Cataract Post-Surgery Results
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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, 75 replies
Night-Hawk
Posted
I found a chart showing typical eye pupil size (day vs night) at various ages:
Eye Pupil Size (mm) versus Age
Age Day Night
20 4.7 8.0
30 4.3 7.0
40 3.9 6.0
50 3.5 5.0
60 3.1 4.1
70 2.7 3.2
80 2.3 2.5
So my night vision issue seeing half circles around some bright lights that only happens at my current max pupil size on a dark night outside that goes away if my pupil size shrinks very slightly, should hopefully go away completely as my eye ages. Possibly in less than a year my max pupil size may shrink enough naturally so I won't see the half circles anymore, except when the eye is artificially dilated with eyedrops for a dilated eye exam, but that lasts only for a few hours thankfully.
Night-Hawk
Posted
I just did a quick measurement of my right eye's pupil size using a 7x magnifying mirror, a small ruler designed for measuring PD, and as little light as possible and got about 5mm. And it probably gets a little bit larger with more reduced light. Thats getting pretty close to the optical diameter of my IOL (6mm) so it makes sense if it gets close to that diameter IOL edge reflections from some lights could cause the effects I notice only when my pupil size is at its max.
My pupil size currently seems quite a bit larger than typical for my age (63), its more like that of a typical 45-50 year old from the chart. I wouldn't see the nighttime effects at all if my pupil size gets just slightly smaller. I bet that cataract surgery patients younger than 50, would be more susceptible to this type of nighttime effects than older patients that have smaller pupils.
Night-Hawk
Posted
Its now a little over 4 months since the cataract surgery in my right eye. I had another office visit with my eye doctor yesterday and as usual first a tech does an autorefraction and pressure check. I got a copy of the results.
It also showed my pupil size as about 7mm, so that is a bit larger than expected for my age (63), so probably explains the little half circle think arc of light I see sometimes above bright light sources when my right eye is dilated at night, since thats a bit larger size than the optical diameter of the IOL which is about 6mm. Hopefully as I age my eye's pupil will get a bit smaller and the effect will disappear completely.
The latest autorefraction for my right eye yesterday came out about 0 to +0.25D power and -0.50D to -0.75D cylinder residual astigmatism. So pretty close to the estimate I'd expect with my getting usually 20/20 to 20/25 distance vision in that eye during the day the last couple months. I'd doubt I could get significant improvement with a full optometrist refraction with an eyeglasses correction trying to eliminate that relatively small cylinder of astigmatism since I think it varies a bit daily.
My eye pressures have been remaining close to the same range it was the past couple months measured at the eye doctor office visits I've had over that time, compared to that prior to my cataract surgery. I'm still getting about 15-16 IOP in my right eye. So it doesn't look like I will get any significant IOP reduction from the cataract surgery in my right eye, though typically some get about 4 points reduction from that, but not everybody...
Night-Hawk
Posted
At the eye doctor office yesterday I could only read the 20/25 line clearly with my right eye, my left eye could read the 20/20 line corrected with eyeglasses. Whereas at home I can usually read one line smaller than that which each eye using a standard eye chart at 20feet.
I did try a drop of lubricating eyedrop in my right eye yesterday and for a minute or so at the doctor's office it improved my right eye vision to be able to read the 20/20 line clearly, but didn't last long. I've notice that effect at home too, an eye drop will often improve my vision for a short while after. So my dry eye condition though it doesn't bother me in terms of eye comfort apparently does affect my visual accuity results somewhat.
Sue.An Night-Hawk
Posted
Read your comments about pupil size. Wondering how common it is for people to have pupils bigger than IOL size and if IOLs should come in larger size. Some people really find that edge glare or arch very annoying. Read many comments from patients who feel totally dismissed by their doctors about seeing the edge of the IOLs. one shouldn’t have to wait for years for pupil to decrease in size for that annoyance to go away. Was reading an interesting article about cataracts and the trend of younger and younger patients is on the rise. Personally I think it has to do with the sun. It certainly accounts for younger and younger patients getting skin cancer so I can only imagine what the sun does to eyes. So if patients are getting cataracts younger and generally their pupil size is larger I wonder if we will see IOLs come in 7 vs 6mm.
