Posterior Sub Capsular Cataract

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41 and diagnosed with posterior sub capsular cataract in both eyes.   I have one parent who had cataract surgery in the 40s.

The vision in only the left eye is blurred.  The prescription can be altered to imrpove clarity but cannot be altered enough to be 20/20 but the haziness and shadow go away.

My successful 20/20 test on the left eye was on 3/31 this year.  I have never had my eyes dilated before so have never known if there has been a cataract in there.

1. Are these kind of contacts reparable or does the capsule that holds the lens gets damaged?

2. Should I try to ride this out as much as I can?

3. My parent did have the retina detach after YAG, 7 years after the catarcat surgery.  Can retina detachment be repaired if it is cause by YAG?

4. Is is correct, that me under 50 have higher risk of retina detachment?

My appointment with surgeon is next week so he may have answers to these questions.  Until then I am losing my mind and seeking thoughts.

 

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  • Posted

    While every surgery has associated risks, the cataract surgery is relatively low risk. Thus, if your vision is degraded (due to the cataract) to the point that even with glasses, it is not acceptable, then you should not hesitate to have the cataract surgery. Please just make sure that you have a good surgeon.

    If your genetics pre-dispose you to having a higher-than-average chance retinal detachment, that can happen irrespective of whether or not you have cataract surgery. So, that should not have too much influence on your cataract surgery decision

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  • Posted

    Hi,

    I advise you to get them taken care of. I had the same kind and they started with blurriness when reading followed soon by mild haziness when in bright light. My glasses got stronger over about two years and I started to think my good vision I had always enjoyed was a thing of the past.

    I am 49 and had both eyes done a month apart in November and December. I chose monovision which means I have one close eye and a distance eye. My close vision is 20/20 and my distance vision is 20/25. I have been fortunate I had no issues and I now live without glasses.

    I did research (I study as a nurse) and discovered that post subcapular cataracts can be some of the fastest growing. Also where other cataracts give a yellow dim cast to the world these actually are like looking through frosted glass especially in sunlight. By the time I went for help I was approximately 75% blind in my right eye in sunlight.

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    • Posted

      Thanks for the replies.

      That's how mine started too.  I was losing my near sight and thought it was just normal aging.  I went for check up because I bent my glasses an after putting them back to shape i tried to test the eyes the left eye wasn't normal.

      Is the surgery any different for these type of cataracts than others? 

      How did they determine the power of the lenses that you got implanted?  Are they calculated by their equipment?

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    • Posted

      The equipment takes the reading of the cornea surface profile as well as the distances to the retina etc to figure out the desired power of the lens. It can be usually done to within about +-0.5 D error.
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    • Posted

      If you have a good surgeon they do very well at selecting the correct lenses. I thought very heavily about going with a toric lenses in my distance eye due pretty bad astigmatism. However after reading about issues with halos around lights and talking it over with my I decided to go with standard lenses. He assured me that if my vision was crisp enough he could do a relaxing inscsion to correct it. He also told me that many times just the inscsion from the procedure is enough to correct it. I'm glad I listened and did my research because he was correct.

      I also underwent the procedure with no kind of anesthesia. I only received numbing drops because I wanted to see the lenses go into place. It was quite amazing t o watch.

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    • Posted

      Thanks.  So the subcapsule posterior cataract does not change the surgery procedure. Correct?
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    • Posted

      Cart4950 did both your eyes start getting blurry at the same time?

      I am told I have the cataract in my right eye too but vision in that eye is not yet affected. 

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  • Posted

    Correct I was told it does not. The procedure was very easy. I did not even miss work and I drove the next day.

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  • Posted

    Hello Soks,

    I m 45. Psc cataract in both eyes. Blurring started in dec 2016. I had my left eye cataract surgery in june 2017 when I have really great difficulty seeing faces and road signs under sunlight and bothersome starburst of car lights at night.

    Surgery was smooth , it took 20 mins. I can see well the next day. I had a +1.25D prior to surgery and is corrected to -0.25D after. Vision of left eye after surgery is 20/20.

    My right eye vision is getting hazy now. So if there isnt any risk, I would have the cataract surgery right away.

    But I remembered my doctor said men in the age below 55 has a 6% risk in retinal detachment within the ten years after cataract surgery. Thats why I am deferring my right eye until the vision has 0.2 left. My vision in right eye is pretty bad now, I cant see any faces that is 2 meters away. And if I were to walk with only my right eye only, I would be having great difficulty in my daily life.

    So the question is should you take the risk or not ?

    Personally , I think when your vision has deteriorated to some point when you find getting out of your home has become difficult then you basically have no choice but to have one eye fixed first . Choose the dominant eye (distance eye) in that case. And for the other eye defer it until you cant tolerate .

    Psc cataract advances quite fast .

    For now, put your worries behind, and make a self judgement whether your vision now is affecting your daily tasks

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    • Posted

      Thanks Peter.  Your situation seems to be somewhat similar to me. 

