May 8, 2008

THE EYE MAN: Complications to surgery have patient seeking 2nd opinion

Dr. Andrew Soss / Daily News columnist

Dr. Soss: About 3 months ago I had cataract surgery. The problem is that I still can't see well.

At first, the eye doctors told me that in a week or two I'll see better when they start checking for eyeglasses that will help. They also told me that in about four to five weeks I'll have an eyeglass prescription that will help me see well. Now, the doctors want to perform cataract surgery on my other eye.

I don't know what to do. If the same thing happens to my second eye, I'll really be in trouble. What's going on here?

J.M.



J.M.: Well, there can be a number of reasons that the first surgery did not have the desired outcome. Sometimes, the natural lens in your eye is so opaque that eye doctors have a difficult time assessing the potential vision outcome post-surgically. In this case, eye doctors try to assess the optic nerve and central retina (macula) with special instruments that allow us to help predict the outcome visually.

Based upon your apparent magnitude of visual symptoms, it may be that you had a complication associated with the surgery. Although significant surgical complications from cataracts involve less than 3 percent of surgeries, they still occur.

One of the more frequent complications involves the macula. Some susceptible individuals can develop a condition known as cystoid macular edema (CME). Unfortunately, the visual results following this condition, while not blinding, can impair the vision significantly based upon the individual and the appropriate timely management.

Personally, I would want to have a better grasp on which of these two types of situations existed in my eyes. If your surgeon is not able to clarify the exact cause of your visual outcome, do not have surgery on your other eye until you are comfortable with knowing what has happened. I believe, as I often say that it is very important to get a second opinion or maybe even a third opinion, in your case, prior to considering cataract surgery on your other eye.

Questions to Dr. Soss should be sent to his e-mail theeyedoctor@att.net or via his Web site at www.dr-andrewsoss.com. All answers and opinions are those of Dr. Soss and not necessarily shared, endorsed or affiliated with this or any newspaper agencies.

Dr. Andrew C. Soss OD, FAAO, has been practicing for more than 20 years. During that time he has been a clinical instructor in the department of ocular pathology at the University of California. As a primary eye care provider in private practice in Burlingame, he is also board certified in the diagnosis, treatment, and management of primary open angle glaucoma.