Is my IO implant the wrong size?

My cataract was removed in December 2005 and replaced by an AMO lens, model AR40e, Diopter 19.0.  I had halos and problems with light immediately.  It was so bad that I thought the lens was not in place.  Peripheral light was creating fireworks in my field of vision.  My doctor said subsequent YAG surgery would correct that.  The YAG surgery was May 3 and the halos and light problems are worse.  Dr. says not to dwell on in and I will get used to it.  I feel as though the implant is too small and that is why I feel like light catches the edges of it and flashes across my right eye.  I'd like to get a second opinion but I'm not sure how to chose a doctor at this point.

[Forum-OD-MP]

already answered by other posters...

[eyecu]

Idoubt the implant is too small. There is another thread about halos with a different IOL model. Any IOL can have this effect. You probably dilate with a large pupil at night. You could get your doc too prescribe you some drops to use at night to bring your pupil down to see if this helps. Time usually does diminish the halo effect as your brain adjusts. The capsular opeing in front of the lens could be a little larger than the lens which gives you some edge effect or there could be some tilt. If you opt for an exchange and go with a rounded edge silicone model or evan a larger optic, you are running a risk since you have had a YAG of complications and there is no guarantee it would go away. Second opinions never hurt. I would still work with your doc as he knows what is going on and probably wants to give it some time to see if you adjust before taking the next step which could offer more risk.

[KCM25]

Thank you.  My doctor said the same thing but I wasn't sure if he was just trying to cover up a mistake on his part.  It took several attempts when he was taking the measurments for the implant before he got readings that he was happy with.  He also spent some time explaining the measuring instrument to his partner and it seemed to be rather new to their practise.  I started to think that the measurement was incorrect due to inexperience with the device.  I realize that the YAG surgery has made the lens capsule very fragile so I am very concerned about long term problems that have no solution.

What is the best way to pick a surgeon for my next cataract surgery?  How would I know which IOL is the way to go next time and possibly avoid the issues I am having this time.  I don't know if the fact that I am only 52 made the process different that the usual cataract removal.  I will wait and see if my brain compensates for the light issues but I am very leery about having the next surgery and doubling my problems.

[eyecu]

Being 52 you are younger and more active and susceptable to edge phenomenon at night no matter what lens. The lens you have implanted is very widely used and actually has an edge designed not to give you aberrations. It is rounded on the front, slanted on the side and square on the back. It was designed to reduce edge glare versus sqaure edge IOL's. There are trade offs with every material and design. But I also know patients that it does eventually go away or they tolerate it. If you like your surgeon and he did a good job and is still working with you, that says a lot. He will have your records and be more atuned to your second eye and might even try a different implant. For know, I would try the drops to see if it reduces your night time problems.

[KCM25]

This is the best second opinion I could have received.  Thank you so much for making this service available!

My doctor has always been very careful and thoughtful about each decision he has made for me.  He is very risk adverse, which is comforting to me.  Without having other patients in my age group to compare results with, it has been difficult for me to deal with the results of the surgery without thinking something went wrong.  I'm usually surrounded by 70 + year old patients in his waiting room and they all seem to have no problems with their cataract surgeries.

You have relieved my anxiety over this.  Thank you.