I have problems with post cataract surgery glares

[badcataract]

I had cataract surgery first time on 10/17 and my doctor used Symfony lens with extended depth of focus as I have near sighted, astigmatism, far sighted, prism,  but it did not work as I could see pretty good at close and intermediate ranges but it blurred at the distance, I couldn’t see the street names , which could be corrected by wearing contact lenses or glasses, but the main problem was the exceptional glare of the lens . At night, the auto headlights and any bright lights like street lights, market lights, are big like fireworks ! So my doctor had to remove it & replaced it with a Tecnis Model AZ 9003, an aspheric monofocal lens by Abbott , the same company manufacturing Symfony . I just had my second surgery 3 days ago. The surgery went well without any complications as I had been afraid of and I ‘ve been really happy. But alas ! Tonight I went out with my husband and saw the glares at auto headlights & street lights again, this time the glares are more condensed & shorter but they have a very big ,round halo around them....I am very disappointed and concerned ....Are they going away ? or it’s just the way Abbott makes it ? Does the Acrysoft IQ by Alcon doing better ? I looked it up on Internet it has a much smalller glare. I have asked my doctor to install Acrysoft IQ for me but he said he couldn’t do it because of the tears of the first surgery. Anybody has experience with Acrysoft IQ ? Any glare ? May I have advice from Dr. John Hagan ? I have read your posts and am very thankful for your explanations about cataract problems. Any help / advices are greatly appreciated. I am really “worn out” after 7 weeks of anxiety & depression & frustration and 2 surgeries for one eye . And I still have the right eye to have cataract surgery ! Is it ok if I have the Acrysoft IQ for my right eye ?

[JohnHaganMD]

Your experience with the Symfony IOL is becoming more and more common in reports in this forum and elsewhere.  The IOL you have in your eye now is ultra-high quality, in fact my wife about 4 months ago had one put in each eye. Post-operatively (say 6-8 weeks) many people with all kinds of IOLs have the symptoms you describe now as did my wife. They almost always get better and usually go away completely after you get your custom post surgery glasses. In most cases these are prescribed 3-5 weeks post operative. Remember a person with no cataracts but needing glasses especially if they have astigmatism will have the same type of problem at night if they don't wear their glasses.

[badcataract]

Thank you for responding me so quickly. It helps to ease a lot of my tension & worries.
May I ask if your wife see any unusual glare or big halo any more ? Does she just see the normal glares like she did before the surgery ?

[JohnHaganMD]

We just got home from a Christmas concert and she noted that she was seeing no halos or starbursts and that she sees much better than she did prior to the surgery which was in August.  She was very annoyed by light reflexes for a couple of weeks in each eye after surgery.  Happy camper now.

[badcataract]

Thank you so much for the information. I have tried to write back to you right away twice but the computer had some problems so it did not go through. Tonight I try again. I really appreciate your response . It gives me hope and understanding of how long it takes for the lens to be stable so not to be upset but be patient instead.
Thanks God, my eye is getting better every day and tonight I am happy to report that I no longer see the halo and the glare has been reduced substantially ! Now I am confident for the next surgery for my right eye .
The night you & your wife went to a Christmas concert, I talked to my friend in Ballwin, MO, she & her husband also went to a concert in Herman, west of St. louis.  I wonder if you went to the same concert. My friend said it’s very cold there , esp.with the wind from the river.
Wishing you and your wife a wonderful Christmas and a very Happy New Year full of blessings from the Lord !

[JohnHaganMD]

The glitch on this website is that people often make a post, press "comment" and it disappears.  They have been unable to fix that for years.  All you need to do is make another comment by typing in any single letter then press comment again and it will show up.
You need to brush up on Missouri geography. St. Louis is as far as you can get from Kansas City and stay in the state.  The Christmas program I went to was fabulous and at the Church of the Redemption in Overland Park KS.  Glad things are 'looking better" Best of luck and thanks for the kind greetings.

[MrPresley]

I have had an Acrysof IQ monofocal IOL in my left eye since cataract surgery in late March and have no glare or halo issues with it.

[badcataract]

Thank you for letting me know. So, do you see well ? No other problems ?  How long it takes you to see well after the surgery ? Do you have to pay for it or Medicare covers ?

[MrPresley]

20/20 or 20/15 corrected.  Vision was pretty much back to normal after two months or less.  Note that I only had cataract surgery in my left eye, my right eye does not need it at this time.  There was a flickering light effect when in bright sunlight or under fluorescent fixtures that has since totally disappeared.

I do not have Medicare yet but my out of pocket for everything ran about $400, including the surgeon, the surgical facility, and the anesthesiologist.

[JohnHaganMD]

Generally speaking hospitals, surgicenters cannot afford to stock every type of monofocal IOL so usually they only have one or two to choose from. However monofocal IOLS are extremely high quality its when you go to "add on's" that the problems come those are toric and mutifocal and accommodating IOLs. We do not have Medicare and were not given discounts which are illegal at our facility. It costs roughly $425 per eye for everything including 90 days of care and office visits. Compare that with $1500-$3000 for a dental crown which is two visits in a dentists office.

[NightHawkGuy]

My part of the basic cataract surgery costs after insurance paid the bulk of it, so it was similar to your cost MrPresley, well under $400 including surgeon, facility, anesthesia, Rx eyedrops, copays for pre-op exams, etc.

I went with a Tecnis toric monofocal, so that of course included extra out of pocket costs, in my case that added $1300 - about $540 for the lens and $760 for the extra work involved for it.

[NightHawkGuy]

badcataract, in regard to your questions, its taken a little over 4 weeks for my right eye's vision to really improve to what I had hoped for about 20/20-20/25 and stabilize near there daily.  In the first 4 weeks it was varying a lot, some days really blurry maybe 20/100, and only a few days near 20/25.  But it got better and more stable after the 4 week point - I am at 6.5 weeks now.

The only artifact I've noticed is outside in a dark environment when my right eye's pupil size is at is maximum I see a thin jagged half circle of light above some bright light sources.  But if my pupil size reduces just slightly by looking quickly at a light up close like the cabin light in my car, the half circles disappear.  Probably its caused by light scatter at the cornea incision spot?  Hopefully that will go away as it heals more, I believe its happening less often now than a few weeks ago, so that gives me hope.  But even while driving at night there seems to be enough light from cars around to keep my pupil size from getting to the point where I see the half circles most of the time, so it hasn't been a big deal fortunately.  And I don't have that issue at all indoors.

[JohnHaganMD]

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[badcataract]

Thank you for all information. It’s very useful. Here ‘s in CA , everything costs more. I have Medicare and Blue Cross PPO. For the first surgery with Symfony lens, I had to pay in addition of $3650 out of my pocket and it didn’t work so my surgeon had to perform the second surgery at no cost and he used Tecnis ZA9003 which is an aspheric monofocal lens provided free by Medicare. He had been very hesitating to do the second surgery as he said it might cause complications , and gave me contact lenses but it didn’t help about the exceptional glares. He now said that he will process paperworks for me to get a refund from the manufacturer for about $800-900 ( the rest was to cover the costs of other things ).
Good luck to you, NightHawkGuy. Hope it will work out well for you.
After my failure with Symfony, I got on line doing my own research and decided to use monofocals only. The other lens did not help astigmatism as they said.