I’ve had two exchanges of restor 2.5 multifocal toric iol in my right eye. Today I went to a second opinion dr at baptist medical to see what can be done with the left eye as I do not have 20/20 in distance let alone anywhere else . This is my first dialation exam since exchange in April this year.
First initial exam was everything looks ok. Want to have yag in right eye today? I said I would think about it and let them know if I wanted to do it ( not good with quick decisions when it comes these things). Dr says I have wrinkles in my retina ( so now I’ve been told wrinkles in cornea after surgery, wrinkles in bag by lasik evaluation 2 weeks ago and now wrinkles in the retina. Apparently I have wrinkles everywhere )
So we dialate. Dr looks through the slit lamp : straight ahead. To the right. To the left. To the right again. Blah blah blah. Quick look at left eye. Goes back to right eye and pulls away. We can’t do yag. The “arm” ( can’t recall the technical term right now as we are driving home) of the iol is outside of the bag. This happens . Do you have pressure issues? Do you have pain? The “ arm” is rubbing , some people feel this. So do not. I’d like to see you in 4 months. In the mean time see your local optomists to check pressure and vision in 2 months.
Also he says we can not exchange with the same lens I have in there now. So i assume that means I go with a clear lens and be done with it.
I’m beyond frustrated
Wow. Sorry you are having such difficulties. I never knew that these iols could cause so many problems before I started my own journey.
I am going through issues I never thought would happen having cataracts removed.From all the information I had heard was positive,until I found this site and saw where people is haven't very troublesome issues for a simple procedure(or that's what I was lead to believe).
It seems that "if the arm of the IOL is outside the bag," you should find a surgeon who can put the lens in place.
This is a quote from an article "How to Put an IOL in Its Place" published in "Review of Ophthalmology" of January 2013:
Lens partially out of the capsule: In this scenario, one haptic is in the capsular bag while the other is outside of it. “Usually, these lenses have to be dealt with because the haptic that’s out of the bag is rubbing against the iris and causing problems,” Dr. Hoffman says. “However, the approach for this is similar to that for a decentered lens in the capsule: You can usually get the bag viscodissected open and then reposition the lens within the bag.”
"Not doing anything to fix an IOL installation" is not a good suggestion by your doctor.
So sorry Julielyn- please seek out an expert - doesn’t sound like the doctor you are seeing would be competent enough. Telling you to do nothing for several months doesn’t sound right. The lens hasn’t been inserted right and needs to be corrected. Not sure where you live but you may want to travel to major city and get the advice of an expert.
He mentioned something about the bag being smaller now and that this lens wouldn’t fit. This is a dr who does several exchanges, not my original dr who after completing both eyes the first go round than admitted to only doing a few exchanges. Obviously there is more to the issue than just the arm sitting outside the bag, I will know more in a few months
That’s exactly what I’ve done sue. This is not the same original surgeon.
First, I'm so sorry to hear of the problems you're having. I can't even imagine the frustration you're going through right now. More importantly, Sue.An gave you great advice. I know this one's an expert, but maybe you got 2 duds in a row? It's possible. I would get another expert opinion ASAP. Telling you to wait means the lens has time to settle in the wrong position and correction will be more difficult later. Obviously, I'm no expert, but your eyes are too important to even have one miniscule twinkle of a doubt.
Please let us know how you're doing.
So yea, my first post was pretty emotional. This is a non stop worry for the last 8 months. I will not be returning to original surgeon, other than to inform him of my issues.
The right eye, which had had an exchange never achieved 20/20 vision. Now has cells growing on the bag and I’ve noticed my vision since April ( exchange date) slowly getting fuzzier. During the initial part of the evaluation, yag was suggested to clear away the bag. This was before we started the dialation. Once the dr came back in to look through dialated eyes with the slit lamp, only then was it discovered the haptic was out of the bag. The drs wife had a similar situation happen to her client. She is also an opthamologist. An exchange was necessary. Currently I have no symptoms but this could definitely explain why I have a rim effect as the lens is centered with a slight tilt. My first lens also had a slight tilt, so this is nothing unusual..just how my eye accepts the lens. I’ve never been satisfied with these lenses. I’ve never have had 20/20 or even remotely close to clear vision at any distance to be happy. In a way, this haptic being out of the bag and probably needing an exchange ( unless it corrects itself—not sure if that can happen 4 months out) is the decision I needed to hear. These lenses just don’t work for me.
