Cataract Surgery: What to expect after surgery

Posted by dablues @dablues, Aug 13, 2020

I had my left eye done yesterday, and have an appointment to see the durgedon today in Atlanta. My eye is blurry so don't know if that is normal or not. She said I could resume exercising at the Y after a week, no driving for 3 days but shaid nothing else. I guess I cn wait and ask until I get there but some say no heavy lifinting, not to bvend, and not to exercise for 2 weeks. I also have exercises to do at night from my therapy on neck and legss. Is blurryiness normal? I see less thsan I did before. I have exfoliation which I told the doctor but she said not to worry. Any thoughts on this? Am I jumping the gun thinking I would cleary see after surgery:? Also this AM saw halos around lights

@marjou

@bobbyo The first surgery would be for floaters and gel substance removal. The second surgery for cataracts which actually I don't notice at all but I guess the first surgery would make that more noticeable.

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Here are some points I’ve picked up, mostly, in online research:
-risks appear to be less than years ago for vitrectomies. Some doctors have compared risk to that of cataract surgery. I’ve mentioned doctors Randall Wong and Jerry Sebag in previous FOV posts. Listen to there presentations/workshops, if you can.
– certain surgeons do cataract surgery and vitrectomy simultaneously. This can lower surgery cost.
Eye surgeries, like retinal repair, cataract surgery, PCO surgery, CAN CAUSE more floaters. The disruption in the caused an eye surgery can causes various “debris” to break off and show up in vitreous. As I’ve related to Mayo discussion groups, my FOV surgeon was adamant the I’d have -0- floaters after FOV. I am 6 months post surgery and have 5 or so spec floaters that are often prominent. HOWEVER, I would say I’m MUCH better than prior to the surgery.

I repeat myself a lot (from similar comments I’ve made in discussion groups) but hope it is understandable.

NO surgery is without risk and, any, is scary when involving your eyes. I don’t understand the 6-month recovery times, unless you have other eye problems that would protract the healing period.

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@bobbyo

Here are some points I’ve picked up, mostly, in online research:
-risks appear to be less than years ago for vitrectomies. Some doctors have compared risk to that of cataract surgery. I’ve mentioned doctors Randall Wong and Jerry Sebag in previous FOV posts. Listen to there presentations/workshops, if you can.
– certain surgeons do cataract surgery and vitrectomy simultaneously. This can lower surgery cost.
Eye surgeries, like retinal repair, cataract surgery, PCO surgery, CAN CAUSE more floaters. The disruption in the caused an eye surgery can causes various “debris” to break off and show up in vitreous. As I’ve related to Mayo discussion groups, my FOV surgeon was adamant the I’d have -0- floaters after FOV. I am 6 months post surgery and have 5 or so spec floaters that are often prominent. HOWEVER, I would say I’m MUCH better than prior to the surgery.

I repeat myself a lot (from similar comments I’ve made in discussion groups) but hope it is understandable.

NO surgery is without risk and, any, is scary when involving your eyes. I don’t understand the 6-month recovery times, unless you have other eye problems that would protract the healing period.

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Thank you for your post. I’m supposed to have cataract surgery this summer and I’m nervous. Your post was actually calming. Thank you

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@marjou

No Uber or Lyft in this area up in the mountains, but good suggestion Area Agency on Aging. Problem is no secondary insurance to cover out of pocket expenses like this and eye surgery. Surgery would need to be done in city 3 hours away.

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That is just so difficult for you. The Area Agency on Aging May also know of some transportation help.
Do you have any friends nearer to the hospital?
Also check with the hospital about lodging. Surely, you’re not the 1st person who lives at a great distance. They may have some solutions.
Will you try and let me know what you learn?

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At 60, I developed an early cataract in my left eye and had cataract surgery with a square-edged, acrylic IOL implanted in December 2019 to correct my distance vision. Since then, in controlled settings, my distance vision is good (almost 20-20).

However, I have had peripheral “lights streaks” since the time of the surgery that are disconcerting and disappointing. Examples: Sunlight coming in window to my left causes considerable light streaks to my left. 2. Viewing approaching cars’ headlights in rearview mirror when night-driving results in splay of lights streaks. 3. Driving through Pittsburgh tunnels results in dizzying feeling caused by the streaks of the tunnel perimeter lights. In sum, if I see any leftward appearance of light it is accompanied by the light streaks.

