Second Cataract Surgery
Posted , 10 users are following.
I have to decide by friday whether to have 2nd surgery or not. I do not know whether to get a second opinion. The first surgery resulted in 20/30 vision but i cannot read my notes on a notepad even if i hold it up to my eye. I cannot read the title on a certificate about four feet away on a table. My doctor says I will be able to see clearly after I get new glasses. it has been 1 week since my surgery. My left eye has much clearer vision with glasses. Please advise.
0 likes, 40 replies
rwbil teresa13383
Posted
"It was just disconcerting to find that, unlike with my left eye, I cant read notes on a notepad holding it up to the eye."
At this time no man made IOL can successfully mimic what the natural lens does. Maybe with the exception of the Crystalens, they are all non moving piece of plastic and just use different techniques like providing multi focus points and hope your brain figures out the best picture to present to you.
Expecting to read tiny notes held up to your eye is a tall order for any IOL. Even with my MF IOL I have to find the right sweet spot and need decent lighting depending on what I am trying to read.
I think it would be really helpful to take some time and research IOL and defocus curves to get an idea of realistic expectations.
Below is a video just put out on defocus curve, you can start there and in fact this Opthmalogist has a series of videos on various IOLs.
Go to youtube and search for, "Vision Acuity and IOL characteristics - a defocus curve understanding" by Eye Surgery Explained and watch that and his other videos.
Warning he talks fast, maybe it is the accent, so prepare to listen closely.
And while at youtube check out Shannon Wong and his various videos on cataracts. Just fron watching those videos you will get a tremendous education on Cataracts, IOL options and the tradeoffs.
teresa13383
Posted
My eye doctor said she implanted an Alcon monofocal lens.
The vision for both eyes when I had glasses was 20/40 (right eye) and 20/30 (left eye).
My vision without glasses was-10. Because of my extreme myopia and glaucoma she thought it best to stick with monofocal and not more expensive lenses. In all of her surgeries it was set at long distance. She says I will be able to read fine print with glasses and not requiring a second set of glasses. The cataract in the right eye was worse. She said I have 2 options: Get left eye surgery and wear bifocals or wear a contact lens on the left eye and get the bifocal glasses instead of surgery.
I have worn hard contact lenses for years without too much trouble. I had to wear glasses when my contacts started popping out at work and my optometrist said I was too old to wear contacts.
The doctor says my eye will be fully healed 1 month after surgery.
I have to make an appointment with an optometrist. My appointment for a second opinion is not until July.
RonAKA teresa13383
Posted
My thoughts would be to get the same monofocal lens set for distance in your left eye and get yourself clear of the cataract issues. I would not bother with the contact lens solution when you are still fighting a cataract for vision. I think with the issues you have you would be best to get progressive glasses when both eyes are done. That should give you all around good vision and correct for any residual astigmatism.
teresa13383 RonAKA
Posted
I thought no one responded to my last post. I overlooked one reply. The reply was very helpful. I will probably end up with surgery to the left eye just like the right one. Because it is my eyesight that is at stake I will continue to get a second opinion. I have an appointment to see an optometrist in July. Thanks.
teresa13383
Posted
I went to see a 2nd eye surgeon. He said I could have had a toric lens put in for astigmatism. If seeing perfectly close up without glasses is important to me I can have one put in the left eye. He said I could not have one lens set at a closer distance because of the astigmatism.
teresa13383
Posted
I cant find the latest posts in my discussion. Anyway I told my eye surgeon it was still disconcerting that I could not see clearly up close without glasses after my surgery on my right eye. I cannot grab my phone at night and read it without glasses for example. The doctor misinterpreted this to mean that I want to be able to read my phone without glasses. She gave me 3 options. I immediately discarded the third option because it is "tricky," The first option is toric but nearsighted. I would need glasses for distance. The second is toric but Plano like the right. I would need glasses to read. I imagine the vast majority of people who get monofocal lenses are not bothered by not being able to see close without glasses. is this true?
RonAKA teresa13383
Posted
I think it depends on the pre IOL status of the eyes. Those who are far sighted and older are used to needing readers to see close, and a distance IOL really is no change for them. Those who are myopic or near sighted have a harder time adjusting as they are used to being able to see clearly close up without glasses.
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My solution has been to go to mini monovision with one eye under corrected by -1.25 D to give me some reasonable reading ability. I currently simulate that with a contact lens, but plan to make it permanent when it comes time to do my second eye with an IOL.
Night-Hawk teresa13383
Edited
Most folks when they get cataract surgery are usually age 60+ and after age 40 even a person with normal vision will start to lose their near focus vision. By age 60 it affects even at 2 feet focus like looking at a computer monitor. So beyond age 40, most folks have to use reading glasses, unless you are near-sighted that acts like using reading glasses.
So folks who are used to good distance vision without glasses and are older achieve the same vision they are used to with monofocal IOLs set for distance focus. But for those who are used to being nearsighted and able to focus at near distance without glasses even when they are older, they will of course be not used to the difference if they are given monofocal IOLs set for distance focus.
So each individual has to decide before cataract surgery what focus range they prefer without glasses: distance, intermediate, or near, and alert the eye doctor to your preference to discuss options. Mixing focus range for each eye (monovision) is a possibility, to possibly cover two of the three focus ranges.
