just had cataract procedure

Sorry my computer got frozen and the above message got sent while I was still typing it.

Any way to repeat, just couple of suggestions:

1. Wait for at least 2-3 weeks to see the actual prescription which you achieve for the right eye.

2. You may want to have the left eye set for either -0.5D less or more than the right eye (and not the same), depending on what you end up with the right eye and what you like better using a trial lens in the left eye. You will probably be better off to have good near vision in one eye and good intermediate vision in the other eye, and then use glasses for distance.

Salty I am going through the same Ordeal,I would not have had it don't Unless it was my last alternative,my eyes is worst since the surgery.People say it's a simple surgery and with great results.

I wish I had better results like most patients are saying,but unfortunately I am on the 2% list that have major issues.

     

Please excuse the brevity of my reply, but can you tell what it is that you are experiencing? For how long? And what your doctor says is your recourse? And did you have your surgery in the US? I'm trying to get a handle on the truthfulness of my doctor's response i.e. the 1/3rd of all cataract patients rnd up with cloudy membranes, it sounded rather high to me. You mentioned 2%?

Hi Salty - yes I would say your doctor was right about PCO (cloudy capsule) occurring one third of the time.  Some say it is higher than that at 50%.  It does seem to occur more with round edge IOLs vs the square edge ones but square edge have more edge glare - so I suppose it is pick which you’d rather.

Part of my annoyance with my self and my doctor is that I didn't even know there was a choice between lenses, nevermind the differences in results , no one mentioned square vs round, the doctor made the choice, my only choices were whether I was going to pay $1900 for a toric lense and/or pay for laser surgery rather than standard surgery, the choices all were about money nothing about manufacturer, size, or square or round. The information flowing my way was so limited I might as well as been choosing something very trivial. I think that's how they run it here in the US. I'm thinking the people who are well informed on this forum are from Europe and Canada, but I could be wrong.

I am from Canada and I wouldn’t necessarily say we get more info.  The diagnosis in Jan 2017 of cataracts blindsided me.  All the optometrist did was refer me to a surgeon as she couldn’t correct my vision any better than 20/60 RE and 20/50 LE.   It was a 3 month wait and during that time I researched cataracts on the net as I had no clue what would be done about them.  My parents and no one I knew had the surgery.  My husband’s mother had the surgery years ago but I recall she couldn’t see well even after the surgery and spent weeks eyes downcast whole her eyes healed.   So came across this forum and wrote down questions I had and when it was time to have my consultation (I had 2 due to my indecisiveness about lens) I asked those questions.  In Canada our surgeons are paid same amount no matter which lens you choose so they aren’t motivated by $ unless you do clear lens exchange and go private vs hospital.   But I was with 15 or so other people in the waiting room that had not discussed any lens options etc with SAME SURGEON - one was shocked to learn that morning her natural lens was being removed.  So I am not sure unless you ask you get much info and it is a shame b cause vision affects many a thing and quality of life.  There was so much time in surgeon’s office waiting for that first appointment you’d think they’d hand you some info to read on cataract surgery and IOL selection.  

Everyone but me that day got a monofocal lens.  24 hours at post op ( with these same people) they were amazed I Coulter’s not only distance chart but reading one too.

Yes not sure with how prevalent this surgery is why people aren’t given a longer consult and handed a questionnaire about your hobbies preferences type of work.  Sure would help.

Hi Salty0, After my cataract surgery 8 months ago, on some days my eye has a "film" or "cloudiness". I have a history of "dry eyes" and have been using Systane eye drops but recently switch to Santan SOFT SANTEAR to relieve the "grittiness". I also take vitamin supplements including Lutein+zinc, and eat foods best for eye-health. The "film" or "cloudiness" still comes and goes. I am following all the PVD and PCO discussions here, and keeping myself educated on the subjects.

US still has the best medical treatments and facilities, that is if one can afford them. Been to a few clinics in California, everyone was so helpful and amicable.

The shortfall of a universal healthcare system is mediocrity. All surgeons are paid the same amount irrespective of their skills+experience, and never mind about their overhead costs+expensive hi-Tech equipment.

Dr Gimble of Calgary was bankrupted by the Federal government, if not for the timely intervention of the then Albertan government to pay the hefty fines imposed on his surgery. His first Out-of-Hospital operating rooms for eye surgery in Canada was the first to apply radically different new small incision cataract surgery, combined with the revolutionary intraocular lens implants. He is one of the pioneers in the procedures and developed innovations in the surgical techniques that have become world standards.  I rest my case.

