I had cataract surgery on bothe eyes at age of 54. my eyesight has not improved. My dr said I have cotton ball-like shapes behind eye with evidence?

Retina issue. It seems like you have some retina issue which involves your macula. The cotton wool changes could happen from ischemia to the nerve fiber layer of the retina. The causes are from high blood pressure or other vascular problems(inflammation, or infection. Please see a retina specialist for further diagnosis test and exam.
Poor vision after CS. Poor vision after Cataract Surgery can be due to: Posterior Capsular Opacification (treated with laser), amblyopia (lazy eye), macular/retina damage, optic nerve damage (ie glaucoma, trauma), brain damage. Something obstructing retina & optic nerve such as a vitritis, mass is uncommon. Send your MD's retina photos for more info if needed. [email protected]