Vision improved after cataract surgery, then worsened 1 month later

Hi Sue

I have had cataract removed from both eyes and it was never discussed with me anything about types of lens but others on this site have mentioned different types of lens.  My understanding would be that after the optician has tested your eyes and referred you to the hospital Consultant for your operation that they are the people to decide on what type of lens to insert, you wouldnt know yourself what should be put in there and if the Consultants dont know with all the information that has arisen from all the test that have been done on your eyes then there is something wrong. Please let us know what you/the surgeons decide and please let us know how you get on

Regards Agnes

Hi Agnes, not sure where you live but in Canada only one type of lens is covered under Medicare meaning there are no out of pocket expense to me (when it is for cataract surgery). For other types of lenses multifocals, trifocals or extended focus lens they are not covered under Medicare and there would be additional out of pocket expenses. My surgeon is in no way pressuring me one way or another (I have already had my pre-op consultation). Due to additional questions I have he has scheduled another appointment for me). I am aware there is a compromise to be made whether I go for ones covered under Medicare and a different compromise to make if I opt for the premium lenses that incur additional cost. Mostly to do with night. vision (glare halos & starbursts around light sources at night). Of course there is a smaller risk with monofocals that those could be issues too. The surgeon of course from his calculations knows the power, etc that's needed. For me it is which lens to choose that I want additional info on.

Hi Sue, im in Scotland, its so different depending both where you live and what kind of consultant you get, over here I dont think its discussed "types of lens" it is all dependant on the tests that are done this is what should determine which lens you need.  I expect maybe they would want you to decide if you want lens that will enable you to see either long distance or short distance, I dont know if they can insert lens that would cope with both, whatever I have I can see fine to drive, I wasnt allowed to drive before my op but I am just fine now, I cant use the computer without glasses but when reading, depending on the size of print I need to wear reading glasses, let me know what they decide after your next consultation

Regards Agnes

Couldn't agree more Agnes. The upside might be different places approve new technology faster than Canada so can learn a bit how newer lenses are doing elsewhere. Must be late where you are. I have family in England - challenge to find times to chat.

Thanks Agnes

I know the other conditions are progressive, but she was ecstatic after years of not seeing well due to the cataract, being nervous about whether the surgery would imnprover her vision or not....if it had already been compromised due to the mac degen or glaucoma. Then to have it sort of just go away soon after the surgery. I have no idea why she did not return to the surgeon. She has a retina specialist and an opthamologist and at her visits they never really say anything in response to her " I don't know why it was so good and now I really can't see". I know they never encouraged her to see the surgeon again. Months and months passsed and after seeing the retina specialist for the 3rd time or so post surgery, now he says oh this is to do with your retina. See it has changed. But, he didn't mention it the other two times post surgery. So, I really don't know about the correlation. I had her see a dry eye specialist, who prescribed a regimen, which was too much for her to deal with...so that variable is not really out of the running. But, I must say that her opthamologist disouraged her from trying a fairly assertive approach to the dry eye, which the specialist said was 40% tear film, 60% meibian gland. So, it is improvable. At times, my mom has mentioned that she sees better for a short time when she cries! But, I got her some hyaluronic drops and she doesn't have any improvement. Anyway, I think I am close to convinving her at least to go back to the surgeon. We are in the USA, and one can not always get a truthful answer from Drs when something unexpected happens because they are on lawsuit alert. Anyway, I thought maybe there was a common thread here with the better vision for short time post surgery, then declining, that I could find, and somehow I could seek out the cause. I'll let you know if we get any answer to this issue. It is a big deal. since it could determine what type of care facility she should look into if she doesn't have good vision.

Perhaps you may want to take your mom to another Dr for a second opinion if getting nowhere with current one.   Aside from the other issues that could be a factor you might want to look into what's called PCO.  There is a risk of developing posterior lens capsule opacification (PCO) following your cataract surgery. PCO is a complication that causes the back of the lens capsule (which holds your artificial lens in place) to thicken which causes cloudy vision. If this is what's happened laser treatment can be used to make vision clear again.  I am certainly no expert but might be a question to ask an expert.

?Hope your mom gets her answers soon.  Must be so frustrating for her.

Hi Maryram, how worried you must be, eyesight is so important, I can understand why she is feeling so down.  I am in Scotland so things, according to this site are quite different regarding lens etc, but one thing is the same, Drs are on the alert, they are much cleverer here, before the operation they expalin to you that there could be complications of various sorts, this is to cover themselves and if you dont sign to say you accept this then they wont do the operation, fortunately, so far im ok and hoping it remains that way but one never knows. Something else mary, I think everyone will have different symptoms after surgery, yes some similar but in general we all come out of this operation with something different.  I have my fingers crossed for your Mum, please let us know how she gets on with her appointment

Kindest regards Agnes

Thanks, Agnes.

Interesting how it is presented in Scotland (and UK?). Here, they hardly talked about complications, aside from no improvement - blaming it on other conditions, or severe complications (blindness) - saying it is sooooo rare. I found out just by reading around on the web about dry eye - I think we asked, but (as expected) the DR poo pooed it. Incidentally Drs also "hide" dry eye complications when talking about Lasik. It is frustrating for sure that you don't know all the "in between" complications etc that can happen. For that, one has to pretty much read through medical literature. where at least there is a more open discussion - but that is a big undertaking! For the present, we'll do the rounds once more and go back to her surgeon and see what is said. Then a second opinion may be in order as Sue suggested. I will let you know! Best, Mary

Hi Maryram

I cease to be amazed at the after op complications, sorry if im repeating myself, for goodness sake isnt it terrible that the specialists dont know what to do or what to tell you, this is my, and others experience, after surgery instructions just doesnt happen, small things like what to do if you have itchy eyes or if you get something in your eye or a dozen other things, it would be so good if they would tell you what you can or cant do, if for instance if you rub your eye or try to take something out how would this affect the lens or anything else they have done to your eye.  My sight is ok not wonderful but I can live with them like this ie drive, watch tv, I do have to wear glasses if I read but they are just over the counter ones that didnt cost very much, they are just fine for reading but I do have tired, gritty  and a heavy feeling in them both but its better than being blind.  Please keep us up to date with how your Mum is doing

Regards Agnes