Can relate to mediocrity statement referring to canada’s Healthcare system. Ist is what is is!   But no one is without - trade-offs.

I'm more concerned with Birth Tourism with absconding tourist leaving behind a medical bill of C$1.2 million for the taxpayers to absorb. Ours is supposed to be a Bring Cash province.

Morning Salty,I had surgery in Canada,I think your doctors response to 1/3 having cloudiness in the eye is more accurate than most surgeons led on it to be.The 2% I mentioned is a percentage I read on her with regards to Cataracts surgery results where 98% percent have satisfactory results  and 2% have issues.

From what I have read and seen on here I don't feel these results are very accurate.  

The caveat to the doctor's truthfulness about the "cloudy membranes" or PCO issues I'm experiencing is that it came 4 months after my surgery and much complaining on my part about the issues I was experiencing. I kind of got the general impression that their attitude was to keep this information about the PCO effect to themselves in the hope that the issue would go away or I would go away. During this entire time getting these people to acknowledge I had a "real" problem and it wasn't all in my head seemed to be a the overall attitude, in simpler terms it was like pulling teeth nothing proactive on the part of these doctors, not before, during or after these surgeries. I'm livid.

That’s a real shame.  Have to wonder whether the issue is PCO or not.  If one never had clear vision from the get go I would be investigating other reasons first.  Because if it isn’t PCO and you go ahead with a YAG and it doesn’t fix the cloudiness you cannot do a lens exchange.  It could be residual astigmatism or miscalculation in power that was the real reason and the surgeon may not want to admit to or have to correct the issue on their dime.

If getting no where with surgeon might be worth going to get another opinion.

It has been 4 months since her cataract surgery, is a lens exchange still possible?

@Salty0, Has your eye doctor examined your eye and then ensured you that you do not have PCO? Getting a second opinion will put your mind at ease hopefully.

Hi feeman62151, Before my cataract surgery I learned that cases of retina detachment are < 3%. Anyways I signed the pre-Op paper(s) just before being wheeled into the Day Operating Room, fully aware that I might come out blind LOL.

You can find interesting stats and info from your local Health Authority website. For example,

"HealthLinkBC" has a page on "Cataract Surgery" covering topics from "Surgery Overview" to "What to Expect After Surgery", etc.

Under the "Risks" heading, it states that fewer than 10 out of 100 people have complications from cataract surgery that could threaten their sight or require further surgery. The rate of complications increases in people who have other eye diseases in addition to the cataract.

"How Well It Works":  Cataract surgery is successful for 85 to 92 out of 100 adults.

In one large study, 95 out of 100 adults were satisfied with the results of their surgery. The people who were not satisfied were older adults who had other eye problems along with cataracts.footnote

I would not trust results from any study, unless the investigators talked with the patients directly and not just with the surgeons, who performed the  surgery. (most of them do not do that)

By the way, one can have blurriness from more than 1 reason. One can have blurriness from another reason in addition to having it due to the PCO. Thus, one has to have confidence in the surgeon to sort it out before having the surgery.

Also, unless a PCO is really a major reason for the blurriness, one can choose to leave it alone. I have chosen to live with my PCO in the left eye for the last 20 years because my vision with it is reasonably good and the expected improvement by the YAG laser to remove it is rather small.

Thanks at201. Always appreciate your wisdom.

That's the heart and soul of my trepidation. My first surgery was on my dominant eye with the most significant astigmatism and cataract on March 7th, they implanted a Toric Lens ( Alcon) I now know and it was like someone wave a majic wand, my vision improved to the point I had no need for glasses for reading or distance even computer work improved . No problem with burning eyes , gritty stuff , zero issue I was anxious to get on with the second surgery. I was on cloud nine. After the second surgery it was a 180° turn around. within weeks I had burning blurry eyes. We thought perhaps it was a reaction to the steroid drops. Tbese drops were supposed to be well shaken and during mu first surgery and after I want remembering to shake this little bottle so the thinking was perhaps I was getting the more concentrated dose because I was still using that same bottle, which we agreed I should stop using it.. None the less both developed "dry eye syndrome" and then things got progressively worse to where I am now, apply for an application to the library for the blind and visually impaired because I can no longer read comfortably. It's like after reading for a bit when I look up everything is blurry and out of focus. I'm sailor, I can't read a chart nor can I read a chartplotter. I'm screwed.