By post-surgery reading I did, I self-diagnosed this as a positive dysphotopsia (yes, fun name) that means an unwanted image patients see after cataracr surgery. Some on-line articles by ophthalmologists have said that the use of square-edged IOLs can be the cause in and appreciable number of patients. Apparently, light reflects off the square edges and causes the lights streaks. I’ve brought this up to my top ophthalmologists and they either blow it off or posit other theories. They shrug their shoulders and tell me “I’m lucky” that it’s as good as it is and “the IOL is well-positioned.”

My questions: Has anyone in the group had a similar symptom of light streaks after cataract surgery? Has anyone had discussion of the risks/benefits of different TYPES of IOLS to be implanted (square vs round edge) with their surgeon? NOTE: I’m well past 20 months since my surgery, so I’m not figuring the symptoms will “settle down” at this late date.

I ask, even more, because my right eye cataract is advancing and I will need surgery within next year, I would think. I want to be informed as I can be and get a better result on it, if possible.

Thank you so much

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@bobbyo

At 60, I developed an early cataract in my left eye and had cataract surgery with a square-edged, acrylic IOL implanted in December 2019 to correct my distance vision. Since then, in controlled settings, my distance vision is good (almost 20-20).

However, I have had peripheral “lights streaks” since the time of the surgery that are disconcerting and disappointing. Examples: Sunlight coming in window to my left causes considerable light streaks to my left. 2. Viewing approaching cars’ headlights in rearview mirror when night-driving results in splay of lights streaks. 3. Driving through Pittsburgh tunnels results in dizzying feeling caused by the streaks of the tunnel perimeter lights. In sum, if I see any leftward appearance of light it is accompanied by the light streaks.

By post-surgery reading I did, I self-diagnosed this as a positive dysphotopsia (yes, fun name) that means an unwanted image patients see after cataracr surgery. Some on-line articles by ophthalmologists have said that the use of square-edged IOLs can be the cause in and appreciable number of patients. Apparently, light reflects off the square edges and causes the lights streaks. I’ve brought this up to my top ophthalmologists and they either blow it off or posit other theories. They shrug their shoulders and tell me “I’m lucky” that it’s as good as it is and “the IOL is well-positioned.”

My questions: Has anyone in the group had a similar symptom of light streaks after cataract surgery? Has anyone had discussion of the risks/benefits of different TYPES of IOLS to be implanted (square vs round edge) with their surgeon? NOTE: I’m well past 20 months since my surgery, so I’m not figuring the symptoms will “settle down” at this late date.

I ask, even more, because my right eye cataract is advancing and I will need surgery within next year, I would think. I want to be informed as I can be and get a better result on it, if possible.

Thank you so much

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@bobbyo – I had cataract surgery in both eyes last year. My eyes are sensitive to light before I had the surgeries and they are both still a little sensitive to light. I let my surgeon talk me into not getting the lenses that also correct my astigmatism so the IOLS that I had implanted were the standard ones which did a good job of correcting my vision so that I can drive without glasses but needed reading glasses to read small print. I recently decided to get new glasses that added the small correction for the astigmatism and also were progressive with correction for reading small print.

Now I'm wearing them daily and while driving but the sun and brightness/glare causes me some problems. I'm looking at getting some prescription sunglasses to use for driving.

I was not aware that the edges of the IOLS can make a difference. That would be a great question for folks to ask their surgeon when they have a consultation before the cataract surgery. Is this the article you read?

Dysphotopsia: Not Just Black and White: https://www.reviewofophthalmology.com/article/dysphotopsia-not-just-black-and-white

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@bobbyo

I don’t know how much my input will help. I had cataract surgery…both eyes,,couple months apart in 2009. This was the round lens. Only just became aware of the square lens.
My left eye has a halo effect at night…not a full halo. This is noticeable with the lights of oncoming cars and street lights and it really has to be dark. I didn’t notice it several years ago when we’re in Broadway..NY with all the lights at night and notice it didn’t occur at an outside Christmas tree exhibit last year…at night…but if I looked off to a streetlight I saw the half halo. Nothing has ever happened like that during daylight hours.

I don’t drive much at night anymore but , to mitigate the halo effect, I can squint a bit….have even closed it on occasion. Other than that I consider myself lucky having read or known of other people with more complicated after effects. I may have mentioned it to my surgeon but didn’t consider it a big problem then. I was 68 when I had that done.

And, yes I would be concerned about having the other eye done with the sane type of lens.
In you position, I personally would not choose that type of lens again. There are no guarantees with either type.

Would be interested in knowing what you decide and hope you get input from someone with similar problems.

