thats another alternative.  If as I believe that the right eye Rx is getting an even smaller cylinder value, I doubt even if it gets stable where I could correct it with eyeglasses that it would make a significant difference for the night vision - thats probably just due to some other issue with that eye or it may improve on its own after months more healing.

    So I'll have to stick with my old eyeglasses with the right lens popped out for awhile longer it seems...

    Report Reply
    • Posted

      Well on on hand a disappointment that the new glasses don’t work and tou’ll Have to get new prescription and order again.  On other hand seems that there had been big improvements in your vision.

      I can relate to having to go around with one eyeglass popped out!

      Report Reply
    • Posted

      Yes I ordered online thru Zenni as I have done for several years, took 2weeks and 1 day from when I ordered until the eyeglasses were delivered. Too bad I'll have to give up the nice 20% discount I got for the Black Friday sale when I ordered, when I return them for credit for a future order.

      I just experimented with the progressive pair and found if I tilt the glasses about 45degrees to the right (clockwise) that gives the best vision thru the right lens at 20feet, however if only gets it close to what I'm getting without any glasses in the right eye.  But this would indicate the proper axis for my right eye now is a little over 45degrees from the axis the optometrist came up with 2 weeks ago. The axis value in the Rx from 2 weeks ago was 115, if I add 50 to that its 165 which is what the axis was for my astigmatism before cataract surgery, I doubt thats a coincidence if tilting it to the right adds to the axis.  If so, then that would be more of what I expected in the first place that the toric IOL would reduce the astigmatism cylinder but not change the axis angle significantly.

      The cornea incision could add its own astigmatism and that could change as it heals, perhaps initially swamping the effect from the original angle. That might have been what was measured 2 weeks ago but since then the incision has healed more, indicated by my observed improvement and stability of uncorrected vision in the right eye over the past couple weeks. So now I may be very close to the original target for the right eye. The power appears to be between 0D and -0.25D because often a -0.25 lens does improve the 20feet distance vision slightly.  And the astigmatism cylinder must be lower than it was a couple weeks ago since I have observed improved uncorrected vision, especially in the mornings where today and the past several days its been better than 20/20. I suspect to be that good the cylinder must have reduced to -0.5D or less instead of -1.0D at a strange axis angle that the optometrist came up with two weeks ago.  If that is indeed the case, and the vision stays stable in the coming weeks, it may not be worth the trouble to try to correct -0.5D or less cylinder astigmatism in the right eye since it might keep varying slightly anyway.

      Report Reply
  • Posted

    I did an internet search with "astigmatism test" and found some online websites with some free astigmatism test patterns that can be viewed from the computer screen.  They are basically lines at various angles from horizontal to vertical and diagonals in between like spokes on a wheel.  Also a test pattern that is just a bunch of horizontal and vertical lines.

    With significant astigmatism, some of the lines at different angles will appear darker/thicker/sharper than others.  Without astigmatism, all the lines look the same.

    With my left eye (no IOL) that has about 2D cylinder astigmatism near axis 180 without eyeglasses, the vertical lines look dark and clear while the horizontal lines on the computer test pattern look gray and less clear. At other angles the lines appearances varies.  But with my eyeglasses correcting the astigmatism in the left eye, all the lines look about the same clear and dark at all angles.

    With my right eye (with the toric IOL) uncorrected all the astigmatism test patterns lines at different angles look dark and similar, close to how they look with my left eye with they eyeglasses correcting the astigmatism.  So I would conclude from these tests, that my right eye must now have a very low amount of residual astigmatism now.  I would think with 1D or more cylinder the test patterns would not look this good, so I suspect the cylinder is probably down to 0.5D or less now, which probably isn't worth trying to correct that small amount, if it stays there!

    Report Reply
  • Posted

    I was able to get a RA to return my order of eyeglasses and they are shipped back now for a 100% credit for a future order that I will probably do next month when I'm certain my right eye's Rx is stable.