Aside from that does sound like your results are very acceptable and serving you well.
Night-Hawk Sue.An
Posted
I've been taking a good quality Omega 3 pill daily for a couple years, but I don't know if its helped the dry eye at all. I never have had any eye discomfort issues from dry eye, I wouldn't even know I had it except the eye doctors can see that the cornea is dry when they look at it with the close up lamp. I think the only rare times I felt real dry eye symptoms were on a day when the air was super dry with very low humidity. But I have been using various lubricating drops for the past year daily in any case, since it might help stabilize my variable vision in my right eye. The type that seems to help the most without causing blurriness is Nanotears gel drops, they have several variations, I lately got the ones for more severe dry eye. Works better for me than the big name brands like Refresh and Systane, and its lower price online too.
My right eye vision is excellent outdoors in good sunlight and pretty good indoors too now, 20/20 or better in the morning and maybe 20/25 in the mid-late afternoon. Not as good driving in the dark where it is probably 20/30-40, but my left eye is still 20/20 corrected then so it makes up for it - I wouldn't notice it unless I close one eye to compare the distance I can read road signs at night. But fortunately I only drive at night maybe a couple times a week, and with both eyes its not an issue.
I find whats working for me well is using my older eyeglasses pairs with a progressive lens correcting my left eye with its still good natural lens and no lens for the right eye. I tried a cheap pair with progressive lenses in both eyes but I couldn't get used to it even after 3 weeks since the overall focused area was too narrow for me. If I paid for expensive high quality progressives it would probably work, but I don't want to spend so much right now. Since I'm getting good results with only the left eye having a progressive (multifocal) lens and the right eye uncorrected for decent distance vision with clear vision at all angles for that eye.
I figure that is similar to what I might expect if I eventually got a Symfony toric IOL for my left eye in the future. I also have a pair of my older computer single focus glasses again with the right eye lens removed, so that is similar to what I might expect with mini-monovision like a monofocal in the left eye with a little nearsighted -0.75D. That too works well inside for watching TV, in the kitchen I can read labels, computer work, etc. Only rarely need reading glasses for fine print with the "monovision" pair, and not at all with the progressive one eye pair.
So I think what I may do next is order a cheap single vision distance pair of glasses with the same frame of my existing progressive pair and just move the new right lens into the old frame to go with the existing left eye progressive lens - better than having no lens so it doesn't look strange and then I get UV filter too. At most I would only need a small cylinder like -0.50D for the right eye with plano power.
Night-Hawk Sue.An
Posted
I noticed an interesting thing today.
While using a red laser light that produces a red spot on the wall (cats like to play and chase it) - I observed that when I view it with my eyeglasses correcting the 2D astigmatism in my left eye with the natural lens it looks like a small circle red spot with a faint cloud of red around it.
Similar with my right eye with the toric monofocal IOL which has only a little residual astigmatism.
But if I view the red spot with my left eye without eyeglasses, it turns into a small vertical line!
So that must be an easy way to test for significant astigmatism and the angle of the line must relate to the axis value, in my case my left eye axis for astigmatism is close to 180degrees.
I then looked closer at the red laser spot with only my right eye with the IOL and could notice a very slight stretch at an angle, so that is probably due to the small 0.50D to 0.75D cylinder left in that eye.
The laser/flashlight I was using also has a mode to be used as a flashlight either white or blue-ish. When I used its blue-ish mode from a distance it appeared like it was actually producing more of a violet light on the wall and I couldn't see it nearly at all with my left eye with the natural lens but very easy to see with my right eye with the clear IOL. That makes sense since an older natural lens turns yellowish and blocks a lot of the blue/violet colors.
If you have or can get a simple red laser pointer or simliar, would be interesting to see what others see to compare.
