Tuesday, May 29, 2012

Droopy Eyelid after Cataract Surgery

Question: My mom had cataract surgery about 25 days ago.  We have noticed the upper eyelid is now droopy or perhaps swollen.  Is this normal or a side effect of the surgery?

Answer: In the past it was quite common to use something called a "bridle suture" during Cataract Surgery to stabilize the eye movements during the procedure. This technique did result in a droopy eyelid or, what is referred to as ptosis, from time to time. While not terribly popular today it could have used during your mom's Cataract Surgery. Also, if for whatever reason, a "superior approach" for the procedure was used rather than a "temporal approach"-meaning performing the procedure from above rather than from the side-it is also possible that some eyelid swelling and drooping could occur.More often than not, when patients claim their eyelid is drooping it is really just the discovery of preexisting eyelid asymmetry that becomes "noticeable" when the patient is no longer wearing glasses. If it seems to persist or become worse bring it to the attention of your mom's Cataract Surgeon so he or she can evaluate it and comment.

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 www.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 www.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, May 22, 2012

Cataract Surgery with COPD

Question: I was wondering what I need to know about having cataract surgery if I have chronic obstructive pulmonary disease (COPD). I have severe COPD and am on oxygen 24/7 - is there anything I need to know before I have my cataracts removed? I haven't been to the cataract surgeon yet but I need to know as much about the cataract removal as possible.

Answer: Assuming that your COPD is somewhat stable and that you are otherwise in generally good health, your Cataract Surgeon will obtain clearance from your primary care physician or pulmonologist prior to your Cataract Surgery. The Cataract and Lens Implant operation is relatively quick and in most cases can be done using "eye drop anesthesia" or a local injectable anesthesia so as not to require intubation or in any way compromising your breathing. That said, you will need to be able to lay flat on the operating table for a brief period of time and continue to breathe. Any restrictions or limitations will be fully evaluated by your Cataract Surgeon and with proper planning can be accommodated. Follow the instructions of BOTH your primary care physician and you eye surgeon carefully and you should expect to do 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.

Sunday, May 20, 2012

Reading Vision after Lens Implants

Question: I thought vision would stay the same after cataract surgery and lens implants but I keep getting stronger reading glasses. Should I have new lenses inserted?

Answer: Indeed your vision should stay pretty constant after Cataract Surgery and Lens Implants unless there is some other eye problem or condition reducing the quality of your vision. You do not state over what period of time you have been experiencing the reduced vision, whether it is rapidly progressive or sudden, or your age-all of which may indicate that other problems may be occurring. The best next step is to discuss this with your Cataract Surgeon and certainly be sure to have a thorough examination of the Retina and in particular the Macula as this could be potential source of the decline.

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, May 15, 2012

Bubbles after Cataract Surgery

Question: I have a question about bubbles in the eye after cataract surgery. My husband recently had cataract surgery, which my son and I watched via a computer screen. At the end of the surgery, bubbles formed over the eye. The person explaining the surgery to us, said, "He isn't going to like that!" When I asked what problem the bubbles could cause he said, nothing, and they will dissipate after awhile. My husband has been having trouble with that eye. Is there a problem with bubbles?

Answer: Bubbles after Cataract Surgery can occur from time to time from the introduction of fluids and viscoelastic substances used to assist in the removal of the Cataract and the placement of the Lens Implant. These bubbles are transient and do indeed dissipate in short order with no real impact on the eye or vision. If your husband is having trouble the eye that had the cataract operation then he should return to his Cataract Surgeon to determine the cause.

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, May 14, 2012

Toric Lens Implant Problems

Question: The toric lens implant for astigmatism after cataract surgery did not work properly and the glasses which were fitted do not correct the vision problem. What are the options now?

