Lens Exchange after Cataract Surgery

Question: I am a 53-year-old male who had cataract surgery in one eye in March 2011. Prior to the surgery I was near-sighted in both eyes, about -2.75, with some astigmatism. I discussed the replacement lens with one of the doctors, and we decided they'd try to get the vision as close to "perfect" in that eye as possible. Four months after surgery, I am now far-sighted in the eye with the replacement lens, +1.25. Because of this, I no longer have the option of wearing glasses, and must now wear contacts. This can be extremely inconvenient at times for various reasons, including the fact that my seasonal allergies can make it uncomfortable to wear contacts. I'm thinking of asking my surgeon if we could redo the surgery to replace the lens so I am not far-sighted in that eye, so that I have the option of wearing glasses. Would a second surgery be advisable? Would it be unreasonable for me to expect them to "fix" this free of charge? It seems like a bit of a mistake on their part to leave me +1.25 with the new lens when I'm -2.75 in the other eye. Thanks for your help.


Answer: While the precision of the calculations for Lens Implants with Cataract Surgery is generally quite good, occasionally due to some unpredictable factors the actual result is not as planned. In your case the unplanned residual refractive error and magnitude of the inequality between eyes necessitates wearing a contact lens correction in order to achieve good vision correction. There are three options that are available to assuming your eyes are healthy. You can continue to wear the contact lens correction as you are doing but that does not seem satisfactory. You can also discuss having a Lens Exchange with your Cataract Surgeon in order to get closer to a more symmetrical refractive error in each eye which would allow you to wear glasses to see clearly at distance. This is done with some regularity with patients who have this type of situation. Last, you can discuss with your Cataract Surgeon the possibility if having a LASIK Surgery procedure in the -2.75 D eye with a planned overcorrection so that both eyes were +1.25 and would necessitate the wearing of glasses for both far and near.

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