Sue.An Night-Hawk
Posted
Night-Hawk
Posted
I've now passed the 6month mark since my right eye cataract surgery.
In the past few months, I've only had maybe one day a month or so where my right eye vision was more blurry than normal which is usually about 20/25 (sometimes a little better or worse at times during the day/night).
I believe now that dry eye is primarily responsible for any variable vision I've had in that eye so I've been using eye lube drops several times a day plus an Occusoft eyelid antiseptic cleaning pad once every other night or so and that seems to help keep the eye's vision more stable.
I'm not bothering to try to correct the right eye's small residual astigmatism since I think it varies some due to the dry cornea condition. A small -0.25D power correction can help slightly so I'm just using that for my right eye's lens in my latest eyeglasses pair. My left eye still corrects with its old eyeglasses Rx to better than 20/20 so with both eyes together its excellent.
I just got today my driver's license renewal notice due within in a couple months and I will have to go into the DMV office and take their eye test at that time. I've read that with both eyes you need to have 20/40 or better, and not worse than 20/70 with each eye alone. So I actually may able to pass that test now without eyeglasses for the first time, since my right eye with the IOL can do better than 20/40 (typically 20/25) and my left eye though it has almost 2D cylinder astigmatism might possibly achieve 20/70. Its not really a issue if I can't pass that test uncorrected, since I can still use my eyeglasses which I use for driving always anyway. It would just be interesting if I could pass the test uncorrected for the first time since I first got a driver's license as a teenager.
Sue.An Night-Hawk
Posted
I too had 2 things that I am looking forward to post cataract surgeries. One accomplished in February- was never able to see the beauty under the sea (snorkeling). With glasses that was never possible. 2nd being able to watch my daughter play soccer. This is lSt year she is eligible to play premier U17. Hoping her team makes nationals. But just seeing the girls and being able to read their jersey numbers will be so welcome.
Night-Hawk
Posted
I decided to get another optometrist basic refraction eye exam today since its now over 6 months since my right eye cataract surgery. My right eye vision still varies some, but most days its been about 20/25-20/30 uncorrected though I get maybe one or two days a month where its more blurry maybe 20/40 or so. Probably just due to dry eye variable conditions. But I wanted to see if I could achieve 20/20 with eyeglasses correction.
I went to a Lenscrafters optometrist this time and got a discount so the exam was only about $40 compared to their regular $7t price. They did a pretty detailed non-dilated eye exam for their basic exam. Even checked your depth perception (3D) vision and compared your vision of black text on a green vs a red background which I've never had done before.
The refraction result for my left eye was exactly as expected since its Rx hasn't changed for several years, thats my eye with the natural lens. The result for my right eye with the toric monofocal IOL was very close to the last auto-refraction measurement at my regular ophthalmologist from a couple months ago:
+0.25D -1.00D x107
So at least the axis appears to have been stable now compared to the first month or so after surgery. I think the cylinder value varies for me at different times of day and different days. But today my uncorrected vision was pretty close to 20/25 so its a pretty good vision day. With this Rx thru the refractor I was reading the 20/20 line pretty clear. Interestingly today I was very slightly farsighted, but I think that too varies, more likely PLANO most of the time.
I will go ahead and order a very low priced single vision distance only pair for under $15 including shipping next week from the discount online eyeglasses vendor to test this new Rx for my right eye and see how well it does over a month or so of vision variation, before I would order a more expensive progressive pair.
sunny68454 Night-Hawk
Posted
Also, so much cylinder remaining after a toric implant surprises me.
Night-Hawk sunny68454
Posted
The IOL was targetted for distance vision near PLANO and that is where its at except for the additional astigmatism. So as I expected near and intermediate focus is blurry and requires reading glasses for that eye. Distance vision from 4 feet and beyond is OK but about 20/25-20/30 due to the astigmatism.
sunny68454 Night-Hawk
Posted
Night-Hawk sunny68454
Posted
ayeaye Night-Hawk
Posted
hello. could you give me the web address of this discount online eyehlass vendor? getting glasses for $15 is insane!!!