Carl Zeiss bi focal lens

[nichova]

I am very short sighted (-16 on both eyes). I had an implant of a Carl Zeiss bi focal lens 2 months ago on my right eye only. My doctor told me that this was a much better improvement than the previous generation. Results : my distant vision is ok with the aid of glasses (astigmatism only). But the close vision is bad. The close focus is only 10 inches from my eye, makes it very difficult for me to read normally, especially with contact lens on my left eye. Other common features such as glare, halo, double vision, whitening of objects (like being covered by a flimsy paper) appear. Night vision is bad due to glare and halo. I am very disappointed by this implantation.

Question 1: the glasses with astigmatism does improve distant vision, but it make things blur at a distant of 12 inches to 32 inches. I can see clearly the computer monitor at a distance of 28 inches with my right eye without glasses. But the glasses make it worse. For objects at about 10 to 12 inches, it improves my vision slightly. Can somone please explain to me why this happens. My astigmatism on right eye is 125 degree, axis at 100.

Question 2 : I am considering to implant a monofocal lens for my left eye. Will this cause any imbalance between the 2 eyes? Will monofocal lens also have the problem of glare, halos, double vision problems?

Question 3 : any has any experience with Carl Zeiss lens ? What is your result?
Pls advise. Many Many thanks !!

[nichova]

Hi Alan
hows your latest situation now ??
I still have only my right eye done with the IOL surgery.
I do not have the courage to do it on my left eye until it is absolutely necessary

[AlanKhoo]

After about 1 month yag laser capsulatomy, my vision is very bad with extreme star burst and also hallos vision, even from the afternoon sun reflect on any shinny surface. What do you think what is causing this effect ? Can this be due to the implanted lens has mismatch diameter with pupil diameter ? My eye doctor suspected the posterial capsule hole created during yag laser could be too small causing this, can you advise me what best to do? Make the hole bigger ?

[AlanKhoo]

Share experience: After 10days of Yag LASIK, still night vision see bad star bursting light,, 1ft vision ok, 2-3ft vision bad/ non readable, far vision ok but seem very bright, i think the Carl Zeiss implanted lens is like that, I give up hope.. Dizziness and headache persist, my eye doctor recommended contact lens for right eye, I may try this weekend.
Rgds

[John C Hagan III, MD, FACS, FAAO]

I don't know the range of IOL powers on aspheric monofocal IOLS but I would think they would be available.

JCH MD

[nichova]

I think you have similar situation as me. Pls keep in touch. My email address is ***@****.

I have emailed Car Zeiss and asked about the glare and halos. They gave me standard answer...."the glare and halos will disappear over time....extreme patient will need 6 to 9 months to adapt...."
I really have no confidence that this glare and halos will disappear. And I hate the whitening (like looking through a flimsy paper) of vision. I just had a progressive eye-glasses, it does not give me any edge over 2 pair of glasses, except a little bit convenience.

To Dr JCH
I heard that there is no aspheric monofocal lens for hight myopia (-16), is this true ??

Many thanks

[John C Hagan III, MD, FACS, FAAO]

Since I cannot see the membrane I cannot advise you one way or the other. If the second opinion was recent you can call their office and ask how cloudy the membrane was when the consultant saw you.

JCH MD

[AlanKhoo]

Thank you for the feedback, my eye doctor commented that the Yag LASIK is to remove a membrane with is causing poor vision , also causing glare. A second opinion informed me that the implanted lens is perfectly located, but explain that multifocal lens has poor vision at intermediate, however did not comment anything on membrane. My eye doctor did inform me that a small hole will be created at posterrior capsule but very low risk and vision will improve after that. What is you opinion regarding membrane ? Since giddy persist, do you recommend to proceed surgery to the right eye ?

[John C Hagan III, MD, FACS, FAAO]

?4  progressive bifocals will work at all distances. Lasik and single vision glasses will not allow you to see at different distances. very few people are happy in the situation you are in with such a huge difference between eyes.
?5 no  
?6 the worse risk is loss of your eye
?7 yes

ALANKHOO  
consider getting a second opinion from another refractive cataract surgeon before having the yag.  It is much easier and safer to do IOL exchange if there is no hole in the posterior capsule.   RE GLASSES: you have a 3 diopter difference between your eyes, most people have trouble with that much. If you haven't adjusted to glasses at 2-3 weeks you likely will not be able to.

JCH MD

[AlanKhoo]

I share with you your experience and can understand your disappointment. I have my left eye performed cataract surgery with Carl Zeiss multifocal lens implanted abou 3 months ago. Results: far distance vision good but not perfect, still has short sight at -0.25, astigmatism 50 degree and need a glass. Near vision (reading) at 1ft is poor /blurr but intermediate 2-3ft is worst to non readable!. Night vision bad, with glares, halos, occasionally see ring!. my eye doctor recommend me to do yag surgery and I am going to do on this week Saturday, however, with this experience, I hate to do anything on my eye.  My  right eye, currently with low cataract,  short sight -3.00, long sight +0.50 and astigmatism 100 degree and I am using glass but feel so giddy and unbalance. To balance up, My eye doctor advise to do cataract surgery with multifocal lens implant as soon as possible. I like to stay with glass, however, the giddy experience, I hope can go away with time.
Question to Dr Hagen : can the giddy go away after long time if I continue with glass?

[nichova]

Really grateful for your response.

My eye doctor advise me to do a Lasik touch up on my right eye (the one I had implant). Since my myopia is only -0.25, the only thing left to "touch up" is only astigmatism which is 125 degree, axis at 100.

Question 4: as I stated before, the adding of glasses with astigmatism only work well for distant vision, but not for middle vision (ie roughly 30 inches distance), will the Lasik make my middle vision even worse ?? FYI, I have a second pair of glasses with Presbyopia and Astigmatism together and it works well for me on both middle and close vision.

Question 5 : Is there any way (take whatever food or do whatever exercise) to help reduce the glare, halos and double visions?

Question 6: If I extract the bifocal lens from my right eye and replace it by monofocal lens, what are the risks? What is the experience of the patients who have actually done so?

Question 7 : I may stick to contact lens for my left eye until one day i cannot wear it. I have checked with my optometrist who said that it is now difficult to find contact lens with such deep myopia (-16) nowadays. Most of the suppliers have stopped producing them already and one-day-lens cater for at most -10 myopia. Is this true ?

Thanks and Regards,

[John C Hagan III, MD, FACS, FAAO]

1. To achieve clear vision at all distances you need progressive bifocals.
2. Many excellent surgeons mix IOL types and use monofocal and multifocal in different eyes. Dysphotopsia is much less of a problem with aspheric monofocal IOLs than all multifocal-accommodating IOLS

Good luck. Glasses are in your future.
JCH MD

[nichova]

Could you pls look at Q1 and Q2 of my original posting? I wish to know whether my problems are common and how to tackle them

[John C Hagan III, MD, FACS, FAAO]

I have no experience with that IOL

JCH MD