Vision Change after Cataract Surgery & Lens Implants

Question: I had cataract surgery and lens implants some 12 years ago and had perfect vision until 6 months ago. The distance vision in my right eye decreased to where I would need a +2.50 D eyeglass correction. This happened with no particular event. I was examined by two different Ophthalmologists who had no explanation for the vision loss and agreed that the lens implant was clear, properly in position and there was no disease process. One of the eye doctors thought that the lens implant might have moved slightly but he has only heard of this happening one other time in 15 years. Is there some other explanation or a way to correct the problem with a new lens implant?


Answer: It is very unusual to have a large refractive shift like this 12 years after successful Cataract and Lens Implant Surgery. Without an examination it is only possible to speculate about some things you may wish to consider with your Cataract Surgeon. First, you did not specify whether the vision in the affected eye was actually correctable to close to 20/20 with the +2.50 D eyeglass lens. If the vision could not be restored with the eyeglass prescription to a near normal level then one must consider whether there was at one time a fluid accumulation or swelling or other disruption of the Macula.

If the vision could be restored to near normal, than the likelihood of a Macula problem is greatly reduced and it is most probable that the Ophthalmologists who examined you carefully looked for this possibility and ruled it out. Another possibility that can cause the late onset of a shifting of a lens Implant is a disease process called Pseudoexfoliation Syndrome in which the zonules that normally hold the capsular bag firmly in place begin to weaken allowing the capsule to shift and move the lens implant. Typically when this occurs there is a white flaky material that can be observed on the front surface of the Lens Implant, often way out in the periphery of the IOL. Also, it is often accompanied by a high pressure in the eye causing Glaucoma. PXF occurs more commonly in older patients of Scandinavian and Mediterranean origin. Again, it is highly likely that your Cataract Surgeon has thoroughly examined you for this disease process.

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