Post-Cataract Surgery Myopia Increase: Causes and Solutions

After cataract surgery, the myopia increased to 175 degrees?

Hello Doctor, I have undergone cataract surgery on both eyes sequentially, with the implantation of a monofocal aspheric intraocular lens (Bausch + Lomb enVista).
About a month after the surgery on my right eye (with a prescription of +2.25), my uncorrected vision decreased from 0.3 to 0.1, and my corrected vision dropped from 0.8 to 0.7.
However, after the cataract surgery, I experienced significant halos around streetlights at night, which affects my driving vision.
I have glaucoma and cataracts (with a quarter of visual field loss in my left eye, while my right eye has no defects).

The day after the surgery on my left eye, I had the eye patch removed and my uncorrected vision was 0.5.
A computer refraction test indicated a myopic prescription of -1.00 diopters, but a week later, my uncorrected vision dropped to 0.2.
I feel that my vision is not as clear as before; initially, I could read TV subtitles the day after surgery, but now I cannot see them clearly.
Is it possible for posterior capsule opacification to develop that quickly? Or could it be due to lens bag fibrosis causing a shift in the lens prescription? Can changes in lens prescription due to capsule fibrosis be detected during a computer refraction test?
Two weeks post-surgery for my left eye, my follow-up computer refraction indicated an increase in myopic prescription to -1.75 diopters, with uncorrected vision at 0.15 and corrected vision at 0.6.
I would like to ask:
1.
Is it possible to adjust the post-operative myopic prescription back to -1.00 diopters?
2.
Can the corrected vision of 0.6 be improved to 0.9?
3.
What causes the severe halos around streetlights at night after cataract surgery, and is there a way to improve this?
4.
Is it normal to see multiple light streaks from streetlights when turning or looking up and down at night?
5.
When I look to the right with my left eye, I see reflected light shadows on the left side of my left eye; is this normal, and can it be improved?
The surgeon who performed my operation left the country three days post-surgery and will not return for over a month, so I really appreciate your help.
Thank you, Jacky.

JACKY, 50~59 year old female. Ask Date: 2018/06/23

Dr. Cai Wenyuan reply Ophthalmology

Hello, I apologize, but your issue may require a physical examination to determine.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Department of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/06/23

More Info

Dear Jacky,
Thank you for your detailed inquiry regarding your post-cataract surgery experiences and concerns. It sounds like you are facing several challenges following your surgeries, and I will do my best to address your questions based on the information provided.

1. Post-Surgery Myopia Increase: It is not uncommon for patients to experience changes in their vision after cataract surgery, including fluctuations in refractive error. The increase in myopia (from 100 degrees to 175 degrees) could be attributed to several factors, including the healing process of the eye, changes in the cornea, or even the development of posterior capsule opacification (PCO), which is a common complication after cataract surgery. PCO occurs when the thin membrane that holds the intraocular lens (IOL) becomes cloudy, leading to blurred vision. If this is the case, a simple outpatient procedure called YAG laser capsulotomy can be performed to clear the cloudy membrane, which may help restore your vision.

2. Potential for Vision Improvement: Regarding your corrected vision of 0.6, it is possible to improve your visual acuity further, but this depends on the underlying cause of your vision issues. If the increase in myopia is due to PCO, treating it could potentially enhance your vision. However, if the changes are due to other factors, such as corneal changes or lens positioning, further evaluation by an ophthalmologist would be necessary to determine the best course of action.

3. Halos and Glare: The halos and glare you are experiencing, especially at night when viewing lights, are common complaints after cataract surgery, particularly with certain types of IOLs. These symptoms can be exacerbated by the presence of PCO or by the optical properties of the lens itself. If the halos are bothersome, discussing the possibility of a different lens type or additional treatments with your eye doctor may be beneficial.

4. Light Striations: Seeing multiple light streaks or rays emanating from streetlights at night can be a result of several factors, including the optical design of the IOL, corneal irregularities, or even dry eye syndrome, which can be exacerbated after surgery. If this symptom persists, it would be wise to consult with your ophthalmologist for a thorough examination.

5. Reflected Light Shadows: The phenomenon of seeing reflections or shadows when looking to the side may be related to the positioning of the IOL or the healing process of your eye. This could also be a result of light scattering due to corneal changes or the lens itself. Again, a follow-up with your eye care provider is essential to assess this symptom.

In summary, it is crucial to have a follow-up appointment with your ophthalmologist as soon as possible, especially since your surgeon is currently unavailable. If you experience significant changes in your vision or new symptoms, consider seeking care from another eye specialist in the meantime. They can perform a comprehensive examination to determine the cause of your symptoms and recommend appropriate treatments.

I hope this information helps clarify your concerns, and I wish you the best in your recovery and vision improvement.

Best regards,
Doctor Q&A Teams

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