Update (ICL)

[eskravitz]

Now about a half a year since my surgery and I've received private messages asking for an update about my glare issue, so in the interest of spreading knowledge, I've decided to post here.

The glare has continued under low light conditions in my left eye at all times, and sometimes in my right eye as well. I've been checked by the doctor, who says the ICL's appear to be perfect. Evidently, the glare is caused when the pupil dilates beyond the edge of the implanted lens "usable" area. I'm annoyed, since I was told that glare is less of an issue with ICL and also when he checked my pupil size I was told they were not too large. He actually did a followup surgery, repositioning my left ICL to see if he could get rid of the glare since it only appears in the lower right portion of my vision, but to no avail. Pilocarpine (0.10%) helps, but since it needs to be made up specially by the pharmacy and must be refrigerated, is not optimal. So, I also keep Alphagan P handy in case I am out when it gets dark. These get rid of the glare completely, but exacerbate the light aberration from the iridotomy holes (I guess when the meds cause the pupil to constrict it pulls the holes down further from under my eyelids so they are more exposed). Also, my dry eye condition has gotten markedly worse. I think this might be due to the pilocarpine or perhaps the alphagan as it seems to be a bit better if don't use them for a day or two, but my eyes sting quite a bit almost all the time.

Anyway, trying to get by a day at a time and find a regimen that works for me...that's my update.


This discussion is related to Glare in Left Eye after ICL Implant.

[JohnHaganMD]

No posts since 2013. Doubt you will get a response.

[Bhav1809]

I am amazed to find our condition is so much similar. But I had this surgery about a month back. Could you let me know how is your vision now?

[Bhav1809]

I am amazed to find our condition is so much similar. But I had this surgery about a month back. Could you let me know how is your vision now?

[lizjar]

Also, pls tell me who did your explantation of your icl's. Im considering.

[lizjar]

How are your eyes now without the icl's (in contacts). re you comfortable. I recently made the mistake of having Icl's about 3 weeks ago. I highly regret it and want to go back to contacts.

[abhinavz]

Hi..abhinav here
undergone ICL surgery in my right eye. It was -28d in right eye.Docs said that everything would be ok after d treatment and further correction would be done by LASIK.But just after ICL I'm unable to see anything with my right eye.doctor says this is due to the high eye pressure which lasts for 5-7 days after that everything would be fine.
Is it really true as I've invested a lot in d surgery    

[autumn606]

Dear all,
I just wanted to share my experience with ICL and a potential solution to the glare/iridotomy lines. I went into my surgeons office and asked isnt there something that we can cover the iridotomy holes with so that the light doesnt come though (thats the reason for glare and line) she thought about it for a while and she said we can do a tatoo! Initially I laughed BUT I just had it done on one eye and it really works! The glare has decreased substantially , she did say we may need to add some more ink. I also have severe dry eye syndrome but I had that before surgery and it stayed the same after surgery,

this is what can be done for dry eye syndrome (I have done it all)

restasis ( drug)
punctal plugs
if that doesnt work cauterization of the tear ducts(the last resort, I have done this)
warm compresses
and 1000 mg of fish oil daily.

[Jewels379]

Just found this site, its pretty neat, although its still not what I was looking for, it has simulators to adujust different things like ghosting, glare, halos floaters...ect
http://www.visionsimulations.com/

[kg17]

Think carefully about ICL removal.  There are risks of removal - one the biggest is cataract.  In my case, my intraocular pressure was increasing due to pigment dispersion so the risk was worth it.  If you do choose to have them removed, make certain that you select a surgeon who has done several explantations - you may have to travel to find one.

Getting back into contact lenses was not easy - it took about 5 months after surgery before I felt reasonably comfortable again.  The combination that has worked for me is to use 1-day Acuvue daily disposables - this was to eliminate the use of any contact lens solutions that can be irritating and drying.  The disposables are also thinner for the highly myopic eye.  I additionally use Restasis (takes about 3 months to work), take fish oil 3x daily, had silicone punctal plugs put in to keep tears from draining, and use an indoor humidifier to keep air moist in the winter.

What truly frustrates me is that if I'd had an ophthalmologist tell me that there was effective treatment for dry eye, I would have stayed in contact lenses rather than risk surgery.  But I suppose there's much less money to be made than with Visian ICLs.  By the way, the latest research coming out of Europe has stipulated very cautious use of phakic lenses due to the risk of cataract.  The last thing that the myopic eye needs is cataract surgery.

Good luck.

[eskravitz]

Thanks kg,

I don't have any of the visual abnormalities of the other poster. "Just" as previously mentioned, the glare, the iridotomy lines, and the dry eyes. I am considering having the ICL's removed. That will obviously eliminate the glare under low light conditions that occur when my pupils dilate beyond the effective area of the ICL's. The iridotomy lines will never go away but I think I can live with them. My concern is being able to wear contacts again since my eyes are so dry. What lenses do you wear? Does it really help the pain?

