Tuesday, May 13, 2014

Shadow Line after Cataract Surgery

Question: I had cataract surgery 2 days ago and now I am seeing a black shadow line in the outside corner of the eye they operated on. The line jumps back and forth making it impossible to read and I have trouble driving. A friend had the same surgery a year ago and he has the same problem. Can this be fixed?

Answer: In all likelihood you are seeing the outer edge of the lens implant used to correct your vision. Many patients experience this as they adapt to the new implant and vision. In almost all instances over time this will become completely unnoticeable. Please be patient and discuss this with your cataract surgeon at you next visit.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Spider Web Vision after Cataract Surgery


Question: I had cataracts removed and toric lens implants in March. The left eye was done first. I had severe astigmatism and nearsightedness. I was told that I would only need glasses for working on the computer and reading. However, while I'm waiting on my glasses, I find that I have developed some massive spider web like floaters in my direct line of vision. My cataract surgeon even could see that is where they are. My distance is getting worse and prior to the surgery, I could see to read slightly without my glasses. Now, I cannot see to read anything without help (using readers for now). Everything is cloudy, out of focus and I feel like I have made a grave error in having this procedure done. I feel like I'm losing my mind. Any help you can give me would be greatly appreciated.

Answer: Without a careful examination it is impossible to say for sure but it does sound like you are describing a common occurrence after cataract surgery called a vitreous detachment. In fact some 50% or more of patients having cataract surgery experience a vitreous detachment-but not all instances cause vision problems. The vitreous gel is normally adhering to the surface of the retina. With age the gel liquefies and separates-especially after cataract surgery-from the retinal surface. If this happens on the visual axis it can cause exactly what you are noting. The good news is that over time this disturbance does go away by itself with no treatment necessary.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Allergy to Lens Implant Acrylic Monomer?

Question: I work in a dental lab and am allergic to the monomer that is used to make dentures. This is an acrylic. Since the cataract lens is acrylic, will I be able to have a cataract lens? Or is this a totally different type of acrylic? This may seem like a silly question but I still want to ask.

Answer: First, not all lens implants are made from acrylic materials if you are very sensitive. Second, being allergic to raw unreacted monomer is much more likely than reacting to a miniscule trace of unpolymerized residual monomer that might be in a finished lens implant. The FDA holds IOL manufacturers to exceedingly strict tolerances and specifications regarding residual monomer-especially in implantable devices, thus the chance of an allergy are quite remote. However, discuss this with your cataract surgeon who can then choose a different lens implant material for you in order to avoid all risk if necessary.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Lens Implant Edge &Tremors

Question: I had cataract surgery a month ago. I have clear vision but I can see a portion of my lens and it moves. It also has very quick tremors that don't affect my vision but scare me. Is this normal or should I worry and will it ever go away.

Answer: It is not uncommon for some people to actually see the edge of their lens implant after cataract surgery. Some patients do also experience a sort of tremoring as part of the adaptation to the lens implant. All of these visual occurrences seem to be self limiting over time.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Flickering after Cataract Surgery

Question: It has been 3 months since I had cataract surgery andastigmatism correction, with a monofocal lens. I have terrible "flickering" when I am in an area with fluorescent lights. Will this ever go away?

Answer: Some patients having cataract surgery and lens implants do report seeing some flickering of light under certain conditions which are thought to be related to the adaptation to and reflections of light from the intraocular lens implant (IOL). For just about all patients this visual effect does subside after some period of time which varies patient to patient. Please be patient and feel free to discuss it with your cataract surgeon if it continues or gets worse.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, April 14, 2014

Different Multifocal Lens Implants in Each Eye?

Question: I have cataract in both eyes and need cataract surgery. Is it possible to have a ReSTOR® multifocal lens implant in one eye and a different multifocal that would do well in dim light? Would Medicare pay for one single vision lens implant if I have a multifocal lens implant in the other eye?

Answer: While it is possible to mix and match multifocal lens implants, it is not a generally used practice as it can result not only in adding some benefits, but in extending some problems and optical complexity. Generally one would “mix and match” if there was a need to modify the near and intermediate range of vision this could be attempted-BUT could result in the highlighting of side effects of each. Follow the recommendations of your cataract surgeon. Medicare will pay for the monofocal lens only-even if you have a multifocal in the opposite eye.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, April 1, 2014

Toric Lens Implants & No Astigmatism Correction

Question: I had cataract surgery and toric lens implants. After an extensive exam yesterday, I have found out I still have almost all of the astigmatism that I had before surgery nearly 2 years ago.  How can I find out if I really have the toric lens?

