Lens Implant Materials with Retinal Surgery Risk

Question:  I am considered legally blind in one eye and now need cataract surgery in my good eye. Years ago I had a vitreous detachment in that eye, and I have floaters. I read that silicone lenses should not be used in a person that may have to have vitreoretinal surgery down the way.  Because I had a vitreous detachment and have floaters, does that mean me?  My cataractsurgeon only uses a silicone lens which is the Bausch & Lomb L161AO.  I went to another doctor who uses the Alcon AcrySof SN60WF, but I read of a glistening from this lens.  Which lens would be better for me?

Answer: Certainly in any one eyed patient the cataract surgeon wants to be as cautious as necessary and will guide you to the best choice of lens implant. First, while you had a vitreous detachment you do not state whether the retina is in any way compromised with excessive thinning, holes or tears, or whether there are any tractional areas on the retina. This should be evaluated by your cataract surgeon and perhaps even having a consultation with a retina specialist might be in order. This information is the basis for assessing the risk of needing vitreoretinal surgeon and might lead to some preventative treatment options. Once ths is evaluated and discussed you can as the cataract surgeon and the retinal specialist to make a lens implant material recommendation 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 CataractSurgeons 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.

Monovision Lens Implant with Astigmatism

Question: Will a monovision lens implant for cataract surgery work if you have an astigmatism condition? If so, will an intermediate distance mono lens enhance the dominant eye long distance vision at all?

Answer: Depending on the amount of astigmatism and the expected amount you will have after cataract surgery, the astigmatism will most likely need to be corrected in order to have the best monovision cataract and lens surgery results. As it sounds like you are hoping to be either somewhat or completely independent of eyeglasses after your cataract surgery then using eyeglasses to correct the astigmatism is not a good option. There are really three options for you to consider-a) laser cataract surgery at which time the laser can possibly correct the astigmatism, b) an LRI or Limbal Relaxing Incision placed at the time or surgery or c) using a toric astigmatism correcting lens implants. Which is best really depends on your individual case and should be discussed with your cataract surgeon. Using an intermediate monovision lens implant correction will in likelihood give you sharper distance vision but will probably require you to use reading glasses for some finer close reading or near vision tasks.

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.

Motion Sickness after Cataract Surgery

Question: I had cataract surgery on my left eye last Thursday. Since then I have been experiencing nausea, like motion sickness/sea sickness because the balance between my two eyes has been altered. Is this common?  What medication helps?

Answer: If there is now a significant imbalance between the vision or prescription in the operated eye as compared to the unoperated eye it very well could cause the sensation of motion sickness or vertigo. Your brain is trying very hard to adapt to the big difference between eyes and the only way to get rid of this in the immediate short term is to cover the unoperated eye. In virtually all instances the problem goes away as soon as the second eye is operated. You should speak with your cataract surgeon and explain the situation and he or she can counsel you on the timing to operate the second eye. Often it is only about 1-2 weeks if all is healing well.

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.

Floating Ring Shadow after Cataract Surgery

Question: After my cataract surgery and lens implant surgery I am having a problem with seeing a ring like floating shadow which moves with the lens. What is this and will it go away? 

Answer: Without a clinical exam it is impossible to know for sure but it sounds like what you are describing could be some annoyance as you adapt to seeing the edge of the lens implant. Sometimes the lens implant edge can scatter light and cause a shadow or other types of visual disturbances. If this is accompanied by an actual decrease in your vision or a bending or distortion of your vision you should visit your cataract surgeon at once. Otherwise make sure that you keep your follow-up appointments and ask your cataract surgeon about it if you are still experiencing this shadow. In almost all instances patients become accustomed the new lens implant in a matter of weeks or months and then forget about the shadow.

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.

Astigmatism after Cataract Surgery

Question: I had cataract surgery on both eyes, six months apart. My vision was 20/20 after surgery. Afterward my eyes started blurring and I started seeing double. I went for a follow-up Monday and with my left eye I could not read eye chart. My eye doctor that did the surgery said it was because I had astigmatism in my left eye. He said he could prescribe glasses. I am not happy with this answer.

Answer: While it is not possible to know the exact reason that you have developed astigmatism after your cataract surgery, there are several possible reasons that could contribute. First, depending on the type and location of the incision used to remove the cataract and place the lens implant it is possible that during the natural healing process some astigmatism was induced. This could be even more likely if sutures or stitches were placed to close the incision. It is also possible that the lens implant itself has shifted slightly but this is much less common. Another somewhat common reason might be the formation of posterior capsular opacification whereby the capsule that was left in place to support the lens implant has become fibrosed and induced some optical aberration and cloudiness. All of these possibilities can be carefully investigated and each has a different way of being helped. If you are not happy with the answers your cataract surgeon has provided then seek a second opinion from another cataract surgeon in your area. 

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.

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.

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.

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.

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.

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.