Thanks,
Elliot

[kg17]

You might want to ask an independent, well-respected cataract surgeon to examine your eyes.  You may have vacuoules on the anterior capsule of your crystalline lens.  This finding is considered the beginning of a cataract and can cause light defraction and thus result in visual aberrations - especially in the highly myopic eye.  The STAAR company will tell you that this is no big deal, but any well-regarded ophthalmologist who does cataract surgery for a living will likely tell you that the presence of vacuoules on the anterior capsule can negatively affect the quality of your vision, and can eventually result in opacities of the crystalline lens necessitating cataract surgery - putting you at additional risk for complications (i.e., retinal detachment) if you are highly myopic.  

Furthermore, you might want to go to the website "Preventing Blindness in America" and go to the glaucoma forum.  Dr. Anderson, a glaucoma specialist from the highly regarded Bascom Palmer Eye Institute, is very well-versed in visual optics and has discussed at length the visual aberrrations that can result from iridotomies in the highly myopic eye.

The surgery also permanently worsened my pre-existing dry eye symptoms resulting in four punctal plugs and daily use of Restasis.  With the ICLs removed, I am back in contacts and the pain is better since the contacts act as a sort of "bandage."

[Jewels379]

"1 - The iridotomy holes are not sufficiently covered by my lids with the result that I have bright lines that move across my vision as I open and close my eyes"
I also have that problem, sometimes it bothers me, but its not as bad as the other things that are going on. I have been debating on weather or not to go see another doctor about this. Its a shame they say how great this surgery is, and how disappointed I have been with it.
When I wore contacts I always had dry and red eyes. Now they still get dry (maybe more) but they dont get red nearly as much.

Do you know anything about double vision. Is double vision seeing 2 of everything? or can it just be seeing sort of a double of an object… for example… when I look at the eye chart it  looks kinda like this
http://i62.photobucket.com/albums/h91/jewels379/example-eye.jpg
Which I thought was a glare affect, but I noticed the other day that I saw the same affect on a tag on my blanket. And sometimes I see an affect like that with my hand.

I also have noticed that what I see out of my left eye is bigger then what I see out of my right eye, which they told me a lot of people are like that. I never really noticed it before, but I never compared my eyes so much before either.

Thanks for the fast response.

[dukey]

kg17 where have you been? I sent you a PM

[kg17]

I obtained the Visian ICLs 2 years ago and had them removed 1 year ago.  Please read my posts as they will explain the numerous visual aberrations and complications that I've had from the ICLs.  After doing extensive research into the subject of phakic ICLs, I'm convinced that it is a surgery with real risks - especially to the myopic eye.  Much better to remain in contacts and/or glasses if at all possible.

[eskravitz]

Hi,
Sorry to hear you're experiencing troubles. Unfortunately, I don't have any info for you that is likely to make you feel better. I continue to have three problems that I attribute to the ICL surgery. 1 - The iridotomy holes are not sufficiently covered by my lids with the result that I have bright lines that move across my vision as I open and close my eyes. This was more annoying at first, but actually I've come to pretty much ignore it. 2 - I have pronounced glare under low light conditions. I'm using Alphagan when I need to drive or am going to a movie, which helps alot. However, I try to restrict my usage to once or twice a week so that I don't develop a sensitivity to the preservative. Also, the more it is used, the less effective it becomes (I believe the effect is called tachyphylaxis (sp?)). If I use the Alphagan only once a week, on Friday evening before going out, it tends to last through to Sunday, which I can live with. 3 - The new problem I'm experiencing is severe dry eye syndrome. I have punctal plugs in now, and am on Restasis, and use lid scrubber once a day, which seems to help somewhat, but still it's very annoying.

I wish you luck!

[Jewels379]

Has your vision gotten any better? I had ICLs done on my right eye in July 2008 and on my left eye in Aug 2008. I also had to have Lasik done, which was done in Nov 2008 (one of my eyes was a -16 (whatever that means)). After my first surgery I could see amazingly out of my right eye (20/40) and everything was fine. After the ICL surgery in my left eye... my eye has just seem weird. I am experiencing glare and halo and it almost seems like something else is going on as well. Doctors keep telling me it just needs to heal, or that I am just noticing things beccause its new. I can read the same line on the eye chart with each eye, but its blurry with my left eye. And the docs just say that one eye is going to be better then the other. And I know that, I understand and except it, but it was never like that before when I had contacts. And the last check-up I went to, he tried to say something about where the "drainage hole" was made, it was lower them my eye lid so its letting in extra light and that could becausing some of the problem. Was that mentioned to you? I wonder if you can explain any better into detail about your glare. I know its not something easily explained, but I wonder if something else is wrong with my eye, cause it just doesn't seem right, ever since I came out of surgery I even said to my mom it seems weird on the day of surgery. After having so much spent on the surgery, I would expect to be seeing better. I also have been seeing floaters alot more often, which are extremely annoying. Without contacts or glasses before my surgery I could only see a few inches in front of my face and everything else was blurry... and somedays I still question if I should have had the surgery done. Its been great not having to deal with contacts and glasses, but somedays I just want to cry from this. Let me know whatever you can. Thanks!

[Ray T Oyakawa, MD]

Thanks for the update.