Cataracts, Lens Implants, and Disappointments
Last year, I began having trouble seeing well at night. This was especially troublesome when driving. I would see a lot of glare, and multiple images, especially of headlights and taillights. I knew this was caused by worsening cataracts, and my Optometrist recommended that I have the cataracts removed. He recommended an eye surgeon in Wilkes-Barre to do the surgery.
My initial visit with the surgeon confirmed that I did indeed have cataracts as the source of my trouble, and he recommended that I get multi-focal implants. He told me that with these implants, I would be able to see well at distance, intermediate, and reading distances. His recommendation was to put a Technis lens in my left eye, and a ReZoom in the right (at an additional cost of $2400 per eye).
According to the surgeon, I should expect to have good vision with some halos around bright lights and some glare with these lens. He also told me that he could not correct my astigmatism with the implants, so I would either have to wear single vision glasses, or have Lasik surgery later to correct the astigmatism. He said the cataract surgery and lens implantation was quick and painless.
I arrived at the surgery center early in the morning, and the nurses started putting drops in my eye almost as soon as I got there. I think there were over 10 different drugs they were putting in my right eye. They also started an IV drip containing mannitol. When it was time for the surgery, an anesthetist administered IV Versed, a drug which induces amnesia so you don’t remember too much.
During the surgery, I was awake, and remember the event even with the Versed. I was instructed to look at 3 lights which I assume was in his microscope. I felt no pain when he made the incision, and when my lens was removed. I know when the lens was removed because the lights I was looking at quickly went out of focus, and all I could see was light. Shortly after that, I did feel pain. I think this happened when he injected the implant lens and positioned it in my eye. The implant is rolled up like a taco and inserted through a syringe like device.
The entire procedure only took a couple of minutes, and they wheeled me out of the operating room. A few more minutes to remove my IV, and I was on my way to breakfast. As soon as the operation was over, I had some vision in my eye. Since my glasses no longer worked and I still had the astigmatism, nothing was clear though.
My wife drove me the 30 mile trip back home, and I rested the remainder of the day. I had some strange visual experiences in that eye the rest of the day, probably because of the meds or irritation. For about an hour, it looked like there was a mound of worms crawling around in the upper right quadrant of my visual field. After that effect dissipated, my eye became foggy, like looking through a smoke filled room. This lasted a couple hours also.
The day after surgery, I removed the right lens from my eyeglasses so I could see well with my left (unoperated) eye. I had an appointment scheduled with the surgeons partner who provided post surgery follow up. He evaluated my incision, and the interior of my eye. The interior pressure had spiked dangerously, so he prescribed a glaucoma drug called Combigan to lower the pressure.
I had several more followup visits with the surgeons partner, and he said I was healing well. However, my vision was not improving, and if anything, was getting worse. However, the doctor assured me that it was too soon to evaluate, and it would get better.
Two weeks after the first surgery, I had the left eye done, with a Technis lens.
The first problem I noticed was a starburst pattern around anything bright. This looked like a Fourth of July firework exploding when I looked at a bright point source of light. For example, when viewing an ordinary LED light from a distance of 20 feet, I see the LED, with 16 more just like it arranged in a pattern around it. This was certainly not what I expected and not what I would call a halo.
The second major problem I noticed is that solid objects appear to have transparent edges when viewed from distances greater than arms length. This is really annoying when looking a people’s faces, and TV images, and cannot in any way be considered normal vision. The only time this effect goes away is in very bright light, like broad daylight outdoors.
The third major problem is additional images of objects. For instance when looking at a newsprint sized letter, I see an additional letter slightly to the left, another above, and 2 more diagonally down to the right. These images are not as strong, but nevertheless are quite noticeable.
It was obvious that the starburst pattern was an aberration of the ReZoom lens itself, because of its inherent symmetry. However the other ghost images had no symmetry, and I believe are not really caused by the implants themselves unless the implants are defective. I believe they are caused by wrinkles in my cornea resulting from the surgical incisions causing my eyes to focus the same image at multiple points on my retinas.
After the second eye was implanted, I had no eyeglasses to improve my poor vision. Neither of my doctors offered to make me new glasses, so I took it upon myself to make my vision as good as possible under the circumstances. By carefully measuring the starburst aberration in my right eye, I was able to mathematically compute a prescription to correct the astigmatism in my right eye. Knowing that the astigmatism had always been the same for both eyes, I ordered glasses to my homemade prescription from an internet company. When the glasses came, they were indeed a huge improvement, and they corrected my right eye for distance in bright light very well. The left eye remained fuzzy at all distances. BUT, I still could not read with them even though my astigmatism was corrected. (If a circle looks eggshaped or a square appears to be a rectangle, it indicates uncorrected astigmatism. If it appears to be the right shape the astigmatism is corrected.)
At this point, I was very concerned that all was not going well, and I feared that I would never see correctly again. So I scheduled an appointment with the surgeon, and I took all my notes and drawings of what I actually see along so he would have as much information as possible. It had been 6 weeks since my right eye surgery, and I still had pain, and poor vision.
The doctor sent several technicians to measure my eyes and visual acuity. He totally was uninterested in the drawings and notes I had made, and told me I needed to have Lasik to correct my astigmatism. He also told me I needed bifocals. I reminded him that the entire purpose of paying $4800 extra was to have good vision without bifocals, whereupon he completely ignored that fact. Instead, he blamed me for not trying hard enough to see. I told him the starbursts were much worse than the cataracts, and that I did not feel comfortable driving at night. I told him that people should not have transparent edges. Instead of helping me, he got visibly irritated and left me sitting in the exam room for over 3 hours. In the end, he prescribed more eye drops and told me to give it more time. How long? Months to a year.
The one thing that I can see clearly is that this doctor and I are not going to have a good relationship. The ability of these multifocal implants to provide good vision at any distance was greatly exaggerated, and the downside of the aberrations was minimized.
I asked the doctor if they could be removed and single vision implants be installed. He really discouraged that idea and implied that the trauma could cause permanently damage my retinas because they could swell up from the released prostaglandins.
So here I am, unable to read a newspaper, with no hope of restoring good vision, and no faith in my eye surgeon. I will report again if there is any change.