Preliminary Update on Stage one of Mini Mono-Vision Surgery this week
Posted , 9 users are following.
Hi All,
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Thought I'd better provide an update post surgery on my cataract removal and IOL implant which occurred Tuesday this week!
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Good News First.
Procedure seemed to go well without any obvious issues. Glowing reports from Dr Genial and Dr Knockout (Anaesthetist) who seemed to be the Director/Conductor of proceedings leaving Dr G to concentrate on the procedure and the Phaco machine etc! 😃
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No irritation, inflammation (edema) or infection etc. that is symptomatic. Taking 4 kinds of eye drops to guard against these issues.
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Visual perception is Bright, Really Bright and colours are Vivid! And can clearly see large objects and shapes etc! Guess that's what happens when one substitutes a Beer Bottle coloured lens for a clear one! 😃
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Not so Good News
Near visual acuity is not great. Best I can do is N11/ N10 on a Jaeger chart and it's still not clear over an arms length! Type/characters seem have a shivering jagged edge to them and not solid, especially when compared to my other cataract eye (corrected) which I can still read the smallest N1/N2 text!
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Not sure why this is as we seem to have hit the MMV target of around -1.75D according to my surgeon Dr G which should give me better intermediate to near Visual Acuity (VA)! 😕
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Spoke to him yesterday re the VA issues and he said to come in for an OCT macular scan on Monday! 😮
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So that's where I am four days after surgery. I know it's only early days, and I still hope and expect things will improve with the 'new' eye in the coming days. I just hope there's nothing else that wasn't anticipated that may require further attention.
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So it's not bad so far, but it is a little concerning nevertheless and causing me a level of stress and anxiety! 😦
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Regards,
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DonD
0 likes, 13 replies
W-H DonDiopter
Edited
Be patient. It will take 2-3 months to know your final numbers. Things WILL improve 😃
Mutti3 DonDiopter
Edited
your vision will improve over time. But as my eye said, vision are meant to work with two eyes! my left eye is set at -1.50 i do need reader for close.
W-H Mutti3
Posted
On the other side my wife with - 1.5 eye does not need readers at all. So it varies from one person to another.
Mutti3 W-H
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lol i have old eyes! i see much better in bright light! maybe with summer light i can do without readers!
W-H Mutti3
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Old is gold dear Mutti 😃
Maybe it has to do with shape of your eyes, astigmatism etc?
Mutti3 W-H
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oh W-H you are so knowledgeable. i so have " long eyes" , and uncorrected astigmatism! But after the placement of the lens , the astigmatism was not significant for glasses. Also i do have ABMD of the cornea. Interestingly alot of light, moist eye,, i can see like an eagle! loo
RonAKA DonDiopter
Posted
I suspect things will get better with more recovery time. You should get pretty good vision at 0.5 meters with a -1.75 in the near eye. See chart below. What lenses did you get? Toric correction for astigmatism?
ara21947 DonDiopter
Posted
Congratulations.
It did take a month or so for my near vision to become nearer but not perfect. My less dominant eye turned out better than the dominant one. like Mutti said, 2 eyes focusing together will work better than 1. The best thing is your vision has improved and will do so over the next few weeks.
DonDiopter
Posted
Hi All,
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Yes, patience does seem to be a virtue with matters of eye surgery and IOL implantation!
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Hi Ron AKA, I followed up on the source of this and the other graph you posted and read the full article. Interesting and somewhat counter intuitive that the near VA falls away quite quickly greater than .5M with the higher add of 2D but either improves or stays much the same with 1 and 1.5D adds! 😕 And then the BCDVA improves for most groups ≥1M ≤ ∞.
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I should be in amongst these groups with my current target and if it moves towards 1.5 it could end up even better. 😃
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I have minimal corneal astigmatism at <.5 so wasn't an issue and they only do correction >.75 anyway. The lens we decided on after consultation with my surgeon and as per my post in the 'I need feedback on the J&J TECNIS® 1-Piece IOL' thread is the ZCB00. As I mentioned, it was mainly due to the greater incidence and faster occurrence of PCO with the Zeiss Asphina/rectangular haptic shape! 😮
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BTW: I also noticed your post/s on the Alcon lens. You may want to read the study I came across in my research called 'Glistenings, anterior/posterior capsular opacification and incidence of Nd:YAG laser treatments with two aspheric hydrophobic acrylic intraocular lenses – a long-term intra-individual study' Where they compare head to head the AcrySof IQ SN60WF and the Tecnis ZCB00!