Answer: If you are questioning whether in fact your cataract surgeon actually used toric lens implants to correct astigmatism rather than conventional spherical or aspheric implants, there are several things you can do. First, you may have been given a small identification card tat identifies the brand and parameters of the lens that was implanted in your eyes. This would identify whether it was a toric lens. If you do not have this card, then perhaps it might be best to schedule an appointment with another cataract surgeon who can review your preoperative records and the results of your recent exam and then after his or her own exam render an opinion regarding the history and state of the astigmatism correction for you.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, March 18, 2014

Lens Implants after LASIK

Question: I had cataract surgery in my left eye 10 days ago. I have terrible halos, rings and pentagon shaped bright lights around all lights at night that are unbearable. I also have blurriness for distance that is much worse than before surgery and double vision. I had LASIK done with monovision 5 years ago with relatively good success. I'm 59 years old. Yesterday my cataract surgeon told me the best solution is to remove my Technis® Lens Implant he had put in as soon as possible and put in a monovision lens or a Crystalens® lens before doing the left eye. I have astigmatism. Which do you think I should choose for my eyes?

Answer: Lens implants after LASIK can be tricky. Depending on the type of LASIK you had and the presence of corneal aberrations, as well as any contrast reduction from the LASIK flap-one needs to VERY carefully select the type of lens implant AND consider optical aberrations and if they are going to interfere with lens implant optical performance. Further, the multifocal lens implants in and of themselves cause many of the symptoms you are describing. You need to have an aberrometry, a careful examination of the placement and position of the lens implant and a determination of the likely cause of your symptoms-only then will it be possible to make the best choice. Certainly the lowest risk choice is to avoid the multifocal or accommodative lens implant and stay with a monovision correction. Last, if you have a meaningful amount of astigmatism this needs to be carefully considered as well so as not to leave it uncorrected. Both the monovision option with a toric lens implant or a Crystalens® toric lens implant can hopefully address that for you. 

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

ReSTOR® Multifocal Lens Implant & Astigmatism

Question: Four months ago had cataract surgery using ReSTOR® Multifocal Lens Implant in both eyes including corneal relaxing incisions for previous astigmatism. I am adjusting to the various distances for reading and computer and the need for good lighting. However my distance vision is blurry so have a problem reading street signs until almost on top of them.  It has been suggested that more relaxing incisions should be done and in the office. 

Answer: It is impossible to know whether you might need additional relaxing incisions as it is not obvious whether the cause of your distance blur is indeed uncorrected astigmatism. Generally if one has a meaningful amount of uncorrected astigmatism it would also impact clarity at other distances and not just distance vision. Before having additional relaxing incisions you might want to get a second opinion and definitive reason for the decreased distance vision. While it could very well be due to the astigmatism, it could be due to other causes or just an inability to tolerate and get the desired performance from that lens implant design-which does cause a considerable contrast reduction. And, it may be that an alternative to the relaxing incisions might provide the beast clarity.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, March 4, 2014

Cataract Surgery Risk & Diabetic Retinopathy

Question: I have had Type 1 Diabetes for close to 34 years and have had vitrectomy and scleral buckle on my right eye 20 years ago along with a gas/fluid exchange. The buckle is still nice and low in that eye and I also developed a cataract and had cataract surgery and a lens implant 8 years ago. I have now developed a cataract in the left eye at age 52. I have also had PRP diabetic retina laser in both eyes. Most of my peripheral vision has been lost in the right eye after the vitrectomy, so my question is, should the cataract surgery be done immediately on my left eye since my quality of life is not being impacted and I still correct to 20/20 in the left eye with full peripheral vision. Are there also greater risks to the cataract surgery now that the PRP was performed years ago? I currently see a retinal specialist and also an ophthalmologist who is a cataract surgeon.

Answer: Generally, the decision to have cataract surgery is up to the patient based on whether there is any decline in quality of life, mobility limitations or safety concerns because of diminished vision from the cataract. If you still correct to 20/20 and do not experience any limitations you can delay the cataract surgery until you judge that it is a problem. There should be no increased risks due to the PRM but your retina specialist will most likely consult with your cataract surgeon and clear the stability of retina and vitreous for surgery when it is time.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, February 25, 2014

Eye Color after Cataract Surgery

Question: When you have cataract surgery does your eye color change or remain the same? I've seen some people's eyes darken or lighten.

Answer: There really should be no change in eye color after cataract surgery unless there is either a complication changing the iris shape or significant inflammation or other complication.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Allergic to Lens Implant Material


Question: My wife has cataracts and needs to have them taken care of, however she is allergic to acrylics and is afraid to have that done for fear that her body will not accept the lens implants. 