Because of my limited ability to use this medium please take a look at my recent response to Sue An. Thanks

Please see my response to Sue An . And yes my doctor said this was "cloudy membranes" which translates to cloudy capsule, which I believe is what's being called PCO. Agin these terms seems to be interchangeable. She is also wondering outloud if I have developed scar tissue. I'm going in to see her again on Tuesday, I've called UCSF to see if I can get a second opinion or some kind of assistance with this mess but I'm told before I can do that I need a referral from this doctor said all my records. A catch 22 if there ever were one.

Yes lens exchange can be done 6 months after (possibly later than that) as long as the capsule still in tact.

I am surprised you were told to use same bottle of post op drops for both eyes.  I had plenty of drops after my first surgery but was given strict instructions to throw them out and get new prescriptions filled for 2nd eye ‘s surgery.  That is for any eye prescription I have ever had even for conjunctivitis.  If that tip touches your eye it is no longer sterile.

Did you have a toric lens in 2nd eye too?  The blurriness could be due to lens rotating (common for toric lenses). A surgery can be done to rotate it back or lasik will do the trick too.

I had 3 different prescription bottles for each surgery, one antibiotic, one called Prolens and another larger bottle that was defined as a steroid, although after the fact I was told that Prolens was also a steroid.. The antibiotics and Prolens ran out after the first surgery and was renewed but the larger bottle had about half the content keft and I was told it was ok to continue to use it. I did have a back up script for a replacement if I needed it. It was about 3 weeks after the second surgery that I developed the burning eyes and the doctor told me that it might be the steroids that were doing it and stopped using them with her agreement. Seemed stupid to me to continue using a medication that was causing that reaction but I was the one that had to bring that up. It was a little after that time that I brought up the fact about the not so well shaken bottle that might have been left concentrated. None of the bottle tips ever touched my either eye. I approached this very carefully that operation for both eyes was painful regardless of what they tell people, I felt all the manuevers, manipulation and was vocal about it during and after the surgery, and she knew.. i am by no means a complainer about pain been through major back surgery so I know what can be this operation was billed as almost painless, " you won't feel anything but pressure", really I beg to differ

It surprises me how pre-op and post op instructions for this “common” procedure are from place to place - even with same country.  I was instructed to take both antibiotic and steriod drops days ahead of surgery and antibiotics continued for 1 week after but steriod drops for 5 weeks.  

But individual experiences can vary.   I fortunately didn’t have any pain - just a slight gritty feeling.  Surgery itself wasn’t painful and there again I find there are differences.  I had my eye frozen but no IV.  Was offered Ativan to calm my nerves and anxiety but that was it.  

Perhaps might be in part due to type of surgery.  Some clinics use laser and others more traditional method )my own was done using

Phacoemulsification (modern cataract surgery in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. )

I felt pressure but no pain.

But others have described a lot of pain.   

This must be extremely frustrating for you and it doesn’t sound as though your doctors want to explore or get to the bottom of why your eyesight is still blurry.

I have no other issues with my eyes other than the Dr. saying at that time my right eye needed lens implants.My left eye was much better than my right eye at that time.

The surgeon ask me if I wanted to proceed to get the left one done ,at which that time he will eventually get worst as I get older.Now my left eye is worst than my right eye,with the black shadow and light flash in the dark syndrome. I had YAG done on my right eye 3 weeks ago,at first it seemed to have improvement,now I see double vision and blurriness at times.I go for a follow up Wednesday with respect to my YAG treatment.I don't think I will be able to read any further down the eye chart than what I did prior to the treatment.

Has for the left eye,I'm not sure what he will suggest to do with it.Has for your percentage values  on cataract surgery,I feel that their is a lot more people having blurriness and other problems than what the surveys indicate,from what I have seen people go through here on the Patient site.

I would agree with you except for the fact that most people who are happy with their results never bother to seek out a forum such as this to register their excellent results, people are usually here looking for answers before surgery or assistance after surgery. What exactly is this YAG procedure? My doctor's use of medical terminology is limited to "cloudy membranes" which I now understand translates to PCO, I think. I appreciate any information. Thanks