Answer: It is impossible to know what your options are as you do not indicate what you mean when you say that the toric lens implant did not work properly. How do you know that the toric lens implant is the problem and not some other aspect of the Cataract Surgery itself or your eye anatomy that is causing you whatever problems you are having. If the problem were entirely due to the optics of the toric lens implant, it is most likely that your vision would still be correctable with eyeglasses-but you do not even indicate whether distance, near or other vision issues are bothering you. If you are dissatisfied with your Cataract Surgery results then you need to discuss this with your Cataract Surgeon. If you are unhappy with your Cataract Surgeon then you need to find the best Cataract Surgeon in your area and schedule an appointment for a second opinion to determine your options.

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 Vision Longevity

Question: I have a question about cataract surgery and premium lens implants. If I get the premium lenses at age 61 will the shape of my eye continue to change requiring me to wear glasses shortly after spending $5500?


Answer: Typically after having Cataract Surgery and Lens Implants of any type the vision and the optical correction required are fairly stable for years and years AS LONG AS THERE ARE NO OTHER ANATOMICAL OR EYE HEALTH CHANGES. Your eyes pretty much do not change shape after your early 20's so this is somewhat irrelevant. If you have or develop other corneal changes, this can certainly impact your prescription however this is not a reason not to attempt to get the best glasses free vision after Cataract Surgery that is possible. A word of caution-you should have realistic expectations of ANY eye surgery and even though you elect to have a multifocal or other advanced technology lens implant there is still the possibility that you will need glasses for certain activities and tasks. This is surgery and this is subject to healing and anatomical factors that although have high degrees of precision still have a certain degree of unpredictability.

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.

Friday, May 4, 2012

Vision Problem after Cataract Surgery & Lens Implant

Question: I had cataract surgery and an AcrySof® ReSTOR® Multifocal Lens Implant in June 2009 to replace a cataract that was removed. At that time I immediately had 20/15 vision then a few days later it slipped to 20/20 and then stabilized at 20/25. Since then my vision has deteriorated to 20/30 to 20/40 with a corrective lens. I'm a private pilot and I'm concerned about my next third class physical which requires a minimum 20/40 to pass. My left eye is corrected to 20/20 with eyeglass lenses. The cataract surgeon removed the cataract and implanted the AcrySof® ReSTOR® Multifocal Lens Implant is an instrument rated pilot and we discussed the night light problems but I don’t fly at night so it isn’t a problem. What is happening to my eyesight? I had a complete eye exam yesterday including full retina examination with a dye injection and numerous bright pictures. The conclusion, I'm not going blind, I don't have macular degeneration and I should probably pass my flight physical flight exam. If everything is so perfect, why can't the eyesight in my right eye be corrected to 20/20 as it always has in the past?


Answer: Your situation may not have an answer but there are some things to consider and confirm with your Cataract Surgeon or even another Refractive Cataract Surgeon just to have another opinion. First and most obvious would be the presence of mild “posterior capsular opacification”. This could do cause of what you are describing. While it should be obvious during a clinical examination this is not always the case and small amounts of PCO can be troubling- if present this is easily remediated with YAG Laser Capsulotomy. Second, you need to have a wavefront analysis and aberrometry measurements looking for the presence of small degrees of higher order aberration. This too can produce the small but annoying vision disturbance that you experience. This measurement is routine and done in the office of a refractive surgeon. Another finding that should be obvious, the tear film should be carefully analyzed for integrity and optical consistency. Last, there is a remote possibility that the hydrophobic acrylic material that the Lens Implant is made from is either calcifying or is creating “glistenings’ which are often found with this material. Any or all of these individually or together can cause a loss of contrast and even visual acuity which is actually compounded by the AcrySof® ReSTOR® Multifocal Lens Implant design itself.

Important Note: The information presented on the See With LASIK Blog or provided in response to a request for information in the Ask LASIK Surgeons section on www.seewithlasik.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 LASIK. In particular a response to an inquiry made on the Ask LASIK Surgeons section of www.seewithlasik.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and LASIK surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, May 3, 2012

Lens Implant Life Span

Question: I have a question about the life span and how long lens implants last. My mother had cataract surgery and lens implants in both of her eyes done in 2004 and has great success. She is now 89 and is wondering if there is a life span on the lens or are they good for the life of the person.