Answer: The acrylic materials used in lens implants are typically highly biocompatible and non reactive as they are carefully tested and there is virtually no residual monomer, however there are indeed reports of low grade inflammation in rare patients that are allergic to acrylics. That aside, your wife's cataract surgeon could consult with the lens implant manufacturer and subject her to a test by exposing her to the material perhaps on an underarm area taped for some time or better yet the cataract surgeon could simply use an alternative lens implant material, for example a silicone material or a collagen-silicone material. The best thing to do is to discuss this with the cataract surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, February 20, 2014

Playing Oboe after Cataract Surgery


Question: Since I play oboe, which requires a rather extreme amount of pressure to blow, would it be advisable to not play for a while after cataract surgery, and how long a time would you think would be advisable?

Answer: The best answer to your question about playing the oboe after cataract surgery really should come from your cataract surgeon as he or she knows the exact course of your surgery, incision status or any potential complications that might have occurred during your cataract operation. That said, the general opinion of cataract surgeons is that waiting a week after an uncomplicated cataract and lens implant surgery should be sufficient to resume your oboe activities.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, February 10, 2014

Cataract Surgery While Pregnant

Question: I am 36 years old and have lost my vision in my right eye due to a cataract. My left eye is becoming more blurry daily. I am 19 weeks pregnant and have been told I cannot have the eye surgery until after my pregnancy from my OB-GYN. I am concerned because I don't want to cause more damage to my eyes by waiting, besides I cannot see. Does this type of surgeryhave risks for the baby?

Answer: Most cataract surgeons would prefer to wait until after the pregnancy to perform cataract surgery. The risks of cataract surgery to the baby are minimal especially if the surgery is performed with eye drop anesthesia and probably even with local anesthesia. Still, there is always risk during surgery and for that reason it is preferable to wait. That said, you do not identify why you have cataracts-and a progressive cataract, and this is more alarming if it is related to your pregnancy and overall health. If you are a high risk pregnancy or have other medical problems, if you not have already done so, you can at least schedule a consultation with a cataract surgeon in your area and allow them to follow your eye health.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Wednesday, February 5, 2014

Retinal Detachment Risk after Cataract Surgery with High Myopia

Question: I am a 49 year-old male, have had cataracts in my right eye for 7 years which is also extremely myopic with a -12.00 correction. Fortunately, my left eye vision has held up, and I have been able to function normally with my left eye vision for many years. Starting last year, my left eye started to develop cataracts.  I have been myopic my whole life, and my left eye has gone from about -6.5 before I developed cataracts to -7.5 now.  With correction, I used to see 20/20 in both eyes. Now with cataracts, my vision is 20/30 in the left, and almost blind with my right.  I have also developed presbyopia so I need reading glasses in both eyes.

Because I am relatively young and myopic, my ophthalmologists have told me that I am in the high risk category for retinal detachment after cataract surgery. Therefore, I have delayed my cataract surgery for as long as possible. Given that my left eye is getting blurry and my right eye cataract is are getting dense, increasing the cataracts surgery risks, I have decided to get cataract surgery soon.  Given that my left eye is still functional, I have decided to get a cataract surgery in my right eye first, with no plans on the left eye surgery, hopefully until many years later.

I was told that I am left eye dominant, so even with near-blindness in my right eye, I have lived a normal life. If I correct the right eye vision for distance thru the cataract surgery, I was told that I would have to wear contacts on my left eye to balance out the vision. 

My question is as follows:  If I don't wear contacts, but rather wear glasses such that the left eye correction is around -3 (versus full correction of -7.5), and right eye would have no correction (except for reading glasses), would I be able to function for reading and distance?  In other words, given that I am left eye dominant, but after the cataract surgery on the right eye, I will have distance vision on the right eye and partial correction on the left eye through glasses, would my brain be able to function or will I be too dizzy?  I'm just trying to see if I can avoid wearing contacts everyday and still function. Thank you so much for your advice!

Answer: It sounds like you are getting careful consideration from your ophthalmologists who know your situation the best. The decision to have the cataract surgery in the right eye first sounds like a good idea-BUT-you may want to have a thorough evaluation of your retina by a retinal specialist if you have not already done so in order to be sure the retina will withstand the cataract operation and to determine whether any prophylactic treatments of holes, tears, weakening or degeneration might help to reduce your risk of retinal detachment. After clearance by a retinal specialist you can be more confident that you have taken any necessary precautions. Regarding the -3.00 D difference after surgery, it is likely to cause headaches and possibly dizziness if you don’t wear a contact lens. You need to know that the best result is when both eyes have had the cataract surgery and thus while delaying the left eye surgery might seem prudent, it does make things even more risky surgically the longer you delay. Of course this is up to you and your cataract surgeon. You can try the eyeglasses with the -3.00 D difference and see if you tolerate it but it is questionable.


Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.