Post-Cataract Surgery: Dealing with Unexpected High Hyperopia Concerns

Post-cataract surgery, the patient developed over 200 degrees of hyperopia?

Hello Doctor: It has been two weeks since my surgery.
I had laser eye surgery for high myopia 20 years ago, and during a recent check-up, cataracts were discovered.
I discussed this with my doctor, who mentioned that having had laser surgery could lead to slight inaccuracies in the lens power, and that I would need to use reading glasses and glasses for glare after the surgery.
The doctor recommended that I only need to use single-vision aspheric lenses, which would cost around NT$40,000.

The day after the surgery, I noticed that both my distance and near vision were blurry, even worse than before.
The doctor reassured me not to worry.
However, a week later, my vision check revealed that I had 275 degrees of hyperopia, which really brought my spirits down.
The doctor said that once the other eye is operated on, a slight hyperopia can be corrected with glasses.
I am feeling very discouraged!
I consulted another ophthalmologist, who said that the lens could be removed and replaced with a new one, or I could opt for multifocal lenses.
I would like to ask the doctor, is there a significant risk involved in replacing the lens? Is it suitable for someone who has previously undergone laser eye surgery to switch to multifocal lenses? This surgery is very important to me! I am the financial supporter of my family, and my job as an accountant requires good eyesight.
I am really worried! I would greatly appreciate your help in alleviating my concerns.
Thank you very much!

Jiejie, 50~59 year old female. Ask Date: 2022/09/10

Dr. Cai Wenyuan reply Ophthalmology

You can consult with the surgeon.

Reply Date: 2022/09/10

More Info

Post-cataract surgery complications, particularly unexpected high hyperopia, can be distressing, especially for someone with a history of refractive surgery like LASIK. It’s understandable that you’re feeling anxious about your vision and the implications for your work as an accountant, where clear eyesight is crucial.

Firstly, it’s important to recognize that cataract surgery can lead to changes in refractive error, particularly in patients who have previously undergone refractive surgery. The corneal shape and the way light is focused can be altered, leading to unexpected outcomes such as hyperopia (farsightedness) or myopia (nearsightedness). The fact that you have experienced a significant change in your vision post-surgery, with a measurement of +2.75 diopters of hyperopia, is indeed concerning and warrants further discussion with your ophthalmologist.

Your doctor’s suggestion to consider a second surgery to replace the intraocular lens (IOL) or to use a multifocal lens is a common approach in such cases. However, it’s essential to weigh the risks and benefits. Replacing the IOL can be performed safely, but it does carry some risks, including infection, bleeding, or retinal detachment, which are inherent to any eye surgery. The decision to proceed should be based on a thorough evaluation of your eye health, the specific characteristics of your cataract surgery outcome, and your overall health status.

Regarding the option of using a multifocal lens, this could potentially address both your distance and near vision needs. However, multifocal lenses may not be suitable for everyone, especially if you have specific visual demands or if your previous LASIK surgery has altered your corneal shape significantly. It’s crucial to have a detailed discussion with your ophthalmologist about your lifestyle needs, the potential for visual disturbances (such as halos or glare), and the realistic outcomes of using multifocal lenses.

In terms of the urgency of the situation, since you are the primary economic provider for your family and your work relies heavily on your vision, it’s understandable that you want a solution that restores your sight effectively. If you decide to pursue a second surgery, ensure that you are fully informed about the procedure, the expected recovery time, and any potential impact on your vision during the healing process.

It may also be beneficial to seek a second opinion from another qualified ophthalmologist who specializes in post-cataract surgery complications, particularly in patients with a history of refractive surgery. They may provide additional insights or alternative solutions that could help alleviate your concerns.

In summary, while the prospect of undergoing another surgery can be daunting, it is a viable option for correcting unexpected hyperopia post-cataract surgery. Ensure that you have all your questions answered, understand the risks involved, and feel confident in your decision before proceeding. Your vision is paramount, and with the right approach, you can work towards achieving the clarity you need for your professional and personal life.

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