multifocal lens -distance problem

[Browngeezer]

Hi, same as the last chaps question, I had a cataract removed and multifocal lens replacement in one eye 2 weeks ago. my close reading vision was great the next day, but anything  past 1 metre is progressively more blurred.and its much worse at night with  ghosting , halo's.
my other eye is very good for distance, what is a reasonable time frame to expect for  distance improvement?
(  I told the surgeon  had Lasik done 5 years ago, but he recommended the  multifocal anyway)
if there is not an improvement after your suggestions, what are the better options to get my clarity of distance back?
, the optometrist thought Laser or piggyback lens if there is no improvement after 3 months, is it possible to have the multifocal removed and replaced with a monolens? any help greatly appreciated.


This discussion is related to Neuroadaptation after multifocal iol implantation.

[JohnHaganMD]

=

[SoftwareDeveloper]

The most likely explanation for the poor distance vision is that  the lens power is off, that they left you myopic in that eye. Did they tell you what your refraction is, what prescription would be required to correct that eye for distance? Unfortunately there isn't an exact formula for determining the lens power to use, they analyze the statistics of prior patients and what lens power worked for them given their eye measurements. For most people the formula works well, but for some unlucky people it doesn't (especially highly myopic people, where there is some though the eye measuring devices may not be completely accurate, among other potential reasons).

If the lens power is off, it can be corrected via contact lens/glasses, or as you mention, lasik or a piggybakc lens, or a lens swap to the right power.  You might try correcting it with a contact lens to see if that fixes the issue and then you can decide whether to use a more permanent approach.


Most people don't have problematic halos, but some do, and the risk is higher with a multifocal lens unfortunately, and for those with prior laser surgery. Most of those who do see halos see them subside in the first few weeks or months, others take several months or a year or two, a small percentage never see the issue go away.

If the issue doesn't go away, in almost all cases they can swap the lens for a monofocal without a problem, though of course every surgery has some risk, its about the same as the initial cataract surgery.   Unfortunately those with prior laser surgery are also at higher risk than others of halos even with a monofocal so there isn't a guarantee that would get rid of the halos, but may reduce them.