If you’re going to have cataract surgery, make sure you know what your doctor is planning for you.
I had cataract surgery last month. Though the operation went well enough, I am bitterly unhappy with the result, which is not what I wanted and not what I asked the ophthalmologist to do. I didn’t even know enough before the surgery to ask the right questions, and she didn’t tell me.
Cataract surgery replaces your now-clouded natural lens with an artificial one and the strength of the artificial lens determines, approximately, what kind of glasses you will need afterward. It’s not an exact prediction, and I understand that.
Having an intraocular lens implanted is like getting glasses you can never take off. The usual procedure is to choose a lens that will give you something close to 20-20 vision in that eye. That’s why people say things like, “I don’t need glasses at all any more except for reading,” and are well pleased, especially if they’ve been juggling two pairs of glasses, one for distance and one for close work (or wearing bifocals to accomplish the same thing).
But that’s not what I wanted. I am ridiculously nearsighted — legally blind in one eye (or so I’ve been told; it matters less than you might think), and needing glasses to see the blackboard in school and later to drive. For comfortable reading, though, I took my glasses off, and that suited me just fine. When my contemporaries started to need reading glasses or had to switch to bifocals, I went contentedly on, taking my glasses off to read. Reading is pretty much what I do all day, anyway. Not having to fuss with reading glasses was the most important thing for me, and I told the ophthalmologist that, as clearly and explicitly as I could.
But she was reluctant to go that far in allowing me to stay as nearsighted as I was used to, though she didn’t tell me that until the day after surgery, when it was too late. It would have pushed her way outside her “comfort zone,” she said. All she said beforehand was that I might not get the results I was expecting. At the time, that sounded to me like the kind of medical boilerplate doctors have to tell you before you sign the consent form. But now I believe she meant something rather more specific.
Since the day after surgery, when I turned up in her office, distraught, we have talked several times. Now I know that my prescription, before the cataract got worse, was -2.5 diopters; she chose a lens with a target range of -1.0 to -2.5 diopters. To be fair, most outcomes in that range would have been workable, except perhaps close to the -1.0 end. In the event, it was even worse; the prescription in that eye now is -0.5 diopters and it is useless for reading without glasses.
We should have had those conversations before surgery, not after. Maybe she would have convinced me that what I thought I wanted was too risky. At least, if I then agreed to what she recommended, it would have been an informed decision. I might still be unhappy with the result, but I wouldn’t be angry. Or I might have convinced her that there were good reasons for what I wanted, and wouldn’t blame her if it didn’t work out as I hoped.
And if neither of us were convinced, she could just have said she couldn’t do it, and sent me to look for a different ophthalmologist. Which is, of course, what I will be doing before going ahead with surgery on the other eye. Only this time, I’ll know what to ask.
Linda Seebach is a retired editorial writer living in Northfield, Minnesota.
EDITOR’S NOTE: This is an online-only column and has not been edited.