If an eye has too much astigmatism (beyond about 1.5 cylinder) toric IOLs would be needed to focus clearly even at one distance range, otherwise glasses or contacts would always be needed.
teresa13383
Posted
I got my new glasses with the right lens corrected for the eye that had surgery. I am seeing double. The optical technician said I need prisms but the receptionist at my surgeons office says to wear them and after awhile I will stop seeing double. Needless to say it is difficult to type or do anything.
The optometrist said I would be able to read fine print perfectly with the eye that had surgery and glasses but that is not the case.
My question is that my surgeon gave me 2 options involving toric lenses but if one eye already has a monofocal lens what is the point of having a toric lens in the other eye? And if one is adjusted so that you need glasses for distance what about the eye that wasnt adjusted for reading?
teresa13383
Posted
I just spoke with eye surgeon and will have toric plano in left eye. I have been using my old glasses which basically relies on the left eye. The right eye cant see anything. Now it seems that I am supposed to use my right eye without glasses to get around and use reading glasses for reading. When I tried moving around using my right eye, I almost fell over. How long will this last? my right eye has a standard monofocal lens.
RonAKA teresa13383
Posted
Just to be clear, a toric lens corrects for astigmatism. That really has little to do with being able to read. When you correct astigmatism it should improve vision at all distances. Astigmatism can also be corrected by eyeglasses. So you do have a bit of a point about whether or not a toric lens is necessary. If you have significant astigmatism in your IOL, right eye, you will need glasses to correct it, so you could use a standard lens and just let your eyeglasses correct the astigmatism. That would likely be the cheaper way to go, if you are paying out of pocket. In Canada a toric lens costs $1,000 more. Kind of the same with prism, if you need prism correction it would be best to correct it with eyeglasses. To make a good decision you need to know if you have residual astigmatism in your right eye after surgery. If there is not much, then going eyeglasses free for distance may be a possibility if you go with a toric IOL in your left eye.
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Correcting astigmatism with a toric IOL is most necessary if the overall objective is to be eyeglass free.
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As far as managing now, I would suggest a contact lens for your left eye. Hard contacts are seldom used any longer. Soft contacts are very good. You may want to ask your optometrist for some trial lenses to use. I find that the Costco Kirkland lenses which are really CooperVision 1 day to be the best for me. J&J Acuvue Oasys 1-day, and Alcon Total 1 are close seconds to me for comfort. If you correct your left eye with a contact for distance, then standard reading glasses should let you read.
teresa13383
Posted
Thank you for your speedy reply!
My surgeon decided on the toric lens because I have twice the amount of astigmatism in the left eye as the right. Also she said if I ever have surgery for my glaucoma it would increase the astigmatism.
My concern is getting around without prescription glasses while waiting for my left eye to heal. For some reason it is difficult. I had been using my old glasses so I could see out of left eye. Now I wont be able to use those glasses and I feel off balance using my right eye that had surgery.
lucy_73160 teresa13383
Posted
Teresa, you said that your vision in your right eye after surgery is 20/30.
That is pretty good!
As background, I had myopia in between -6 and -7 in both eyes with mild astigmatism. My lenses are plain non-toric lenses set for distance. I am happy with them. My vision is now 20/20 in one eye, and 20/40 in the other eye. I do not have to wear glasses all of the time. (Wore glasses since I was 8 years old). I did not get prescription glasses after my cataract surgeries; I just use readers for close-up. I do not need them when using my lap top, but I need them for the phone and reading books, magazines, recipes, etc.
As far as what to do while waiting for your left eye to heal, remember that you will have distance vision even while that eye is healing. It is the close up vision that you will need. This is what I did: I went to the dollar store before my surgery and bought several pairs of cheap readers in various strengths (2.00, 2.50, 3.00, 3.50). It was the 2.50 strength that I needed after surgery, so I threw away the others. You just need something to get you through the period of time until you get prescription glasses.
Good luck!
teresa13383 lucy_73160
Posted
Thank you so much for your reply. I still need to wear prescription glasses after surgery but wont be able to order them for a month while my eye heals. My right eye that had the surgery does not provide clear vision. The tv is blurry and I cant read the captions. I did buy readers for reading and they are ok except for some YouTube captions and medicine bottles. I am trying to just use the right eye around the house and I feel slightly unbalanced. I'm afraid to use the stairs. I have a pair of glasses that are corrected for the right eye after surgery but the left lens is my old correction for my left eye without surgery. I cant use them because I see double. I wonder if the left eyeglass lens can be taken out and that I can use my right eye only.
Right now I wish I had not had surgery. There is not much improvement in my sight and I still have to use glasses. I am losing my natural lens and its ability to focus on near things like my eyebrows.
RonAKA teresa13383
Posted
Yes, you could take the left lens out of the glasses. They can be tricky to remove so you may want to get the optometrist place to do it for you.
teresa13383 RonAKA
Posted
Thank you RonAKA!
teresa13383
Posted
Something strange happened. I got a call from the surgery coordinator that my surgery has been canceled. My surgeon said my eye was "too different" and she wants me to have a cataract evaluation with her partner. A friend of mine had a bad experience with her partner so I dont want to see him. I made an appointment with the surgeon I got the 2nd opinion from. It's in January. I'm really upset. How could the doctor suddenly change her mind? Is it because I kept asking questions like how soon I can drive? I paid for a toric lens and set up rides. How bad can my eye be?