      I spoke with few doctor friends of mine about the risk of retina detachment and their opthamoloist counterparts agreed about the risk.  My mom was an example of the retina detachment resulting in vision loss. 

      The advice is to have a retina looked at every 3 to 6 months.  The detachment can be repaired within 5 to 7 days.  So once there are symtpoms, it can be fixed.  My mom said that she lost the visiona s she delayed the treatment.

      My questions for you are:

      a) From what distance is your vision clear?  Is intermediate vision clear? 

      b) Did you have glasses / contacts for distance before the surgery?  If so what was the correction? 

      c) Did they discuss symfony and its unsuitability for PSC?

      Thanks

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  • Posted

    Hi Soks

    A) both distance and intermediate vision are clear with my monofocal left eye. By intermediate distance , I meant something at 30 inches away. Anything less than 30 inches with small fonts, you will see blurr and you need glasses to read.

    But when I see with both eyes, I can read my mobile phone clearly without glasses because my right eye (still with cataract) is -1.25D . My future plan is do have my right eye lens replaced with a monofocal iol of -1.75D. That should result in no glasses needed.

    b) I do not wear any glasses before the surgery. I was +1.25D left and -1.25D right. Both eyes with presbyopia of 2.00D.

    c) I was asking my doctor to give me symfony iol but the doctor told me that you will only get symfony benefits in first year , but when you have PCO developed and later YAG laser fix, the effects of symfony become only a monofocal because the outer refraction rings cannot pass light through it.

    He suggested using mono vision. I accepted his recommendation.

    However, onething you may want to choose is the brand and type of monofocal lens . He used a abbott traditional lens on me, that lens produced some large circles at night when the source of light is adjacent to my eye ball. I researched online thats call glistening effect. I think some better monofocals may not have this. Also I got a little shadow that looks like the edge of the iol appearing in my vision around 2% of the time , they called that dysphotopsia. It was at first very bothering but now its better I dont see it as often. Some youtube video suggested to put the iol legs in 3-9 position and said this will reduce dysphotopsia. I shall have my second eye done that way.

    Re the retinal detachment risk, some online research says if your posterior capsule did not rupture during the psc cataract removal, then your chance of RD will be lesser. My doctor did the removal and cleaning slowly, with suction pressure low, he charged me more because of this hand skill needed,

    My capsule was intact and I am glad about that.

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  • Posted

    i Just got diagnosed with psc in my right eye.  I only noticed the blurred vision yesterday; the good eye had been masking the symptom.  I'm going back to the eye man in 6 weeks (is that too long an interval?) and my suspicion is that he'll start lining me up for the op.  Reading this chain, I'm pretty relaxed about it.  Better to get it sorted than to go through the process of sight getting worse.  One of my symptoms is that my back is hurting cos I am now leaning over the whole time to read my computer screen!  How long is typical between first diagnosis and a cataract operation, I wonder?  And of course I'm also wondering when the good eye starts blurring.  It seems a good bet...

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    • Posted

      Depends on where the cataract is in the good eye. 

      I am at 6 months since diagnosis. Sight in affected eye is getting worse and worse. Cataract in good eye is not in the line of sight yet. 

      How old are you?

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    • Posted

      I'm 52. No problem in the good eye actually. It was just that the consultant did say that it was a fair bet (but not certain) that I might get one in the other eye at some point as its circumstances were essentially the same...

      ?What is the thinking about where to have the focal length on the artificial lens? I think I would rather have it "set" for focus at distance even though i spend a lot of time staring at screens and documents.

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    • Posted

      The artificial lens question is a difficult one to answer as it is very much dependent on individual preference.  There is still no perfect solution available.  The multiple approaches are:

      1.  Set both eyes for distance.  There will be a need for glasses for near and possibly for intermediate distance.

      2.  Set one eye for distance and one eye for near.  This is monovision.  Some people like it some don't.  You could also do mini monovision where you keep some error on the distance correction in one eye while improving the near vision in exchange.

      3.  Set both eyes for near vision.  Glasses will be required for distance.  These glasses will have to be removed for near work.

      4.  Go with multifocal lenses.  These lenses have 3 focal points.  Near, intermediate and far.  People have complained about night time halos with such lenses.

      5.  Symfony extended depth of focus lenses were approved by FDA in late 2016.  They provide great vision at all distances from 18-24 inches.  You can so mini monovision with these.  Some people have reported extreme night time issues with halos, concentric circles and starburst and consider them very bothersome.  Some people have adapted to these night time issues and are not bothered by it.

      6.  Distance in one dominant eye and Symfony lens in non-dominant eye has also been a suggested approach to get good vision at all distances while minimizing nighttime issues and eliminating need for glasses.

      I have also notices a high complaint rate on the forums on astigmatism correcting multifocal lenses.  This is just my opinion and I encourage you to consider multiple opinions on this,

       

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