I was instructed to take

(1)antibiotics starting 3 days before surgery on the left eye and continuing for about 10 days or more after the surgery, additionally, the steroid drops 2 different bottles ( ProLensa) and something else were to be started after the surgery, this was on the eye with the Toric lense. The right eye with the standard lense was slightly different with a change in the instructions for one of the steroids, so I was taking antibiotics and steroid drops 3 days before the surgery. Weird, I know. Again I am unfamiliar with these medical terms so I have no idea what Phaecoemulsifaction is, however I had non laser removal of both cataracts. As a medicare patient you have a choice Medicare only pays for standard cataract removal surgery which translates to, " if you want to pay for them to use a laser it will cost you just under $4K per eye" and for that these doctors throw in the lense. I opted for standard surgery and paid $2200 for the Toric lense,(1) the other replacement lense was "standard" so that one didn't cost me anything except perhaps my ability to read. Medicare changed the payment for these lenses in 2007 prior to that you could get a Toric lense without shelling out $2200, that I'm sure was our wonderful AMA doing their best for their membership. I just can't wait to see what changes are coming down the pike with all this noise in the newspapers about the financial condition of the Medicare trust. Under this present administration it's anybody's guess and I can imagine people having to make brutal,

unconscionable decisions regarding their health care as our population ages. We are in uncharted territory now.

Phacoemulsification cataract surgery is a procedure in which an ultrasonic device is used to break up and then remove a cloudy lens, or cataract, from the eye to improve vision. The insertion of an intraocular lens (IOL) usually immediately follows phacoemulsification.

Our Canadian Medicare may too have to undergo change.  Many private clinics emerging and if people have funds pay $500 for an MRI to get results sooner vs waiting 6 months to a year.  Even my cataract surgery (although completely covered by Medicare) was a 7 month wait for first surgery.  Surgeon paid same amount no matter the lens selection.  I paid $900 each eye for upgrade to Symfony Lens.  A toric lens would have been $300 if I needed that.

I believe a few Canadian hospitals have laser but most still don’t - major cities would.   Again if you want to pay for procedure you can have it done privately.

Despite these forums which give people impression this surgery doesn’t go as well as stated I still think opposite is true.  If one was satisfied with results (without researching ahead of time) they would not look for this forum or be inclined to comment.

Did you have this done privately?  I would think that surgeon should be held accountable to find out what went wrong in your case.  If done though national health you may want to have someone not associated with clinic you saw take a look to see what went wrong.

I cant see anything wrong with drops or steps you took and there must be an explanation as to what is wrong.

One thing you might want to do is see an optometrist (not the one you regularly see and diagnosed and referred you to your surgeon) to get a written prescription of where your eye is.  That might be very telling.  

Good luck Salty0 - feel for your situation.  Terryifing not to see well and be able to function at your job.  I felt like that with cataracts.  You wouldn’t believe how quickly my vision deteriorated with them.

YAG(yttrium-aluminum-garnet)Laser,it's a treatment used to clean up the lens implant after cataract surgery.From what the Surgeon told me is that in some cases they don't get all the cataract particles/membranes out during the surgery procedure.it's usually out around the rim of the capsulate.If this is the case they will have a tendency to migrate to the back of the lens resulting in the back of the lens being cloudy, similar to looking through a piece of wax paper from what he told me.Hopefully this explains to you what YAG treatment is.For more information on this YAG treatment ,just google it . 

Hi Freeman - thanks for that description.  I was also told that particularly in younger patients it is not just a question of not getting all the particles/membranes but they actually grow back.  A square edge IOL will prevent that from happening more than a round edge lens but can still occur.  

Medicare works differently here in the US. You qualify for Medicare once you reach the age of 65 or if you are judged to be disabled and are receiving Social Security disability benefits. I'm over 65. After going to see an optometrist a number of years ago and finding that I had high pressure in each eye it was suggested that I get that pressure checked every 6 months and I was considered " Pre- Glaucoma" or a Glaucoma suspect with that news I started to see an opthamologist for all those tests to determine what if any damage was done by this high pressure. I was told that I have thick corneas which was a good thing. This opthamology practice is the same one I've been seeing since that diagnosis 7 or 8 years ago. Most medical practices accept Medicare insurance just as they accept other private insurance plans. So to answer your question this is a "private" practice there isn't any "public" clinics they are all independent of the Government, however most of the larger hospitals will accept Medicaid, which is the Government sponsored medical insurance for the low income families or individuals between the ages of 0-64 years of age who can't afford private insurance or are unemployed, this is what the ACA or Obama Care was all about, but thanks to the Republicans & Trump they all but killed that one by abolishing the individual mandate, long stupid story of our shortsighted leaders who want to MAGA. Sorry to go on that tangent but just wanted you to understand how health insurance works here. I am stuck with who I have for the moment, no doctor really wants to clean up someone else's mess if that's what this is so I will see this doctor tomorrow and demand answers, at least I'll know the questions to ask thanks wholly to the very well informed people on this forum. When I get those answers whether I like them or not I will seek a second opinion and as I've said before there's no circumstances under which I will allow this doctor to do any further surgeries on my eyes. I've lost all confidence.