Apparently with the exchange, the bag has now slightly adhered to the lense and has reduced in size. A “different” lens will need to go in. That is what the dr said. The reason for waiting? Probably because I feel no symptoms at this time. I do need to see an optometrist in 2 months to check up. Yes I still have questions. And will call this week to ask them. I will also call the other second opinion dr to see if he has personal experience with this problem.
Both second opinion cataract surgeons agrees that I do not have the visual range I was requesting. The end results are these lenses do not do what I wanted. He original surgeon picked the lens as at that time I went along with what he suggested. I’ve given the man 3 opportunities to correct, and he has failed. I was given “pamphlet “ answers from the get go. Today I’m much more informed. I asked the sr yesterday how long it takes for him to do an exchange. He said 12 minutes depending on the procedure. So when I informed him that my exchange was 42 minutes his answer was “depending on experience”. My original surgeon is a great salesman, obviously. And the majority of his patients that I’ve seen in the waiting room are much older and looking for a basic job meaning a clear lenses. He told me he could handle it. I’m upset but do I have a malpractice case? I don’t know.
Thanks for everyone’s concerns, but I would like to hear advice from others who have had the same or similar experience. Hearing “what I would do” isn’t helpful to me as I am not you and you are not me. Telling me I’ve made poor choices in dr isn’t helpful either, so please keep those comments to yourselves as they are highly damaging to me at this time. I’m already kicking myself in the butt. But I did not know then what I know now.
Thank you
I don't think anyone is telling you that you made a bad choice. Obviously, a good salesman can sell snow to Alaska. Unfortunately, you were caught by one. You told us your problems and we gave you our opinions since that's what this site is. Not criticizing, but you need to relax a bit as those of us who've responded are reacting to the scenario you've presented. Having said that, hopefully, someone who's been in your situation can offer a bit more "been there and this is what happened..." if that's what you're looking for.
Sorry to hear of your eye troubles,I can associate your problems like I have been going through.When I had my first eye done,I had cloudiness two days after the surgery.On my surgery follow up the surgeon told me I would need YAG treatment and it would clear up the cloudiness,which it didn't.I was scheduled in the following three weeks to have the left eye done,which I was very nervous going ahead with the surgery.Once I had it done it turned our worst than my right eye ,with regards to blurriness/cloudiness and a black rim in the corner of my eye.During that follow up for my left eye,he said I would also need to have YAG performed on it which I declined after,not getting any benefits from the right eye YAG treatment.I went to see my family eye Doctor and he advised me not to get YAG at the moment and see if it clears up.In the meantime he suggested I get full time glasses ,which I was not expected to have,after getting cataract removed. I am 5 months into surgery.now and haven't seen any improvement in either eye.I still see double vision and the cloudiness and the black rim at the corner of my eye is still there as it was just after my surgery.Hopefully yours will improve with time,as for me I guest I have to live with the consequences
Have you gone elsewhere for a second opinion? I feel for you too. Had I not gone to a second opinion I would have had yag and who knows where I would be now. Stuck with a lens partially attached and floating around? I called my insurance company to see which drs were in my network. And went to two different established dr with references from well known practices. Both have similar answers
As of this morning I emailed sight trust to see if dr shatz has actually performed this type of procedure. I’m at work so calling isn’t appropriate ...this go round I’m asking for several opinions
Julielyn - So hard when reading words to also communicate empathy which is definitely what I feel for you. Not knowing your surgeons cannot say whether they are competent or not - and as you say perhaps they specialize more in regular monofocal lenses than premium lenses.
What I do know is that haptic outside of the bag won’t correct itself - same way a toric lens once it shifts won’t shift back. The longer it is in that place the more it adheres to the tissues and harder replacement is.
That doesn’t mean you shouldn’t take a few weeks to allow yourself time to come down a bit from this highly emotionally charged feeling of despair.