FL Mary

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@johnbishop

@bobbyo – I had cataract surgery in both eyes last year. My eyes are sensitive to light before I had the surgeries and they are both still a little sensitive to light. I let my surgeon talk me into not getting the lenses that also correct my astigmatism so the IOLS that I had implanted were the standard ones which did a good job of correcting my vision so that I can drive without glasses but needed reading glasses to read small print. I recently decided to get new glasses that added the small correction for the astigmatism and also were progressive with correction for reading small print.

Now I'm wearing them daily and while driving but the sun and brightness/glare causes me some problems. I'm looking at getting some prescription sunglasses to use for driving.

I was not aware that the edges of the IOLS can make a difference. That would be a great question for folks to ask their surgeon when they have a consultation before the cataract surgery. Is this the article you read?

Dysphotopsia: Not Just Black and White: https://www.reviewofophthalmology.com/article/dysphotopsia-not-just-black-and-white

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Thank you for your information and perspective! Yes, I believe the link to article is one of a few that I read.

Check out this excerpt:
“Positive dysphotopsia is characterized by undesired light streaks, arcs, and flashes that emanate from obliquely incident sources of light. “The literature is clear that the chief cause of positive dysphotopsia is square-edge IOLs, which became popular in the mid-90s because of their ability to reduce the incidence or retard the development of posterior capsule opacification. We really didn’t notice positive dysphotopsia until the advent of square-edge IOLs,” says Samuel Masket, MD, who is in practice in Los Angeles.”

So, my surgeon gave me the popular square-edged IOL to AVOID quick development of a posterior capsular opacification (aka PCO or secondary cataract)? As the article says, these IOLs became popular in mid-90s for that reason. Despite this, I developed the opacification within WEEKS of my cataract surgery. My vision in that eye deteriorated quickly with blurry halos around headlights and advance of overall blurry vision. In fact, I had to have the PCO laser surgery just LAST December. So, I, obviously, got no benefit from square-edge.

I will, certainly, be asking of other IOL options in effort of avoiding the same pitfalls with this second cataract. Thank you John and other responses

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Hmmm…I had cataract surgery on both eyes, two days apart, in 2006 or 2007. I asked my eye doc why they did my eyes the same week. He responded that my vision was so bad I had nothing to lose! He was right in that all my adult life I had had 20/480 (20/500 is legally blind) vision in one eye, 20/420-440 in the "good" eye. I wore progressive lenses from the time they first came out (I was in my 30s then), but, even with glasses that degree of nearsightedness and the accompanying astigmatism means you really can't see well, even fairly close.

Following cataract surgery, initially I had 20/20 vision. OMG…buildings have windows and doors, trees have leaves! It's been years, but I still wake up thankful for the vision I now have. During the first year after surgery, my vision settled at 20/40 and 20/60, which is far better than I had ever had with glasses! It's legal for me to drive without glasses for the first time in my life. Because I have a great deal of astigmatism and Meniere's (affected by moving around with uncorrected astigmatism), I wear progressive lenses all the time. I do lots of photography for my job (graphic design), and that has been soooo much easier since surgery! I used to just guess at any distant scenes and even had trouble focussing with things only a few feet away from me. So, for me, cataract surgery has been just one huge blessing and improvement, every waking hour.

One thing that did not happen prior to surgery was loss of ability to discern colors, which many people report. After surgery I reviewed the work I'd done in the months prior to surgery, fearing that I might have cheated clients, but that wasn't the case. For some reason, I've always had a far better ability to "see" colors accurately than most people, and that wasn't affected either by the growing cataracts or since surgery.

I think that cataract surgery, like glasses, is most effective for those who really can't see well at all. When my husband needed to start wearing reading glasses (his distance vision is still nearly perfect), he had nothing but trouble. I think that was because the benefit wasn't all that great, while the glasses were bothersome. He now wears bifocals, but often complains about "how hard it is to see." I remember getting the first pair of no-line progressives: I had absolutely no problem getting used to them, as the benefit of greatly improved distance vision was great. Shoot, I learned then that those big green things hanging over freeways are SIGNS! I've notice the same thing with people who need to wear hearing aids: the ones who have smaller losses have the most trouble, make the most complaints: they just don't gain nearly as much as those of us who live in a nearly silent world without aids.

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@joyces

Hmmm…I had cataract surgery on both eyes, two days apart, in 2006 or 2007. I asked my eye doc why they did my eyes the same week. He responded that my vision was so bad I had nothing to lose! He was right in that all my adult life I had had 20/480 (20/500 is legally blind) vision in one eye, 20/420-440 in the "good" eye. I wore progressive lenses from the time they first came out (I was in my 30s then), but, even with glasses that degree of nearsightedness and the accompanying astigmatism means you really can't see well, even fairly close.

