I had my right eye operated for cataract a month ago, ever since I took the patch off the next day after the operation, there has been this thin back rim at the far end corner of my eye. The doctor who operated me assured me the surgery went well and he saw nothing wrong, and if there is, there is nothing he can do. Went to another doctor, she said it may be due to the small pupils I have and how my retinal is, says I will notice it less eventually. Went to to a third doctor, he said it happens when the IOLs are acrylic, but will not do anything about it since my vision is 20/20 after the operation, He said he can operate my other eye and use a PMMA iol instead, he also added that PMMA lens are not foldable as acrylic lens, therefore he will need to make a bigger incision. I don't know what to believe and I am scared to have my other eye operated. I hope someone in this board can shed some insight on my case. Thank you.
I am sorry to learn that you have "a thin back rim at the far end corner of your eye." Will appreciate it if you can describe it a little more for me to completely understand your symptom.
However, the blank recommendation by the third surgeon to use a PMMA lens surprises me. At least in USA, the opthamologists hardly ever use PMMA lens: practically all of them use lenses made of Silicone, Hydrophobic Acrylic, or Hydrophylic Acrylic with their corresponding advantages and disadvantages (Staar IOL lens is of another proprietary material). The PMMA lens does cause less cases of Posterior Capsule Opaqueness, PCO (which is easily treated by YAG laser), but causes much more eye astigmatism due to the large requied eye incision.
You will have to get "used to it", it happend to me too.
wait before you do the other eye
Thinking some more about your vision issue, it may be Negative Dysphotopsia, which is essentially a shadow cast on the retina by the lens in the eye (tends to be worst for the acylic lenses with square edges). Silicone lenses with rounded edges seem to have less of that issue. Smaller diameter lenses will also tend to have more of this issue.
You can find a good article by Caceres on the subject by searching for "Treating Negative Dysphotopsia Caceres 2014". Most of the patients with this problem find that the problem gets less severe or they just get used to it. If the problem is really bad, the doctors will sometimes replace the square-edged acrylic lens with a rounded-edge silicon lens.
Missed the word edge in my statement, "...which is essentially a shadow cast on the retina by the lens in the eye...".
It should have read:
"...which is essentially a shadow cast on the retina by the lens EDGE in the eye...:
Hi peggy, your exactly the same as me. I had this when i had my first eye done with the same acrylic lens. I also had 20/20 vision. I also had my other eye done and had the same symptom, but that was March 2nd 2017 when i had other eye done and can honestly say that now i dont even notice this anymore. I was a bit sceptical at first when doctor said you will get used to it and i have to say i have got used to it. I also suffered with rings of light in certain shades of light, but that does not even bother me no more. I have certainly got used to this and considering the vision i have now, i will always be grateful for the surgery. When you think of the technology used in this surgery and the fact they are trying to replicate your original lens, its never going to be 100% the same. Maybe in 20-30 years they might be able to grow lenses like they do meat, but for now peggy i would not worry too much about this.
I don't know if your condition is the same as what I had, but after my surgery I could see a curved dark edge. It was as if I saw the edge of the implant in my periphery. One year later it has mostly disappeared. If rarely notice it. In fact, I can't even say for sure that I see it at all.
Thank you indeed for your response, I so appreciate it. The thin black rim, right, it is a thin black, not straight line located permanently at the far end corner inside my right eye, it does not obstruct my center vision, it feels real, so real that I even try to push it away with my hand (it would be so great if only it works, sigh). When I shfit my eyesight to my left, the line moves more a bit more inward to the left, too, but it does not come to the center. When I shift my eysight to the extreme right, it disappears. I am afraid of PMMA lens too as I looked it up in youtube, the operation looks complicated, I think of how the surgeon tries to position the lens manually, I get wearied, now that you told me about astigmatism, a possibility he didn't mention at all, I am definitely not going back to him. The replacement lens my surgeon used on me is a Alcon, acrySofIQ mod.SN60WF, I can't tell if it is hydrophylic acrylic or acrylic, but I presume it is not silicone. I hope he made the right choice. The thing that upsets me most that he did not even entertain the fact that I have this side effects, I can accept that no body replacement parts can match exactly the same as the originals, and eyes are so sentive, if only he would share my discomforts, tell me the reason. It is of great comfort to me to be able to reach out to good people, professionals or otherwise in this forum, to share, to learn and to be guided. Again, thank you.,
Yes, thank you Katerine, I have in fact postponed the operation until further notice, shall I say. It is indeed comforting to know that I am not alone with this problem, and it is a problem that can be ignored in course of time. Thank you for sharing, Katherine.
Hi Rick, thank you! You made me happy thinking that it took you in just about 2 months to get used to this nuisance to the extent that you don't even notice it anymore. I think I am hanging in there for a while yet before I go ahead to have my other eye operated. True, it is a small price to pay for the 20/20 vision, the day that I took off the eye patch, I was stunned by the finess and vividity of colours in the tv! Three weeks after, I went to play tennis and was so quick on my feet to the ball that my opponent said he wanted a bionic eye, too!
I totally agree that technologies do wonders, I only wish doctors were more forthcoming, more honest with us, and most of all, use both ears to listen to patients instead using the mouth to dismiss the issue. Thank you, Rick.
I think we have similar issue, the thin, black rim is in the far end corner of my eye. So it took about a year to disappear, or for your brain to ignore it. I suppose it became less and less visibile during the year, I can work with that, I don't have any choice. As I said it is a small price to pay for such vivid vision! Thank you.
As a matter of fact, I did read about (and a lot, too) negative dysphotopsia when I was looking for answers to this black curved rim I feel to have in my eye after the surgery.