And I totally agree with you that if the premium lenses aren’t providing vision you need you should consider a monofocal lens. If you are concerned about intermediate/ close vision I would target for -1.50 and wear glasses for distance if you need to work on a computer all day. If the other eye is giving you good distance and intermediate vision you may find you don’t need glasses at all.
I think all of us here on the forums would caution you against a YAG even if you have PCO due to the haptic being in wrong position. And 2nd to seek out an expert who has done many exchanges. My own surgeon flat out told me when I opted for Symfony that he does not do them and I would have to seek out someone else (and he is one of the best here where I live). So there are far fewer surgeons that do exchanges than those that do initial implantation of IOLs.
But please know we are on your side and not trying to stress you out. Want you to have a better outcome than you have. Sometimes when emotions run high we don’t have clear heads to chose right course of action. We’ve all been there st one point. So give yourself time but not the time that other surgeon suggested of 4 months.
Sue.An, just wondering if you have the Symfony lenses in and what you think of them.
Thank you. You seem very informed.
Hi Kaya13 - yes I do have Symfony lenses implanted both eyes. Surgeries were 6 weeks apart last summer. Was diagnosed with cataracts at regular optometrist visit and my vision could no longer be corrected with glasses. So had to have cataract surgery at 53.
I was here looking for info here on these forums prior to surgeries. At that time I wasn’t seeing many positive reviews of these lenses.
I work full time mostly with a computer so was concerned about my intermediate and near vision. The way monofocal lenses were proposed to me I understood I would need glasses for reading.
I was concerned about the compromise I would need to make with Symfony of night vision so likely if I drove a lot at night for a livinjbg my choice would be for a different lens. Symfony lenses due to their design which gives me excellent vision at all ranges during the day, at night I see 10 concentric circles around certain light sources at night.
I was expecting to still need readers to read tiny print - like stock quotes in a newspaper but I am pleased to say I don’t - read well from 11 inches out.
I would be happy to answer any questions you have.
What is your situation and current prescription?
You might want to take a look at an article titled "Decentered multifocal IOLs may be cause of worsened vision," which you can find by doing a web search of the title. The article describes a patient with an issue similar to yours and states, "The IOL decentered and tilted because one haptic was placed in the capsular bag while the other was outside of it. When the capsular bag contracted, it caused the IOL optic to shift out of the visual axis. In this case, the fix was to re-inflate the capsular bag and place both haptics within it."
If you are going to have the lens replaced with a monofocal IOL and are concerned that tilting may again occur, you might want to seek a surgeon who will implant an IOL that has zero correction for spherical aberration, such as one by Bausch & Lomb. Vision is not affected when zero-correction IOLs are off center or tilted. The Acrysof and Technis monofocals most commonly implanted have negative correction to account for the average eye's positive spherical aberration, but vision is affected when these lenses are off center or tilted. The Restor 2.5 also has negative correction, so the tilting caused by the haptic outside your capsular bag could be the reason your vision isn't as expected.
Great explanation BobDob. Exactly what happened to me. First lense was wrong needed another lense for astigmatism . After the second lense the yag. Saw double and even reading glasses did not help the eye ran fluid like tears for weeks. After over a year it finally worked out.
Sorry you had to go through that, hope4cure. Glad it worked itself out and all is good now.
Thank you for that response BobDob. When I called the dr, his nurse pulled my chart and said the reason for waiting is that I’m not symptomatic at this time. Pressure was 13. It had only spiked to 25 while on durezol after surgery. I’m calling around to see if any surgeon have experience in this situation. Now that I’m aware of the “rubbing” I’m beginning to feel those effects. They may have always been there, thinking it was the area of insertion that kept bothering me. But everyone who has seen me ( my original surgeon, lasik evaluation, exchange evaluation with dialation) says the lens is still centered with a tilt... obviously it may come down to surgeon and first seeing if the haptic can go back in, reevaluate and proceed with moving haptic or removing iol entirely. Some articles I’ve read, 4 different dr opinions went with a sutured or 4 arm(lack of tech terms/sorry)iol.
My thinking is since yag will need to be preformed at some point down the road (clouding of the bag/cell growth) that the current iol can not be used. Fix the lens first then preform yag.
Unfortunately life has taken me to Phoenix to be with my dad who had a massive brain hemmorage Thursday morning.