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Post cataract blurred close vision.
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MedHelp Member's Question

Post cataract blurred close vision.

by tipster42, Feb 17, 2007 12:00AM
Had cataract removed and distance IOL iserted 5 days ago.  On day of surgery, I had to return to Dr's office due to significant eye pain. Dx was corneal abrasion.  Anesthetic drops and patched eye relieved the discomfort. Back to office 2 days later for for post surgery review.  Dr. surprised by lack of acuity improvement. He says this is probably due to remnants of abrasion.  Now 5 days out, and vision seems to be too far sighted.  Street signs and other far details very sharp, No sharp details indoors.  Am I being impatient or is something wrong?
Doctor's Answer

by Forum-OD-MP, Feb 17, 2007 12:00AM
5 days is not nearly enough time to make any visual judgement.  so, probably a little bit of the former...
Member Comments (28)

by aimee37, Feb 17, 2007 12:00AM
To: tipster42
You may still be experiencing some post-surgery inflammation.  Give it a little time.

Were you nearsighted before surgery?  Did you get a monofocal lens set for distance (i.e., plano)?  If both of your answers were "yes," you may have to adjust to the loss of some of your pre-surgery near/intermediate vision.  Monofocal lenses set to plano give sharp distance vision but blurry near/intermediate vision.

by aimee37, Feb 17, 2007 12:00AM
To: Jodiej
Yes and yes. I expected to lose that "remove the glasses and read fine print ability", but I didn't expect to lose so much mid-range sharpness.  Still, it's early days and I can wait.  Also, the reason for going through this process was to eliminate long range ghosting and increase contrast in my dominant eye for driving.  This appears to be accomplished, so I'm satisfied short term.  If necessary I will explore plsno/intermediate varalux for the dominant eye, and keep the current precription in my non-dominant eye.  

by aimee37, Feb 17, 2007 12:00AM
To: hipster42
Do you know what kind of IOL you have?  Aspheric IOLs such as Tecnis and AcrySof IQ are supposed to provide sharper distance and night vision than conventional lenses.  But conventional IOLs may give better near and intermediate vision than the aspherics.  (I guess many things in life involve trade-offs.)

by aimee37, Feb 18, 2007 12:00AM
To: JosieJ
I suspect it is a standard lens,  Card says B&L Ll61A0  Power:-12

by aimee37, Feb 18, 2007 12:00AM
Power is +12

by aimee37, Feb 18, 2007 12:00AM
To: hipster42
Yes, it's a conventional lens.  Actually, a small sample study I read indicated that the majority of people preferred their vision from their conventional lens, when an aspheric lens was implanted in their other eye.  (I'm not sure why.  Maybe those IOLs just don't live up to the manufacturers' claims in the real world.)  I have two aspheric lenses, so I have no basis for comparison.

by aimee37, Feb 18, 2007 12:00AM
To: tipster42
That is the B&L SofPort AO.  Jodie, it is not a conventional spherical IOL.  It is a neutral aspheric, whereas the Tecnis and Alcon aspherics are negative aspherics.  The SofPort AO is a compromise between the aberrations caused by spherical IOLs and the loss of depth of field caused by the negative aspheric IOLs.  It does not compensate for the cornea's spherical aberrations, but it is not bothered by any IOL shift or tilt.  Spherical and negative aspherics are.  One poster last year got them and had 20/15 distance vision and could read some of the 20/10 letters.  I got that IOL in my right eye last week.  My vision is 20/20 and I can read some of the 20/15 letters.  I asked the surgeon to shoot for 0.25 to 0.50 diopter myopic and he seems to have gotten it between those targets.  I had 0.75D of astigmatism in my right eye before surgery, so my vision may get better after I get my new eyeglasses in a few weeks.  That lens is a safe lens to use because IOL shift will not degrade vision.  That is why I chose it before my first consultation and why my surgeon likes it.

by aimee37, Feb 18, 2007 12:00AM
To: tipster42
tipster, I'm sorry.  I got babbling about the IOL and forgot to give you my new vision experience.  I can read my computer without glasses, but it is sharper with 1.00D reading glasses.  I asked for about 0.5D myopic so that my vision would be relatively good over a longer distance range.  My best vision is at about 10 feet, which would put me at about 1/3 diopter myopic.  That gave me 20/20 at the standard 20 feet and I can still see fairly well at 30 inches.  I need glasses for reading and will get new progressive glasses after my eye heals.  I get my left eye done in 1-1/2 weeks and I will be happy if it turns out like the right eye.  The only problem with the right eye is that my posterior capsule has a small wrinkle.  The doctor said that it might go away, but probably not.  It causes a streak from bright lights, but not noticed with most lights.

by aimee37, Feb 18, 2007 12:00AM
Thsnks for all your valuable information, folks.  

I'm still concerned about the corneal abrasion issue.  I have no idea how I could have caused it.  I never removed the shield except to insert post-op drops.  Any input on how this type of injury could affect my midcourse and final outcome.

I'm going back for check-up on the 20th.  Still only 1 week post op.  Will continue to post progress on this thread.

by aimee37, Feb 18, 2007 12:00AM
To: tipster
I had a corneal abrasion about 10 years ago.  I got some dust in my eye while working outside and was stupid enough to rub it.  I'm sure that is not how you got it, but as I recall, it took about a week to heal.  There was some pain for the entire time, so hopefully your cornea will heal in a week or so.  I agree, it is hard to understand how you got it with the shield on.

by aimee37, Feb 18, 2007 12:00AM
Icansee, you're sure right about the B&L lens being aspheric.  I'm glad that it gave you great vision.

I got a corneal abrasion when I had retinal surgery.  (I blame the resident who did my sutures, although I really don't know how it happened.)  It really hurt for about a day.  Tipster42, I'm guessing that your abrasion also happened during surgery.  I'm sure that it won't affect your outcome, so don't worry about it.

by aimee37, Feb 19, 2007 12:00AM
To: Jodie and Icanseenow
How were you able to figure out the type of lens?  I googled the model# and got no reults.  I also went to B&L's site, which was informative  but did not identify my lens type.

I am also pretty sure my doc caused the abrasion, but the pain is gone and if there is no residual damage, so be it.

Visual progress wise, horizontal streaking has disappeared but short/midrange acuity is still below par.

My wife says I'm a bit obsessive (actually a lot):I even printed out my own Snellen chart.  She said I should ask you if this is normal behavior LOL

Thanks again

by aimee37, Feb 19, 2007 12:00AM
To: tipster
You probably Googled the wrong designation.  It is LI61AO - 2 letters, 2 numbers, 2 letters.  In your previous post, you typed in a zero instead of an O.  Also, you can do a search on SofPort AO.  There are several articles on aspheric IOLs that discuss the advantages of each of the 3 brands.

When I scratched my cornea, the scratches were bad, but it healed completely with no long term effects.

Tell your wife that I've got you beat.  I downloaded a scaleable computerized Snellen chart that I can scale to any distance on the computer screen.  Besides the standard letters, it has tumbling Es and open Cs.  Lots of fun.  I'm a retired mechanical engineer and behavior like this is perfectly normal for an engineer.

Intermediate vision