Thank you I appreciate your taking the time to explain the terminology to me. My last consultation with my doctors they touched on such a proceedure but kept it to one sentence about "going in with a laser to clean things up" really trying to minimize this situation which is only leading to me trusting them less and less.

So sorry to hear what you are going through. I too have this "film" that comes and goes. I include beets green and Red Amaranth (Amaranthus Cruentus) in my diet; they are to me what spinach is to PopEye. Hope your vision is on the mend soon.

Posterior Capsule Opacity (PCO):

One of the most common cataract surgery complications is a posterior capsule opacity (also called posterior capsule opacification or PCO).

Posterior capsule opacity or PCO. The PCO has been removed with a YAG laser.

A procedure called a YAG laser capsulotomy can quickly restore vision following posterior capsular opacification.

Although some people call PCO a "secondary cataract," it really is not a cataract. Once a cataract is removed, it does not come back.

During cataract surgery, your surgeon will remove the cloudy natural lens of your eye (cataract) and replace it with an intraocular lens (IOL). Much of the thin clear membrane that surrounds the natural lens (called the lens capsule) is left intact during surgery and the IOL usually is implanted within it.

When the cataract is removed, your surgeon makes every attempt to maintain the integrity of the lens capsule, and normally your vision after cataract surgery should be very clear.

However, in about 20 percent of patients, the posterior portion of the capsule becomes hazy some time during cataract surgery recovery or even months later, causing PCO. Posterior capsule opacification occurs because lens epithelial cells remaining after cataract surgery have grown on the capsule.

In some cases, if the condition progresses significantly, your vision may be worse than it was before cataract surgery.

Treating Posterior Capsule Opacity (PCO):

Fortunately, a YAG laser can treat posterior capsule opacity safely, effectively and painlessly. This procedure, known as YAG laser capsulotomy, often can be performed in your doctor's office.

YAG laser capsulotomy involves just a few simple steps:

    Usually the eye is dilated before the procedure, with dilating eye drops.

    A laser removes the hazy posterior capsule from your line of sight without making an incision or "touching" the eye.

    Many ophthalmologists recommend anti-inflammatory eye drops following the procedure.

The procedure takes only a few minutes and is entirely painless; nor does discomfort occur post-operatively.

You must remain still during the procedure, however. Very uncooperative patients, such as children and mentally disabled people, may require sedation.

Following a YAG laser capsulotomy, you may resume normal activities immediately. You may experience some floaters afterward. These will likely resolve within a few weeks.

Most people can expect their vision to improve within a day. As with any eye procedure, however, call your eye doctor immediately if vision worsens or fails to improve.

Because the YAG laser removes the central zone of the cloudy posterior capsule behind the intraocular lens, the condition cannot return. So only one laser treatment is required to permanently eliminate vision loss caused by posterior capsule opacification after cataract surgery.

YAG Laser Capsulotomy Risks:

Although a YAG laser capsulotomy poses slight additional risk, overall the procedure is extremely safe. The most important risk is that the retina can become detached from the inner back of the eye.

Statistics suggest that the lifetime risk of a detached retina as a cataract surgery complication in the United States is about 1 percent. That number rises to about 2 percent after YAG laser capsulotomy. It is important to be aware of this cataract surgery risk.

Thanks for explaining the healthcare system in US - I hadn’t realized the diffference between yours and canada’s.  Everyone no matter the age qualifies for Canadian Medicare if you are a citizen.  There are pros and cons to it as mentioned before.

I won’t comment on your MAGA - I imagine your country is quite divided.  I vacation plenty in USA and met many wonderful people.  Can’t judge people by who is in power.

Yes I can understand your situation now and the frustration with it.   Really hope you find a kinder surgeon who will clean up someone else mess if need be.

Thank you for providing that very descriptive and informative piece of information. Aside from what has been stated here it is my understanding that once you have elected to undergo the YAG treatment you can never change those lenses because the YAG treatment destroys the membrane . I have no idea

under what circumstances I would ever need to change the lenses that I now have because I know so little about these lenses and the after effects of YAG and/or cataract surgery but I am learning thanks to you guys, that's one of the questions I'll be adding tomorrow .