Post-Surgery Cataract Concerns After Macular Pucker Treatment

Q: Post-Surgery Cataract Concerns After Macular Pucker Treatment

Hello, Miss Hou： 1. If your dominant eye is the left eye and your right eye's vision is not very good, it should be acceptable. The doctor may have evaluated this for you, so you can ask for clarification. 2. It could be age-related macular degeneration, and usi

Postoperative cataract issues following macular pucker surgery?

Hello Doctor, more than six months ago, I underwent surgery for a macular pucker in my right eye.
After the surgery, I had to undergo a gas exchange procedure due to bleeding issues.
Currently, my cataract has matured, and I need to have the lens replaced.
I have two questions to ask:
1.
The doctor has advised me to have a 200-degree intraocular lens (IOL) for my right eye, which would allow me to not wear glasses afterward.
However, my left eye has a prescription of -600 degrees for my myopia and currently does not require lens replacement.
Will this create a balance between my two eyes?
2.
The doctor has only allowed me to choose a non-spherical IOL out of pocket.
Is it because of the macular pucker that I cannot opt for a multifocal intraocular lens? If so, will I really be able to see up close without needing reading glasses for my right eye? Thank you.

Miss Hou, 50~59 year old female. Ask Date: 2021/06/13

Dr. Gao Pilin reply Ophthalmology

Hello, Miss Hou:
1.
If your dominant eye is the left eye and your right eye's vision is not very good, it should be acceptable.
The doctor may have evaluated this for you, so you can ask for clarification.
2.
It could be age-related macular degeneration, and using multifocal lenses may not be very effective, which is why the doctor suggested this.
However, the exact reason should be discussed with your attending physician.
Keeping 200 degrees in the right eye is similar to wearing reading glasses, so you should have no problem seeing up close after the surgery.
Online answers can only serve as a reference; if necessary, you should seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Best regards,
Gao Pilin

Reply Date: 2021/06/13

More Info

After undergoing surgery for a macular pucker, it's understandable to have concerns about subsequent procedures, especially when it comes to cataract surgery and the choice of intraocular lenses (IOLs). Let's address your questions one by one.

1. Balancing Vision Between Eyes: You mentioned that your right eye will receive a 200-degree IOL while your left eye has a prescription of 600 degrees for myopia but does not require surgery at this time. The goal of cataract surgery is to improve vision, and the choice of IOL can significantly affect your visual outcome. If your right eye is corrected to a lower prescription, it may indeed allow you to see well without glasses for distance vision. However, since your left eye is significantly more myopic, you may experience a disparity in vision between the two eyes. This condition, known as anisometropia, can lead to challenges in depth perception and binocular vision. Many patients adapt well to having different prescriptions in each eye, but some may prefer to wear glasses for certain activities, especially if they require precise vision, such as reading or working on a computer.

2. Choice of Intraocular Lens: Regarding your second question about the choice of a non-spherical IOL versus a multifocal lens, it is essential to understand that the decision is often based on several factors, including the health of your retina, the presence of any other ocular conditions, and your visual needs. Multifocal IOLs can provide good vision at multiple distances, but they may not be suitable for everyone, particularly if there are concerns about the retina or if there is a history of complications from previous surgeries. Your surgeon's recommendation to opt for a non-spherical lens may be due to the specific characteristics of your eye and the previous surgery you underwent.
While a non-spherical lens can improve vision quality and reduce spherical aberrations, it may not provide the same level of near vision correction as a multifocal lens. Therefore, you might still need reading glasses for close-up tasks, especially since your left eye is significantly myopic. It's essential to have a detailed discussion with your surgeon about your lifestyle and visual expectations post-surgery to make an informed decision.

Post-Surgery Considerations: After cataract surgery, it is common to experience some fluctuations in vision as your eyes adjust to the new lens. It may take several weeks for your vision to stabilize fully. Additionally, if you notice any changes in your vision, such as increased blurriness, halos, or other visual disturbances, it is crucial to follow up with your eye care provider promptly.

In conclusion, while it is possible to achieve good vision after cataract surgery with a 200-degree IOL in one eye and a 600-degree myopic eye, the balance between the two may require some adjustment. The choice of lens should align with your visual needs and the specific conditions of your eyes. Always feel free to ask your surgeon any questions or express any concerns you may have regarding your surgery and recovery process. Your comfort and understanding are paramount in achieving the best possible outcome.

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