Double vision after cataract surgery

[ddtla]

I just had cataract surgery with rezoom on my left eye 1 week ago. My distant vision is great. On post-op day 1 is 20/20 and near vision is J16. I don't have any halos at night. But on day 3 I started to notice that I am seeing a ghosting image and it gets slightly bigger day to day (it is bigger now compared to day 3,4,5). At night I would see almost a double vision on car tail lights and on intersection lights. I see the same thing through out the day while reading captions or words on TV. At the bottom of the letters I would see another image of the letters (about half the height and of lesser opacity or lighter color). The same thing at night, I would see another image underneath car tail lights, intersection lights, neon lights (about half the height and of a lighter color). The second image is not a complete image but seem to protrude out underneath the original image (again about half the height and of a lighter color).

As for my near vision, I still can't read the monitor as I type this. I had to buy a +1.5 reading glass from the drug store to be able to work on a computer or to read. At this point I am more concern about the double image. I was wondering if anyone has had this experience. What I have is not a halo because I don't see rings around lights. Only a duplicate image underneath the lights or letters.

I am having my second rezoom tomorrow. Please let me know if you have had similar experiences and did it go away with the second rezoom or with time.

[Forum-OD-MP]

someone will reply i'm sure...many here have had this type of surgery/problem

[blue92]

DON'T DO IT until you have a resolution for your first implant. You are experiencing exactly the same symptoms I had after my fist implant. Please see the posting "Mono- or Multifocal". After 10 months of seeking many surgeons opinions and coming up with nothing, my problem has been finally diagnosed. Both implants are decentralized and I now need additional surgery to position the implants correctly. Rezoom and Restor lenses must be placed precisely and I found that not all surgeons understand this because out of the 6 that I saw, not one picked up on it until I saw a world renown doctor in Indiana. There is no room for error. I hope you have a knowledgeable doctor because these lenses require a higher degree of skill and  knowledge than regular monofocal lenses.

[blue92]

By the way, when I mean decentralization, we are only talking .5 to .7 mm. This is a very small number, but yet large enough to create serious visual problems. Again, wait until you resolve your problem before proceeding with the second eye. Ghosting caused by improper refraction just doesn't go away.

[blue92]

Dr. Waltz was able to determine the decentralization of both lenses using a wavefront analysis and by looking at them with and without slit lamp digital photographs. Keep in mind that .6mm or .7mm decentralization in a multifocal lens that is 6mm in diameter is significant enough to cause visual aberrations. I also have some early PCO in both eyes. The ghosting and double vision that I experienced right after the surgery are totally unrelated to the PCO.

[blue92]

Please read the following link related to positioning of multifocal IOL.

http://www.crstoday.com/PDF%20Articles/0406/CRST0406_15.html

And from an article from Medscape Today:

Intraocular Lens Design-Related Positioning

"Some of the newer IOLs designed to treat presbyopia as well as aphakia require specific anatomic locations, and certain malpositions affect each model differently. For example, concentric-ring multifocal IOLs, such as the Array® (Advanced Medical Optics [AMO], Santa Ana, CA), the Acrysof® ReSTOR® (Alcon, Fort Worth, TX), or the ReZoom™ (Advanced Medical Optics, Santa Ana, CA), require perfect centration for proper functioning. Even a slight decentration of 1 mm can cause visual disturbance and undesirable glare symptoms"

[ddtla]

Thanks for the info. I talked to my doctor the morning of the surgery and he looked at my left eye and said that it was centered correctly. He said that it may be due to the swelling and that the rezoom is designed for both eyes. So I went ahead with the surgery for my right eye. The second surgery was yesterday. For today day 1 post op I can see 20/40 distance on my right eye. My left eye(done last week) is now 20/25 for distance. As for near vision both eyes are at J5-7 but still blurry.
The ghost vision on my left eye is still there and in the right eye there is also a small ghost vision again to the bottom and left of the actual image.
The doctor said that I have a window period of about 4 months before the capsule fibrose. So I will give it another 5 weeks to see if the ghost image will disappear or improve after the inflamation (inflammation) goes down. If it doesn't then he will look at other options like recentralizing it.
I was very careful in picking the doctor to do the surgery. I went to opthamologists and felt confident about this one. I even talked to two of his patients with rezoom and they were very happy with their vision, perfect near and far vision. I guessed you never know until after you have the procedure done yourself.
Blue92, which type of lens did you have done, was it rezoom or restor? Based on the article it seems like restor is less forgiving than rezoom regarding centralization.
How long has it been since your surgery? Is your ghost image similar to the way I described mine? When did you start noticing the ghost image and did it ever improve slightly with time?
Again thank you for the information. Keep us updated regarding you upcoming procedure later this month. If things doesn't turn out correctly, I may even have to fly to Indiana to see the doctor that you are talking about. I wish you well.

