Cataract surgery, can see the edge of IOL

Hi

I didn't write the whole thing about the surgery. The capsule was punctured while removing the cataract. Dr. tried to put lens in(Multifocal Toric Soft Lens) Naturally, it wouldn't fit. But it unfolded when he put it in then had to remove it by making the incision in my eye bigger. Once it opens it can't be folded inside the eye to remove. So then he had to put a different lens,soft & part of it is hard, so he said. So it slipped after 3 months and after Yag. The article I found was

"Cataract Surgery Complications- All About Visions .com"

It states

"If IOL dislocation occurs following a recent surgery, repositioning the lens should be done soon.This is because lens implants begin to scar into place approximately three months after original implantation and can become more difficult to remove"

It's too scarry to think about having another surgery that can do more damage. How do they remove a lens that's already fused to the eye?

I can't imagine them pulling it apart.

Sorry I didn't mention all this the first post, it takes me forever to type a lot. Also the Multifocal didn't work even in the first eye he did. I have to wear progressive lens glasses, these aren't working for me. I can't do close up work. He's suggesting I use reading glasses, but it gives me headaches after putting them on & off all the time I'm working. I have to take them off if I waht to see further than maybe 2 feet. Very annoying. I paid a lot of money to get rid of my glasses. He also suggested removing the lens, but the next one (if it can be done) would be a plain one, So I'd have 2 different lens and would have to use reading glasses for sure. He says I couldn't wear progressives.

Wow! this is a lot of typing for me. Now my eyes are heavy & making me sleepy, that's the other problem.

Thanks for your imput. Nice to hear dif. peoples stories.

 

The quote you give seems a bit unclear since it is talking about respositioning at first, but then refers to removing the lens. It may be that it was a typo and they meant it'd be more difficult to reposition (rather thann remove) within the capsular bag due to the  scar tissue. However from your description it sounds like the lens may not have been placed into the capsular bag to begin with, which is why they needed to use a different lens, presumably a 3 piece (I'm assuming  a monofocal) rather than the 1 piece. 

In that case they aren't repositioning the lens within the bag, but likely merely tying it to another part of the eye to hold into place in the correct position.  A surgeon would need to look at the situation and determine what they can do. The issue partly seems to be whether seeing the edge of the lens is due to it being out of position, in which case its not clear why they would replace it rather than repositioning it (oops, I just realized I've been ignoring the comment that the lens is "cloudy", which I guess may be the reason, sorry I missed that). Also if seeing the lens edge isn't due to the position, but merely the type of lens, then perhaps a lens with a different size/shape might avoid you seeing the lens.

If you have problems with the other eye also, I'm really wondering if a 2nd opinion with another surgeon might be useful to consider. The vast majority of people have good vision with multifocals. The usual complaint with multifocals that leads people to consider getting a different lens isn't their visual quality, but that they have problems with halos&glare when driving at night. I'm wondering if either the first eye has residual astigmatism that isn't corrected (if its a toric lens, perhaps its not rotated correctly or the power is wrong), or if the lens power was off. 

If progressive glasses aren't working well for you, I wonder if old fashioned bifocals might work better if you mostly need them for working.  It could be that the multifocal is complicating wearing progressive glasses, did you have luck with them before cataract surgery? (I'm assuming you were old enough to have presbyopia before your surgery and needed them).

If  you swap the multifocal for a monofocal lens, you would have two monofocals, and many people with 2 monofocals wear progressive glasses so it isn't clear why he'd say that wasn't an option. Back before my problem cataract appeared, I hadn't liked progressive glasses and instead wore multifocal contact lenses, which would also be an option if you are comfortable wearing contacts (if you hadn't tried them in the last several years, they are more comfortable than they used to be in decades past). 

Its also possible if you do lens swaps that they could set your eyes for monovision (one eye to see nearer and one eye further) to reduce the need for glasses, or you could also wear contact lenses set for monovision. 

I have  Symfony IOLs rather than multifocal IOLs.   I'd just read alot about cataract surgery issues since I had a complication that seems to be unrelated to the lens itself, which seems a good choice. 

 

Article did say "more difficult to remove" The capsule was punctured so the lens is sitting on the capsule, how, I don't know.

I've always worn progressives. Never had problems.I seen another specialist before Yag laser, he said the mulitfocal lens very seldom work. That office has 7 eye Dr's none of them use mulitfocals lens. But it was too late for me, I already paid for them & had it done. The muli doesn't work in my other eye. But like you said, maybe he put the wrong ones in. I don't know. I know I don't want to use reading glasses & I had contact lens in right eye after surgery for the left eye for about 2 weeks. It was horrible, I could never wear them. My thing is, how do they remove the lens after 5 months with all the scar tissue. I remember being told the tissue would grow around the lens. So I can't see how they'd dislodge the lens from all the scarring. But maybe there is way. I'm seeing a different Dr. in 3 weeks to see what his opinion is.

 

Again, I think the article you quoted might perhaps have had a typo in it and they wrote "removed" instead of "repositioned", that the issue is repositioning a lens with scar tissue. I had a consult with one of the most prominent cataract surgeons in the US while trying to figure out my complication (which turned out not to be related to the lens itself, but my iris) and he said that if needed I could have a lens exchange  at any point in the future, whether is months or decades. Articles around the net that I saw confirmed that. That said, each person is different and its possible there is something unusual about your case, but what I've read suggested its possible in almost all cases even after a YAG, the only issue is that the lens may need to be placed outside the bag and it sounds like may be what you have anyway. 

It does make sense that a multifocal might complicate the use of progressive glasses, but there is no reason monofocals would since they are just single focus lenses, they just leave you with the equivalent of a high degree of presbyopia. Actually I do think I may have heard that progressive glasses may be a bit harder to adapt to when the reading add is higher, with larger degree of myopia, but its still likely not to be  a problem.

Its unfortunate you had back luck with contacts, I'm wondering if perhaps you might have dry eyes or something. 

Studies show the vast majority of patients are happy with multifocal lenses and that they "work". The usual reason for a lens exchange isn't that they don't "work" in terms of visual quality, but that people have problematic halos and glare. Unfortunately it is the case that a very tiny minority do opt to have a lens exchange due to halos&glare, and so many surgeons avoid that because they don't want to deal with unhappy patients. So many surgeons are conservative, they figure that most patients won't know any better and do the easiest thing which is a monofocal lens. In addition due the fact that monofocals are covered by insurance or government plans, most people would wind up with them anyway which is added incentive for doctors to not take time on the minority who do. Also, the earliest models of multifocals weren't as good, just as earlier generations of cell phones weren't, and some surgeons got turned off and didn't bother checking into later generations to realize how much better they are. 

If the other eye has never given you a problem why would you want to get the IOL exchanged?