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Their conclusions were :-
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'Significantly more ACO was seen with SN60WF' .
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And.......
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'In summary, this randomized controlled intra-individual study did not reveal any statistically significant differences regarding visually disturbing PCO development over time between the two monofocal aspherical hydrophobic acrylic IOLs, Alcon AcrySof SN60WF and Abbott Medical Optics Tecnis ZCB00. Anterior capsule fibrosis and contraction as well as glistenings were significantly more pronounced in eyes with the SN60WF IOL.'
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Regards,
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DonD
RonAKA DonDiopter
Edited
I finally read the report and found a couple of notable statements:
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"Indication for Nd:YAG laser treatment of the capsule was a subjective visual complaint from the patient in combination with clinically significant posterior capsule opacification visible at slit‐lamp examination. During this period, 8 of the 100 operated eyes received an Nd:YAG laser capsulotomy. SN60WF was implanted in two of the treated eyes, and ZCB00 in the other 6."
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Although the report determined the difference was not significant, YAG for PCO was required at 3 times the rate for the Tecnis compared to the AcrySof. The graph in the report also showed that the YAG was needed about a year earlier in the Tecnis compared to the AcrySof.
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On glistening they said:
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"The presence and quantity of glistenings did not correlate with visual performance or subjective visual quality."
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I take this to mean they could see the glistenings with the slit-lamp, but the subjects felt they had no impact on actual vision.
RonAKA DonDiopter
Edited
The other interesting finding in this report was that none in the study of 50 people reported any visual issues while having a blue light filtering AcrySof lens in one eye and a clear Tecnis lens in the other eye.
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"No patient reported any disturbing interocular variations in colour perception in spite of the difference in colour between the two study IOLs, with a blue-blocking filter in the material of the SN60WFIOL and a clear optic in the ZCB00IOL (Fig. 1)."
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I also noted that Alcon has subsequent to the lenses used in this study changed the manufacturing process to reduce the issue of glistenings.
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"After the surgeries in this study were performed, a change in the manufacturing process of AcrySof ÒIOLs has been claimed to decrease glistening formation (Thomes & Cal-laghan 2013). Although published in vitro research supports this claim, it remains yet to be proven in clinical follow-up studies"
DonDiopter
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Hi All,
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Just an update on my 'progress' as per my other posts on Sue and Joan's EM threads.
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Looks like I was somewhat prescient as last Monday I went for an OCT scan due to the VA issues experienced post surgery on the advice of Dr Genial. The Orthoptist said it looks like I have an Epiretinal Membrane (EM) and will require retinal surgery! On Friday I had second OCT with my Optometrist and slit lamp eye examination. Good news is the target is still at the desired -1.75D , there are no artefacts, lens issues or PCO but the OCT scan returned the same result of a visible EM! 😦
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Consequently, this week I have an appointment with a new Prof. (#3). of ophthalmology who specialises in retinal surgery! He is The Retinal Specialist here and apparently one of the best if not the best in the country with a long list of degrees, qualifications, board positions and published research papers etc! So hopefully I have the Top Guy and be in the Best 'Hands'! ! 😮
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Stay tuned!
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Regards,
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DonD
RonAKA DonDiopter
Edited
Sorry to hear you are having EM issues. I'm diabetic and used to go to a retina specialist for annual exams. They have a pretty good website (Alberta Retina Consultants). Here is a quote from the page on EM.
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"The decision on trying to repair the membrane depends on how impaired vision has become. This is often determined by whether or not you can read with that eye alone (ie. Cover your good eye). If untreated the epiretinal membrane may remain stable or may continue to increase its distortion and cause further vision loss in the eye.
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What can be done for an epiretinal membrane?
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When vision is significantly impaired a surgical procedure called an vitrectomy and membrane peel can be performed. This procedure involves the removal of the vitreous gel from the eye. The epiretinal membrane is then gently grasped and peeled from the surface of the macula. Once the membrane is removed the traction on the retina is relieved and the macula can begin to flatten and become smoother. The vitreous gel is replaced with a special saline fluid during surgery and gradually your body replaces it with naturally produced fluid. Sometimes your retinal surgeon will decide to replace the vitreous with an air or gas bubble to help flatten the retina. The air bubble gradually goes away on its own and is replaced by the eyes normal intraocular fluid. Three small self-sealing incisions are made into the eye to perform the surgery. Occasionally, dissolving sutures are used."