Iol exchange after cataract surgery miscalculation

Posted , 9 users are following.

I’m a previous lasik patient.  (2001 corrected far vision). I had cataract surgery in right eye 12/23/2017  and left eye the following week. Immediately the right eye was a problem, and we continued on with second procedure because the dr said he knew what to do to correct the issue.

I had iol exchange 4/26/2018 in right eye. Yesterday I had my 2 week follow up. I am currently on durezol steroid drop and over the counter dry eye drops. There is still daily fluctuations and I am not reading 20/20  more like 20/40 and blurry. Lasik enhancement has always been a follow up option. 

During exchange  surgery, which took much longer than expected, my cornea started to dry out, removal of iol was difficult. I could see all the tools needed ( and started to feel fearful of pain as I could start to feel pressure). The Ora machine was used and once again calculations were off. Luckily the dr marked where the toric lens was previously placed in the eye, because the Ora was giving him a new markings that didn’t make sense. He stepped away from the table to consult my chart and decided to go up 1.5 instead of what we thought was a solid 1.0. Previous iol: restor multifocal toric 20.5D 1.5 cyl +2.5 add power new iol: restor multifocal toric 22.0D 1.5 cyl 2.5 add power

During yesterday’s follow up dr said yag would be our next procedure as cloudiness on back of lens is forming. Again, this was expected due to now my 3rd operation in that eye. Yag will be done @ 3 month mark then we will consult with lasik or PRK to tune in @ 2 weeks following yag. Also eye pressure was 25 when normally 12 -13 dr said that’s from the durezol. 

When I inquired about the left eye 20/50 (which now has 1.25 astigmatism) dr said he’d rather see me have lasik to correct because the iol exchange was so tramatic. 

My personal opinion here and still some raw emotions: 3 months from now I will be consulting yet another opinion on iol exchange in left eye. There is no reason to have that large of astigmatism after surgery when I had zero before. @.50 astigmatism is calculated for such a surgery. Also, my second opinion showed a “ mild tilt” in the lens position. And I believe that was caused during a horrific reaction to stepping down dosage from pregnozone drops. The change to durezol drops has cured that problem for now. My hopes are that the astigmatism and visual accuracy will be restored with lasik or PRK and not another iol exchange. But if an iol exchange is needed, I will go to another dr with much more experience and confidence. 

My dr has experience in cataract surgery, but has done very few exchanges. 

I am able to write this review without glasses, but things are not clear. Also where I once had a depth perception issue, that seems to be resolved. ( I get on and off a boat daily, and that has been a challenge seeing how far away I have to step, luckily the preception was things were farther away and I didn’t stub a toe. Haha) . I return to the dr in one month and hopefully things in right eye will settle down and 20/20 vision will appear. Unfortunately it’s just too early to tell how close I will be at this point in time. But it’s a lot better than what I had 

I’m grateful for the exchange, but obviously had hoped for a clearer outcome. I’m also grateful for not having any residual pain other than a few days of tenderness at the incision. 

I hope my results are able to help the next generation of surgeons and previous lasik patients in finding the correct lens the first time. 

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  • Posted

    I had cataract surgery on both eyes in the last 6 weeks,I ended up having cloudiness on the back of the lens.Schedule to have the lens cleaned by laser on June 9th. hopefully it does the truck without other complications.

    Has for my left eye the surgery /lens implant left me with a black shadow in the corner of my eye ,very annoying,The Dr. claims it should go away in 4 mounts.I also get flashes when moving my head in the dark,like you had turned a switch on and off.plus I on my last follow up when he schedule me for the laser  on my right eye ,he tells me the left lens is also cloudy.I think if I would have foreseen the future regarding this surgery/lens implants,I would have stuck the blurred vision and left the cataracts alone. 