Following cataract surgery, initially I had 20/20 vision. OMG…buildings have windows and doors, trees have leaves! It's been years, but I still wake up thankful for the vision I now have. During the first year after surgery, my vision settled at 20/40 and 20/60, which is far better than I had ever had with glasses! It's legal for me to drive without glasses for the first time in my life. Because I have a great deal of astigmatism and Meniere's (affected by moving around with uncorrected astigmatism), I wear progressive lenses all the time. I do lots of photography for my job (graphic design), and that has been soooo much easier since surgery! I used to just guess at any distant scenes and even had trouble focussing with things only a few feet away from me. So, for me, cataract surgery has been just one huge blessing and improvement, every waking hour.

One thing that did not happen prior to surgery was loss of ability to discern colors, which many people report. After surgery I reviewed the work I'd done in the months prior to surgery, fearing that I might have cheated clients, but that wasn't the case. For some reason, I've always had a far better ability to "see" colors accurately than most people, and that wasn't affected either by the growing cataracts or since surgery.

I think that cataract surgery, like glasses, is most effective for those who really can't see well at all. When my husband needed to start wearing reading glasses (his distance vision is still nearly perfect), he had nothing but trouble. I think that was because the benefit wasn't all that great, while the glasses were bothersome. He now wears bifocals, but often complains about "how hard it is to see." I remember getting the first pair of no-line progressives: I had absolutely no problem getting used to them, as the benefit of greatly improved distance vision was great. Shoot, I learned then that those big green things hanging over freeways are SIGNS! I've notice the same thing with people who need to wear hearing aids: the ones who have smaller losses have the most trouble, make the most complaints: they just don't gain nearly as much as those of us who live in a nearly silent world without aids.

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@joyces
What an interesting and undoubtedly accurate observation. I really appreciated your post especially being profoundly hard of hearing and having had successful cataract surgery in 2009 which gave me the far vision. I use cheaters for up close. I also, can drive without glasses but use them because my right eye had a retinal detachment in the 1980s. It makes things a smidge sharper.

FL Mary

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I just had cataract surgery on one eye. The eye doctor had said I could put if off another year. Because I am in my 80's, I decided to do it now, even though my eyesight was good (distance). I had been wearing progressive glasses & also contacts. My other eye's cataract is only a 2-3. My doctor is planning on doing it soon. I like the way I see now, just 5 days after surgery, but am hesitant to have the other eye done real soon. I had no symptoms of cataracts on either eye before the surgery.

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@4health

I just had cataract surgery on one eye. The eye doctor had said I could put if off another year. Because I am in my 80's, I decided to do it now, even though my eyesight was good (distance). I had been wearing progressive glasses & also contacts. My other eye's cataract is only a 2-3. My doctor is planning on doing it soon. I like the way I see now, just 5 days after surgery, but am hesitant to have the other eye done real soon. I had no symptoms of cataracts on either eye before the surgery.

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Welcome, @4health. Is there a rush to get the other eye done? It sounds like you're please with your vision since having the one eye done. Might you wait several months or more?

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I had cataract surgery on my left eye July 29th. The first two weeks I couldn`t see my hand in front of my face. i did go and see another Dr. and he had me put a gel in my eye 3 times daily. I did see the operating dr the day after I got the gel started. He didn`t like I went to get another opinion. He said I should wait. and I said I wasn`t going to have the rt eye done….ever! The eye has improved where I can see images but they are still blurry. I got referred to a cornea specialist 2 days ago and he said the cornea is ok but said I should continue with the drops and gel and wait. I told him I have thousands of floaters in my eye….it`s like someone took a pepper shaker and sprinkled pepper in my eye….he couldn`t tell me for sure what would happen to these floaters. He said wait……it`s been 5 weeks now….it`s like a living nightmare….how much improvement will I get and how long will it take? I`m a Vietnam Vet and stopped at the vet hospital when I was returning from the cornea dr visit. They were, at least, sympathetic with me and said I should wait and see the operating dr again. To see the cornea dr it was a 200 mile trip….to see the operating dr it is a 100 mile trip….so none of these visits is easy for me as I live in the country in Michigan`s upper peninsula. I want to get a third opinion from the U of Michigan eye center at the end of September if my eye hasn`t improved. They have helped me in the past and I feel much more comfortable and safe with them….. the drs say wait and it is easy for them to say this, but it is my eye and my vision and I want to be able to see normal again. I feel if I had done more research( like here on Mayo clinic) I never would have had cataract surgery because my vision was good. Now all I can do is pray that I can find someone who can make it good again. My Aunt once told me,,,when you have good health you are weathy and .how true that is for me now

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