Answer: Lens Implants are made of materials that are designed to last well beyond the life span of the person receiving them. The are made from biocompatible polymers-or plastics-that rarely, if ever degrade. Some of the early Lens Implants used in the mid and late 70's are still in place with patients enjoying clear vision. It is quite typical for Lens Implants to last more than 20-30 years. As long as you mother stays healthy and maintains her eye health, and is free of inflammation or other eye disease, the Lens Implants should serve her well for many years to come. The key is to maintain healthy eyes.

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.

Discomfort after Cataract Surgery

Question: I need some help in understanding why my dad is uncomfortable after cataract surgery. My dad went thru cataract surgery in one eye 2.5 months ago. They have done the surgery by phaco surgery. His age is 71 years. The problem is he is not feeling comfortable and complaining about ache in the eye - not feeling normal. Checked with doctor, found no issue. Doctor is saying just your body is taking time to adjust. Could you please advise.


Answer: There is no way that one could tell from your description why you dad is still uncomfortable after his cataract surgery-especially without an eye examination to determine the possible causes. We also do not know whether there are other conditions present that might be contributing to the discomfort.

Typically most patients are quite comfortable after Cataract Surgery within a very brief period of time and certainly within a month or so. That said, it would be important for you to schedule an appointment with your Cataract Surgeon and relay your dad's symptoms of discomfort. If you are uncomfortable with the Cataract Surgeon who performed the Cataract Surgery then seek a second opinion from the best 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.

Wednesday, May 2, 2012

Toric Lens Implant Double Image

Question: I just had cataract surgery and an astigmatism correcting toric lens implant. Now I have a double image in that eye. My cataract surgeon has checked it twice and doesn't seem too concerned. I don't like any of this. I think the lens isn't positioned properly. How long does the doctor have after surgery before repositioning the lens isn't an option? How long should she wait after the first surgery before using another surgery to reposition the lens?


Answer: The direct answer to your question is that within three months is the preferred time for safest and easiest manipulation of the Lens Implant or even a lens implant exchange, however it can be done beyond that time as well. However, while it is admirable that you believe that the Lens Implant position is the cause of the double image, your personal diagnostic skills may not be quite as good as those of your Cataract Surgeon, as she observes with the slit lamp biomocroscope and visualizes the Lens Implant orientation marks for placement precision. Further there are other clinical reasons for a double image that may include a fine crease in the posterior lens capsule or a host of other reasons. Your best course of action is to follow your Cataract Surgeon's instructions and keep her abreast of your satisfaction or dissatisfaction with your vision. If however you do not trust or believe her opinion, you should find the best Cataract Surgeon you can and schedule an appointment for a second opinion which is never inappropriate.

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 after Contact Lens Wear

Question: I currently wear contact lenses and scheduled to have cataract surgery. I was told that wearing contacts distorts the cornea and that they shouldn't be worn for a period of time prior to cataract surgery. The exact period of time is not really clear. Could you shed some light on this subject for me?

Answer: Contact lenses can distort the curvature, shape and thickness of your cornea which can make the measurements of your eye difficult and reduce the precision of the calculations for a Lens Implant. The risk of this happening really depends on the type of contact lenses you are wearing, and how long you have been wearing them, as well as other factors. Rigid contact lenses worn for years and years tend to have the greatest impact on distortion. Soft daily wear contacts tend to have the least. You should follow your Cataract Surgeon's instructions as he or she will determine how much distortion-if any-has occurred and then make sequential measurements to determine when stability has returned to a normal consistent shape. Thus there is no one right answer-each patient, depending on their contact lens wearing history-is an individual and unique situation. In general, the time can be from one week to three months, but really depends on the factors above.

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.