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    • Posted

      Once you have cataracts that have progressed to the point where your vision can no longer be corrected with glasses or contact lenses there is no choice other than cataract surgery.  Alternative is to go blind.  Waiting till cataract is very dense makes the removal more difficult for surgeon.  So if vision can’t be corrected with glasses better than 20/40 one is facing cataract surgery.
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    • Posted

      Hi Sue. An

      I do understand that Cataracts can cause blindness,however the reason I mentioned that I was sorry to have had it done ,was that my eyes were better before the implants than what I am experiencing now.I guess everyone is different with regards to different reactions from the implants .I guess I must have  been one of the 2% out of the 100% that have those kinds of issues.  

       

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    • Posted

      So sorry freeman.   Usually things are better after the surgery.  Are you saying your eyes could be corrected with glasses (perhaps your cataracts weren’t yet affecting your vision)?

      Is there anything that can be done now?  Will glasses correct your vision?  Or contact lens?   Some people opt for lasik to correct any astigmatism or if power off slightly.  But first you need to know why you aren’t seeing well.

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    • Posted

      Went back to your early posts.  I take it you are still seeing rim of IOL and there is cloudiness in back of lens.   Did you have regular standard lenses (monofocal) implanted?   before having the YAG procedure which clears up the cloudiness due to PCO make sure it is due to that vs the lens itself clouding.  Once a YAG is done it makes lens exchange that much more difficult if not impossible.
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    • Posted

      Hi Sue,Ann

      The lens that I have is the Intraocular Lens type.Model: ZA9003.The surgeon told me they were a soft type lens versus other ones or cheaper ones were hard.I haven't had the YAG procedure as of yet that's suppose to take place in early June.Hopefully this laser  treatment clears up the cloudiness problem,as for the other issues time will tell.

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    • Posted

      The only lens I have heard of to date that has had issues isn’t offered in UDA or Canada but is in Europe is the Oculentis MPlus.

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  • Posted

    I had Lasik and have 2 monofocals set for distance and hardly ever need glasses, except for reading tiny print or an entire book. Multifocals and other premium IOLs like the Symfony lens (and trifocals) are risky and don't guarantee any better vision than what I have with standard, non-toric monofocals set for distance.

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    • Posted

      And I have read about quite a few cases of people with standard non-toric monofocals set for distance who don't need glasses ever, not even to read tiny print.

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    • Posted

      And my vision is 20/20 in one eye and close to 20/20 in the other eye, so my distance and intermediate vision are also excellent. My first operated eye is the 20/20 eye and I could see fine basically at all distances even before I had my 2nd eye surgery. I only needed over the counter mild readers for very small print right after my first surgery (and that improved over time). I drove to the doctor the day after my first surgery and could see my car's speedometer and the rest of my dashboard perfectly with no glasses (it was crystal clear).

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    • Posted

      And I didn't have ORA either, another waste of money in my opinion (but if someone's doctor included it in the fee and insurance covered it, I would do it).

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    • Posted

      And my doctor isn't the one who said people who had Lasik shouldn't get premium lenses (he would have happily took my money for premium lenses). That was from my own research, although I think the risk of complications from premium lenses is probably equal in people who had Lasik and people who didn't have Lasik (or other refractive surgery).

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    • Posted

      And for anyone reading this who's considering getting Lasik, PRK, Smile or any other refractive eye surgery, if I could do it over, I wouldn't get Lasik again or have any other refractive surgery. The risk of serious, irreversible complications is not worth it.

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    • Posted

      If anyone wants info on my experience you can write to me privately since I generally don't follow these discussions.

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    • Posted

      Also, for anyone reading this in the future, if someone who needs cataract surgery had Lasik in the past and doesn't have their medical records from when they had the Lasik, you need to make sure your doctor knows if you had Lasik for nearsightedness or for farsightedness since they use different formulas to figure out the IOL power depending on which one you had. So for example, if you have no records from when you had the Lasik done and had Lasik for farsightedness and don't tell your doctor that, your doctor may just assume you had Lasik for nearsightedness since that's far more common than having Lasik for farsightedness and your IOL power will end up being off.

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    • Posted

      I didn't have my records from the Lasik and made sure I told my doctor I was nearsighted before I had the Lasik done and my cataract surgery turned out great.

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    • Posted

      Andi77. I also had my records from previous lasik and my results were still off. It is not 100 % accurate 
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