    My right eye has had fairly stable vision for the past two weeks each day since then in the morning I'm getting  20/25 or better (at times as good as 2015).  So I believe the refraction is pretty close to -0.25D with very little residual astigmatism now (most likely 0.50D cylinder or less).

    The only issues I still notice is only outside at night.  When my pupil is at its maximum dilated size, outside I can sometimes see a thin jagged half-circle of light above some light bright light sources.  But if my pupil size reduces just slightly from max the half-circle halos disappear.  Also only in dim light like driving at night, I notice my right eye's vision is more blurry than during the day while my left eye stays sharp with ~20/15 vision.  Comparing the right eye (with the IOL) against my good corrected left eye driving at night I'd estimate I have to get at least half the distance to a sign on the freeway to read it clearly with the right eye compared to the left eye.  So the right eye is only getting effectively 20/30-20/40 I'd estimate at night with dim light, compared to near 20/20 with good light during the day inside or outside.

    This reduction in vision at night or dim light only with my right eye may not be related to the cataract surgery however, might be due to a different cause in that eye such as my early stage glaucoma in that eye, or perhaps a retina issue?  I'll have to ask the eye doctor to look closely for that at my next eye exam in a month or two.

    Report Reply
    • Posted

      Night Hawk does the contrast have anything to do with IOL?   I was thinking all IOLs had less contrast than eye’s natural lens and this is more noticed by younger patients.  I found menunreafing difficult in fancy restaurants with low lighting.  During 6 weeks when I had just one eye operated on the unoperated eye could read the menu whereas Symfony eye found the menu harder to read.
      Report Reply
    • Posted

      Well the Tecnis literature claims their IOLs have enhanced contrast senstivity but thats only their claim.

      I didn't think the IOL itself should reduce vision in low light conditions compared to a natural lens, in fact I expected the IOL would improve it since its clear and the old natural lens is yellowish-brown as it ages reducing the amount of light that can get thru?

      I don't know whats causing the reduced night vision in my right eye so I don't know if its a post cataract surgery effect that might improve in time like other night artifacts or if its caused by some other eye issue. I could have had that issue before the surgery, but wouldn't have noticed since the cataract made that eye very blurry day or night for the past couple years. 

      I'll just have to bring up this night vision issue up at my next full comprehensive eye exam with an opthalmologist in a month or so to find out if he can see any issues with the retina or something else. Fortunately nowadays I only drive at night once or twice a week and my left eye can take over since it gets excellent night vision still 20/20 or better corrected with eyeglasses.  The vision outside during the day in the sunlight with the right eye uncorrected is very good though the past couple weeks, at least thats what I get most of the time and indoors with good lighting and lighted screens like for TV watching and computer display.

      Report Reply
    • Posted

      That is a good question.  Optometrists text visual acuity in an ideal situation in a well lit room.  They don’t really test vision in situations where lighting is low.  The brochures for these lenses are produced by the manufacturers so not sure how forthcoming they are.  The one for Symfony sure didn’t highlight the concentric circles.

      Are you able to read well in dimly lit rooms?  IE candle light?   I have a work around using my iphone’s Flashlight.  At home the lamp next to sofa or bed do just fine for providing adequate light to read.  

      Report Reply
    • Posted

      @Night-Hawk, I left you a msg at BritKennel's discussion: "a YouTube video entitled "Symfony Lens" published on Oct-1-2017 by Steven Solomon, mentions about the glare and halos starting at 3:15 (of 8:34) point."

      From an article written by an eye-surgeon: "If your’re a taxi driver that drives at night for work the Symfony or Mplus lens may be the best option for you with occasional use of reading glasses."  smile

      @Sue.An, that is a brilliant idea. You might even make some money posting your 4-hour return trips on YouTube.

       

      Report Reply

Join this discussion or start a new one?

New discussion Reply

Report as inappropriate

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up