No intermediate or close vision after lens implants. Vision worse now than following surgery

Eye care
1

Ok, this is a lot of info, but hoping someone can give me a direction. I was diagnosed with level 2 cataracts in both eyes. I had no symptoms, but when the doctor told me that the implants would correct my major myopia, I was excited to move forward. (I was -11 )
I had a Symfony multifocal placed first in the right (non-dominant eye. Diopter +07. I immediately noticed a color sensitivity in that eye, for instance when I looked at autumn leaves, instead of seeing the red and green that my left eye perceived, everything in the right eye was muddy, so it almost seemed blurry.
After consulting with other doctors, my doctor placed a monofocal (diopter -6.5) in my left eye. At first I was quite pleased, the color issue was resolved, I had 20/15 distance and could read fine without reading glasses.

After a few weeks, I noticed that my close up and midrange vision was getting worse. I wasn’t too concerned about close up as I expected to have to wear reading glasses, but the midrange blur is unbearable, I cant even zip my coat or get something out of my purse without stupid reading glasses so they are on and off my face all day. That same month I had an issue with flashes and floaters and went to a retinal specialist. It was discovered I had a PVD in left eye (and a macular hole in right) no surgery was recommended, but since I needed YAG for capsular clouding, the doc wanted to be sure the eyes could withstand it and that I didn’t have a retinal tear. I had the YAG surgery done on the right eye, and despite assurances it would fix the midrange blur, but it has not improved my midrange vision at all, so I’m hesitant to have it on the left eye (the one with the PVD.)

All I know is that this is unbearable, I’m horribly depressed and I don’t know what to do next. The original doc wants me to come in for “measurements” but I have spent thousands on what is essentially worse vision and not anxious to spend more on guesswork. Yes, distance is fine, but life isn’t lived at a distance. Any help or recommendations? Please?

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So sorry to read your experience. If not for PCO I am not sure a YAG fixes anything and makes a lens exchange if needed a bit more difficult. I have Symfony in both eyes and all was perfect for 2 years. Last year I too experienced deteriorating vision in left eye and diagnosed with epiretinal membrane and waiting to see a specialist. Thankfully with both eyes open all is ok.

Did you ever see well eith your Symfony IOL? Was it a regular or toric? If toric they can shift and astigmatism causes blurred vision. Perhaps your specialist can do another exam to see if everything is correctly in place? If you never saw clearly perhaps the power calculation was off?

Best seek out an expert opinion to rule out another vision issue and check your lenses.

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thanks for reply. Yes, I now have PCO in both eyes, but hesitant to have YAG on the one with PVD, especially since having it on the right eye made absolutely no difference in how I see. I did see well with both IOLs at first. I dont have astigmatism.

I thought I was seeing an expert, but now really am not sure, and I dont have enough knowledge to be able to interpret all of the studies I read online. Maybe I need a second opinion…

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Hello,
I don’t know if I can provide any direction (my own first surgery is in 11 days), but perhaps as a fellow high myope it could help to walk/talk through it.

You had a +7 put in the right eye which is a fairly low power (lower the power the higher the myopia, opposite of what you would think in terms of glasses or contacts prescription with a high negative number). It strikes me as odd that you said the colors were worse, I think with any of the lenses, regardless of contrast differences, most people experience much more vivid colors after the sugery. Maybe Sue Ann could speak to that as she has the same lens. Other than the colors, how was the vision otherwise in that eye? You mention later the YAG to clear up the right, are the symptoms you describe (close and midrange getting worse) only in the right eye, or both?

In the left, you said you had a -6.5 monofocal, but that would be far more myopic than your right. I’m guessing you meant +6.5? Did the vision in this eye decline as well?

Keeping in mind I’m not a Dr, just someone on the internet sharing what I’ve read; here are a few things I learned after some of them happened to me. As a high myope we statistically are at risk for more issues and experience them before the average population. You don’t mention your age, but it’s not unusual for a high myope to have a PVD starting at 40 ( My 1st happened on my 40th birthday ). We are at greater risk for retinal detachments and the like because our eyes are longer ( without getting too technical ). Cataracts happen at a younger age as well.

So depending on age, the PVD happening may not be unexpected, it typically happens to everyone as they age, just usually later on. The macular hole you mentioned in the right eye you were having color issues with after cataract surgery, google “Macular Hole - The American Society of Retina Specialists”. They state that blurriness in the central vision is a symptom; although the macula is responsible for “detailed color vision” (on that same page), they don’t list changes in color perception as a symptom. Again, not a Dr or giving medical advice, but based on that page it sounds like it would make sense if they were related to what you are experiencing. I would be tempted to speak to another retinal specialist for a 2nd opinion.

Regarding PCO, high myopia eyes have a much higher occurrence, it’s theorized it’s because the lower power lens is thinner and it’s easier for the cells to grow over it, so I’m just expecting it will happen soon after and can be pleasantly surprised if it doesn’t.

Are they telling you that you need the YAG for the left eye as well? Do you know what monofocal lens they used for that eye?

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Hi annemarie - as Scott mentioned I do have Symfony IOLs but did have 6 weeks between surgeries and could compare differences in contrast and color. I was amazed by the bright vivid colors after 1st surgery. I had not realized how the cataracts altered how I viewed colors.. My cataract eye saw everything in a brown/yellow tint - especially noticeable with white.

It could be your other eye health issues could be having an impact on your vision and I too would encourage you to seek out another expert opinion. I have an issue with my left eye and see straight lines curvy. Condition called epiretinal membrane. Wait list us ling here and I have been waiting over a year to see someone.

Hope you find the right specialist who can sort this out.