Reasons why you may not see 20/20 post surgery?

Reasons why you may not see 20/20 post surgery?

Some folks are disappointed by their cataract surgery results.   They usually present to me that “the cataract surgery did not take” or “the vision never came back after I had the cataract out”.

It is worthwhile here to make the distinction between (acuity refers to distance vision):
    [1] BEST corrected 20/20
    [2] UNcorrected 20/20
    [3] BEST corrected under 20/20

[1] If you are “Best corrected 20/20” post-surgery – This means that with glasses, you see 20/20 but without glasses you are below perfect 20/20 distance vision.  Common reasons for this can be: uncorrected residual astigmatism, poor pre-surgery measurements (e.g. disrupted by dry eye), predictive algorithm for lens selection was not accurate, incorrect lens was selected, healing caused unexpected astigmatism, lens implant centration/rotation not exact.  This is not a bad thing!   Being best-corrected 20/20 was the goal of cataract surgery only a few years ago.

2] If you are “Uncorrected 20/20” post-surgery – This means that without glasses, you see perfect (20/20) in the distance.  This is the best result but vision could still fluctuate due to such things as dry eye or floaters.  You could also be “uncorrected 20/20” and still have trouble with other things e.g. night glare or transient blur secondary to floaters.

3] If your BEST corrected is under 20/20 – This means that no matter what we do with glasses, your vision does not come back to 20/20.  Typically – but not always - this is not a problem with the cataract surgery itself but rather a pre-existing or concurrent problem that limited the outcome of the cataract surgery.   Cataract surgery can 100% fix your vision only if your vision limitations are 100% related to cataract.  If you have vision loss 25% related to macular degeneration and 25% related to diabetes and 50% related to cataract… the most that cataract surgery can improve your sight is 50%.  The two most common reasons that I see for disappointment after cataract surgery are: retinal complications of diabetes and age-related macular degeneration.  Best vision under 20/20 is sometimes temporary.  Talk to your eye care professional to understand exactly why you are not 20/20 post surgery and the prognosis.


Last modified onWednesday, 08 April 2020 02:12
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