Topic IOL during cataract surgery
Posted , 3 users are following.
I have had toric IOL monofocal (set for distance) implant in my eye during my cataract surgery.
Its been more than 3 weeks and i have been adviced to use the eye drops for some more time.
I still see that my vision for far distance is blurry, although my near and intermediate seems great.
I am worried about my far vision still being blurry, especially several weeks in post-op.
Is this expected.?
I am thinking - this is all possibly the side effect of the still ongoing eye drops regime i have been adviced, and perhaps it may start improving once I completely stop the eye drops routine?
I have seen my surgeon post op, and she seems to be happy with it in terms of surgical situation in the eye.
Has anybody have similar experience - i.e toric iol lens, still blurry vision for distance after several weeks in.
Thanks.
0 likes, 9 replies
s40264
Edited
Sorry, the title is misspelt - it should say Toric not Topic.
My phone thinks i have got my spelling wrong and wants to keep it as topic 😃
Also when I say my near/intermediate is great, i mean manageable with readers, etc. as i did not have have any better expectations there.
Its the far vision being blurry that is my concern at this point.
RonAKA s40264
Posted
Sorry to hear you are having issues. I did not have a toric lens, but my wife did, and had a very normal recovery, the same as I had. It does take 5-6 weeks for a full recovery and stable eye refraction. We had an exam 24 hours after surgery, and again at 3 weeks, and at 5-6 weeks you can get an optical exam and eyeglass prescription. Neither of us had any issues with vision after taking the eye drops other than the few minutes after putting them in. I recall one of the two types I was taking had a bit of a sting to it when you put them in, but that quickly went away.
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Some questions. What brand/model of a lens did you get? What was the target set at? Distance vision or ?? What was the reason for extending the use of eye drops?
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The eye exam at 6 weeks and eyeglass prescription will be very telling as to where you ended up with your vision. Even if you don't plan on getting glasses, ask for a copy for your records. The Sphere and Cylinder numbers will tell you how successful the surgery was.
s40264
Edited
Thanks for the reply.
mine was envista toric set for distance.
Not entirely sure why the drops were extended, maybe she saw some inflamation?
Sure, will check out at 6 weeks completion and see where i find myself.
The current VA is 20/35 apparently.
WIll do full power check after 6 weeks though one more time.
RonAKA s40264
Posted
The enVista is a good lens, and I would not suspect the lens itself to be a problem. But there can be issues with the power selected being correct for your eye. The calculations they use are not exact and there is always a risk of it being off.
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Astigmatism is corrected in an eyeglass by building in a specific cylinder power and angle (axis). With an IOL there is only one angle for the cylinder power correction it has. The surgeon has to manually position the lens at the correct angle during the surgery process. Getting the correct angle is critical to getting the best vision. A question to ask at the next exam would be to question whether the lens has moved, or is still at the correct angle. And also ask if the lens is centered properly in the eye.
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With respect to the power of the lens a normal distance target would be to leave you at -0.25 D of myopia. A visual acuity of 20/35 would suggest you may have been left at -1.0 D instead. The full refraction test is the best way to determine where you are. Also the cylinder and axis will let you know how well the astigmatism has been corrected. If you have old eyeglass prescriptions prior to cataracts you can compare them to where you are now to see what the impact was of getting the toric lens.
RonAKA s40264
Edited
I was thinking a little longer about your situation. If the refraction turns out to be -1.0 D in this eye, that is not all bad, if you can get close to 0.0 D in the other eye. That is called micro-monovision and can give you full distance vision at 20/20, along with intermediate vision, and possibly some computer/tablet reading vision as well. If -1.0D or so is where you end up, and assuming you are going to do the second eye, you will want to have a discussion with the surgeon about what can be done to learn from the first eye experience and more accurately hit the -0.25 to 0.00 D range with the second eye. If you can hit that, then your overall vision should be very good, and better than if both eyes hit 0.0 D.
s40264 RonAKA
Edited
Thanks, agreed its not a problem at all as you say there since i have already done my other eye a while back and hence together i have "pretty much" 20/20 and have no reliance on glasses at this time, since the other eye had no significant astigmatism, and the distance is crystal clear there and therefore resulting in overall better vision.
The interesting thing i am noticing is that the near and intermediate vision seems to be quite good on the toric eye as well, meaning i am not even needing my reading glasses now, leaving only the far with some astigmatic like effect (all that considering i have only done a monofocal toric for distance).
It would have been nice if i had lesser post op particularly distance astig effects in the toric eye, but its cool, overall i do not have a problem, but was hoping just in case the toric IOL eye has some scope to improve in the next few weeks 😃 that will be really nice, hence was hoping that some one here would come around and say that is exactly what happened to them... so wait for say month or more and perhaps the distance astig effects may get lesser over time.
RonAKA s40264
Edited
I was not aware this was your second eye. Was the first eye also an enVista and the same surgeon? If so, it would be surprising that they missed by that much if it does settle at -1.0 D. My optometrist says that at 3 weeks 90% of the healing should be done, and he only sees a few patients where it changes from 3 weeks to 6 weeks.
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In any case having -1.0 in one eye is probably a significant benefit to the overall vision and may leave you eyeglasses free for much of the time.
Spring1951 s40264
Edited
I got Tecnis 1 ZCB00 in my right eye 3 weeks ago set for a distance of -0.50 and now have in the early morning after waking about max 95 inches of distance vision. Throughout the day it is stable at about 65 inches of distance with close up starting about l8 inches. I assume that instead of -0.50 it landed to something like -1.00. I am waiting for 6 weeks for the last Optometrist appointment but somehow think it will not change since it hasn't from day one. My understanding is that the targets can land as far as -0.50 from the original target which would change things substantially. I am not all that unhappy with these results as it is similar to what I had before and better in some ways. I still never ever wear glasses and if I do it is generally for driving as required by law. I think I will now be able to pass the night driving portion of the test since everything is so much brighter without the cataracts.
I asked my doctor about Prednisone eye drops since I dislike putting steroids in my eye and she said they only help and to keep it up for the full month. I have not observed that the affect my eyesight after using them as I have tested it.
I just read something that said that distance bluriness can be caused by using your eyes on the computer encouraging myopia. The default setting for distance would be after waking and then with using one's eyes for close in viewing, the distance vision could get blurry throughout the day. This seems to apply to my situation as my distance is very clear upon waking and for one hour or so. I do use my eyes for very close in vision most of the day.
s40264
Edited
@Spring1951 - Thanks. I suspect i have ended up with a -1D / astig just like your situation.
Perhaps the computer viewing for substantial amount of time during the day is affecting it too.
I am going to wait and watch what happens in the next few weeks and perhaps it will improve - that will be nice.