[ddtla]

I didn't reread my message until after I sent it. I meant to say I went to 3 opthalmologists for consults before picking this one.

[JodieJ]

For what it's worth, aspheric monofocal lenses are also reported to be highly sensitive to decentration and tilt.  Both are reported to negate the benefits of an aspheric lens, i.e., improved contrast sensitivity and night vision.  For monofocal lenses, correct positioning is usually checked by visual inspection of the lenses--which may or may not be adequate.

[blue92]

How are you progressing with your surgery? Is ghosting getting any better. Any halos? I hope you are doing fine.

[ddtla]

How was your surgery in Indiana? Did it improved the ghosting image?
I am now 4 weeks post-op for left eye and 3 weeks post-op for right eye. At my last check-up I was 20/20 for distant vision. J3-5 for left eye and J5-7 for right eye.
I still have ghost image on both of my eyes. They are both inferior and temporal(toward the lateral of the eye) to the actual image. The ghost image is of a lighter opacity and smaller than the actual image. It is more pronounce when I look at objects with contrasting background(white on black background). I see it if it is more than 2 feet from my eye and gets bigger with increasing distant. I see it around light, words on computer screen, TV, and even during the day.
My doctor looked at the lens through his opthalmoscope and said that the lens are centered. He didn't do an ultrasound scan to confirm this. He said that it may be due to the design of the lens since it is a multifocal and that each part of the lens project a different image. I don't buy it because if this were true then I would see ghost image around the entire object not just only inferior and tmporal to the actual image.
I am going to get a second opinion and it is scheduled for next month.
How did your surgery went? Did your vision improved? Do you still see ghost image? By the way which type of lens do you have, rezoom, restor? Also how long was the time frame between the first surgery and the corrective surgery?

[aimee37]

I just had a cataract removed and replaced with a Restor Lens.   I am having double vision, and cannot read or see the letters on the TV.  It has been a week, and the Dr. said wait another week to see if it improves. What will be my option be if this does not go away.  I have read on the internet that they can remove the lens, and replace it, but it has not been done.  My other eye is really bad, and I need cataract surgery on that one also. Not so much fun growing old.  

[aimee37]

I just had cataract surgery and replaced with the Restor lens. I am having double vision and cannot read, or see lettering on the TV.  Even the people on the TV are not clear.  I went back for my first week check up and Dr. said to wait another week.  I have found on the internet that they can replace the lens, but never have.
Just wondering if there are many options for this problem

[aimee37]

You need to give yourself more time, one week is very little time to gauge the outcome. You need to be patient and let the eye heal. I strongly recommend that you wait at least 4 to 6 weeks before you consider other options. When I had my Rezoom lens implanted a year ago, my vision for the first three to four weeks was terrible, but improved in time. It is way too early to tell if you'll have aberrations related to multifocal lenses. With multifocal lenses there is an adaptation period as well. Remember, you are also putting drops in your eyes that could further blur your vision. I strongly suggest that you  wait on your second eye surgery until issues with the operated eye are fully resolved.

I had surgery last week to explant the Rezoom lens on my right eye and replaced it with a monofocal lens. Explanting a lens is much more invasive than the original lens implant surgery so, therefore, one will expect additional inflammation and recovery time. In any event, like you, during the first few days my vision was very blurry to the point that I could not tell what was on the television or even read large billboard signs. Now nine days out, my vision is improving dramatically. There is still blurriness but everything is much more clear and colorful. I'm beginning to enjoy my aberration-free monofocal lens. I expect my vision to continue to improve over time. A week ago I could not even imagine driving at night. Now the operated eye has cleared and improved enough to allow me to safely drive at night.

By the way, for all those who are monitoring my progress, Dr. Kevin Waltz did an outstanding job with the explantation surgery and lens selection. The implanted eye is 100% aberration free (day and night). Dr. Waltz implanted a Tecnis Z9002.

[aimee37]

I saw Dr. Walts last week for a consult regarding the possibilty of explanting my rezoom lense. He was very profesional and took his time to answer all of my questions. I am leaning toward explanting the lense but at this point I have not made a final decission yet.
Blue92, how is your near and distant vision now? With the monofocal lense, how close can you read or see without wearing glasses? Can you see clearly beyond 2 feet? Can you see a person's face sitting across from the dinner table?  
I am very happy for you that your surgery went well.

[barby33]

A related discussion, double vision after cataract surgery was started.

[Philsy]

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