I also tried to bring this subject to my surgeon, I actually had my tablet with this topic on to show him (exactly the papers by Vanessa Caceres), he totally dismissed me as if I was talking nonsense.
I am not experiencing a severe problem, fortunately it is a thin black rim at the far end corner of my eye. I can't tell if the IOL I have is rounded edge or squared edge, I do have the ID card of my IOL, it is Alcon, AcrySof1Q, model SN60WF. I presume it is acrylic. From various reading I have come across, some say the cause of ND is tiny pupils, others say tiny pupils would lessen the chance of ND, so I am lost. I do know I have tiny pupls, every time they dilate my pupls they complain how small they are.
I am going to live with this tiny black rim and hope that it will somehow go unnoticed. I am not comfortable right now to have my other eye operated, because in addition to the black rim, I still feel uncomfortable with my eyelid, I feel as if it is swollen or something is making it heavy, strange to say though, the eyelid is not drooping or anything, in fact it is lifted up, I don't know why, but if I were to have a blepharoplasty, it would not be necessary now.
It is too bad that the surgeons often choose to not listen to the real issues which people have after a cataract surgery (or other treatments). It should have been easy for your surgeon to try to explain to you that many patients (about 1 in 5 by one article) tend to have the negative dysphotopsia after the cataract surgery, that the reasons for it are not clearly understood (although the lens design has an effect), and that most probably the problem will be easier to deal with as the time goes by. This would have saved you much of the unnecessary worries. Instead, he just got defensive and decided to pretend that there is nothing wrong with your eyes.
Any way, I do hope and wish that your symptoms do get better in the coming weeks.
I agree. For the first time in my life I can see without corrective lenses of any kind. I was severely farsighted and was at risk for narrow angle glaucoma. The surgery reduced my risk. Every now and again I see a flash of light and floaters. I also developed a minor case of dry eye - I use eye drops ocassionally. But all in all, I'm happy with my new sight. For the first 9 or 10 months I got concerrned about every little thing, but I've had several check ups and am always told my eyes are in great shape.
Yes, physicians should change their attitude, it would really help the patients, the more they learn about the possible outcome,the better they would be prepared, making an informed choice. My surgeon had me signed a 3 page consent form listing every possible negative health issues a cataract surgery may bring, but nothing like this is in the
form.
Indeed, I do hope the symptomes will go away on tip toes, I am determined not to let them spoil the positive result, paid for so profusely as well from my own pocket... Thank you again,.
It was the same with, very depressing, making me feel like it was my fault that I was ungreatfull. Doctors do not tell you about the side effects which they can not correct. Many issues are ignored, psychological effects that patients suffer as well.
I had same issue as well. I was operated 4 days ago. I thought i am losing my mind. In trying to understand it further.
If you close your unoperated eye, you will notice the cresent vanish; if you keep the unoperated eye closed and put hand where the cresent was the hand will tend to disappear.
My case is similar as well. The cresent moves depending on where i am looking; sometime it feels like i have horse blinders on.
I see the surgeon tomorrow and will level with him. No matter what, they need to give me a proper explanation and most likely give him a piece of mind and recommend to department of health to do a survery to get that rubbish lense Acrysoft IQ taken off the list.
Sometimes, I feel they get kickbacks for choosing some of these lenses - it is us patients who have to put up with their nonsense and mental trauma.
Hi Peg;
Saw the surgeon; lense was definitely centered; I still feel i am not getting the right opinion. bottom line some people's periphery vision is larger than others which happens to be my case.
The lense i had was B&L MX60; in further checking; it is related to the diameter of the lense - in this case it was 6mm; I now feel they do a cookie cutter approach and charge extra for laser measurements which should have taken pupil/peripheral vision as well into consideration.
Lesson learnt...... Always insist with a 7mm lense not default lense if you experienced this phenomena in one eye.
I am getting to see retina specialist who i have been seeing for years to detached retina followup for reconfirming the lense is centered. I can probably cope with it. Mine is pretty nasty - around 10 degree is cut out; over time may be once my prescription comes back i should be able to start tuning it out.
Bottom line is it can happen to anyone but insist you have your peripheral vision measured first to ensure right lense is put in.
Hi Peggy, I had cataract surgery on both eyes in January and have the same issue. I have it at the edges of both eyes. To me, it feels like wearing blinders or like my eyelids are not open completely, but that is not the case. I did not expect any such side effects of the surgery and none other has possible infection were mentioned. I had extensive measurements done by a technician before the surgery. The surgeon said my “brain would adjust” which did not make me happy as there was no mention of this issue in the instructions and literature I read. Now the surgeon said it may resolve in time and to contact him in a couple of months if it is not better and he will dialate my eyes and check the lenses. I hope your issue is resolving and hope to hear back from you. My “instructions” said it could take 3-10 weeks for final results, but I don’t know if that means issues like we here in this thread are having. Diana in CA.
I had surgery on one eye in October and did well. I had the other eye done a month ago. I was seeing 20/20 in 3 days but was having trouble with the black curved line. I had it checked and my doctor said I was seeing the edge of the lens and it could last several weeks. I also had laser surgery due to Fuchs Dystrophy. I can see well without glasses so am happy about that. My eyes wee measured and then double checked by the doctor. I also had concerns about my left eye as I had a birth defect and the eye doesn't move out. My doctor was aware of this and marked my eye right before surgery. I'm going this goes away as it is annoying. I also feel like my eye lid is drooping which it is not. If I hold my hard to the side of my eye, it goes away as light doesnt get in the side of the eye. I have a wonderful young surgeon whom I trust completely so don't blame him. I guess any time we have surgery problems can arise. I'm just hoping it will eventually go away but if it doesn't, I know there are a lots of people a lot worse than I am. I CAN SEE and I am very thankful.