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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3070
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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I had lasix surgery 15 years ago and was satisfied with my

Customer Question

I had lasix surgery 15 years ago and was satisfied with my monovision. I developed cataracts and had surgery with lens replacement in June. My close eye, the right one, had almost perfect close vision and my distance eye was not as good as it could be. Following the surgery, I have no close vision, cannot read anything including the computer screen.
My right eye now has perfect distance vision. My left eye has decreased distance vsion and no close vision. How did this happen?
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 3 years ago.

Hello and thanks for your question.

 

It sounds as though you had a successful monovision scenario through LASIK surgery. I don't know exactly what type of lens implant the cataract surgeon put in your eye, but most surgeons implant a monofocal lens into the eye to replace the existing lens (cataract lens) that was removed at surgery. By monofocal I mean that this lens is designed to make the vision as clear as possible at one focal plane: either in the distance, at near (book reading distance) or intermediate (such as the average computer monitor distance).

 

Most people who get cataract surgery have this type of lens implanted and also most people choose to be as clear as possible in the distance without glasses after the surgery so the power of the lens implant is chosen to correspond to clear vision in the distance in both eyes. But, of necessity, that person absolutely has to wear reading glasses after the surgery because those lenses only put them in focus at one focal plane (in this case, in the distance).

 

It sounds as if you likely have had a monofocal lens implanted into the right eye, explaining why you have perfect distance vision and no close up vision (without reading glasses) in the right eye. For the left eye, there could be a few different scenarios causing this: It may be that your surgeon implanted a presbyopia-correcting lens implant in the left eye. You would likely know about that because it would represent a significant upgrade in costs that insurance doesn't pay for and that you would've had to pay for. It may also be that you had a monofocal lens implanted for clearest vision in the distance, just like the right eye, and that there is something confounding the distance vision. This could be from uncorrected astigmatism (cataract surgery does not correct for astigmatism unless there are extra incision/steps made); without prescription glasses correcting the astigmatism, it would induce blurry vision at far and near.

 

This may also be due to an early clouding of the shell or capsule that holds your lens implant. This eventually happens to 25-30% of patients anywhere from a few weeks to months to years after the surgery, but it's possible this is happening quickly with you. If this is the case, fortunately there is a fairly straightforward solution to this problem: a laser can be used to poke a hole in this cloudy membrane so you can see. That's a painless and quick procedure done in the office.

 

Additionally, if there were any complications that you either do or do not know about, these could affect the ultimate visual potential, and cause your distance vision blurring. Lastly, eye measurements and several calculations are performed before surgery to pick the right power of lens implant to produce the desired visual outcome. If there were errors in either the measurements or the calculations, then the eye could turn out to still have a refractive error (need for glasses in the distance) that was then undesirable, but nevertheless permanent (unless the lens implant is surgically removed, or corneal refractive laser surgery was done to correct this).

 

I know these are a lot of possibilities to consider, but without knowing the specifics of the history, this is as specific as I can get. I would suggest you discuss these possibilities with your surgeon and ask him/her for their honest opinion as to why you don't have the visual outcome you expected/desired.

 

Does that help address your concerns?

 

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter. I would also be happy to continue to answer any more questions you have until we have resolved your concern.

 

Also, any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated.

 

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must be examined by your doctor.

Customer: replied 3 years ago.
if I get a copy of the medical records, would you be willing to review them and at what price? The doctor told me i would still have monovision and i paid no additional for any lens upgrade.....
Expert:  Dr. Dan B. replied 3 years ago.

It might be difficult to access several pages of medical records electronically. The website doesn't seem to have a function to upload scanned documents.

 

An alternative would be to put them on a website and include a link in this message to where I can review the records completely.

 

Reviewing a chart's worth of medical records is a significant amount of time. What price you offer is your decision, but as a medical professional in private practice, I would likely be reimbursed at least twice what you've offered to pay for this question.

 

I would appreciate it if you would hit the accept button to allow me to get credit for helping you with this matter. This would not charge you again, but would allow the monies that you have already been charged to be disbursed to me.

 

Thank you.

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3070
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Dr. Dan B. and other Eye Specialists are ready to help you
Customer: replied 3 years ago.
Could the lenses have been placed in the wrong eye, left in right and right in left? If so can this cause problems? The physician discharged me from his practice and said I should find another doctor. I did nothing. I asked for my options to correct the outcome.
Expert:  Dr. Dan B. replied 3 years ago.

Yes, this is possible. If this were the case, then the refractive correction would likely be off somewhat unless the two eyes were nearly identical in refractive need (and they usually aren't exactly identical).

 

If you were dismissed merely for asking about your options to correct the outcome, then that should tell you something about that physician.

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