Eye lens replacement - poor night vision

[SusanMT]

I had a cataract removed about 16 months ago and had a multi-focal lens implanted.  Because the surgery was in Spring, I would drive home during daylight and didn't notice for quite a few weeks that I was having interesting night vision symptoms.

In full dark - such as on a country road or the freeway - anything reflective reflects back multiple times.  I get smears of reflection from the reflective road paint, whereas a street lamp reflects multiply in a kind of semi-halo.  This effect can be mitigated somewhat if I wear a corrective lens over the eye that did not have surgery.

In testing all types of situations, I note that this does not happen at night on well-lit streets, and did some testing to determine that the problem happens when my pupil opens too far to give proper focus.  If I do NOT wear a corrective lens over the eye that did not have surgery, I am literally night blind from all of the halos and smears of light.

Is there anything I can do?  I am so angry at the manufacturer for making this crappy lens...but what I want most is my night vision back.  I know the lens cannot be removed.  What else can I do?  (Leaving the dome light on while driving does not mitigate the open pupil issue.)

I am 47, female, generally healthy except for some gastric issues.

[Four Surgeries Later and now Schisis]

I am a female in my early 40's and I feel as if I'm going blind in my right eye. I was born with a cateract and had to have it removed 3 years ago along with a Intra-Occular Lens implant. One year later I had not one, but two Retinal Detachments. First they tried the gas bubble procedure and within two weeks I had my second detached Retina. This time they implanted a Scleral buckle which is keeping everything in place. Unfortunately due to my last two surgeries, I lost my pheripheral vision in my right eye. Today after having my eyes dialated, my Optomistrist saw another problem and is sending me to my Opthamalogist for possible Schisis which is the thinning of the Retinal walls which again can lead to a detached retinal or laser surgery. Please offer any advice possible. Thank you.

[JodieJ]

The Tecnis multifocal lens is not expected to received FDA approval for use in the USA for a year or more.  If you take a look at the current professional literature in this area, you'll find that multifocal IOLs are less popular today than a year ago, undoubtedly because of the many associated problems.  These include glare and halos, "Vaseline" vision, loss of contrast sensitivity, and a long (up to 12-month) neuroadaptation time.  Currently, the accommodating IOLs are considered to be the "IOLs of the future."  The Acri Lisa lens that you mentioned is an accommodating IOL, and it is also unavailable in the USA at this time.  (Try entering "Acri Lisa" in a search engine for more information.)

There are many promising new IOLs currently in clinical trials.  If you can wait, there will certainly be more (and better) choices available in the future.



  

[Lyn g]

I was very interested to read your experiences with the multi focal implant. I am a similar age to you and any day I am about to have multi focal implants, my problem is finding a lens as my eye sight is really poor and a lot of lens are not in my power. I have read though, to be effective they should be implanted in both eyes, obviously no first hand knowledge of that.

After reading this forum I now find myself wondering if I should wait a year or so to see if anything else comes on to the market. I live in the UK and can't help wondering if the USA has more experience with these types of implants.

What make is your lens, I wanted to have the tecnis lens but it is not made in my power and therefore have been told about the acri lisa lens, I just wish that I could speak to somebody who has had this lens, can't really see that happening though.      

Regards

Lyn g.

[SusanMT]

I was crushed to read that the lens could be removed.  My surgeon told me no later than a week after surgery - and she didn't tell me that until weeks or months after.  I am horrified.  I could have had this taken care of a year ago...and it still could be too late.

[JodieJ]

Eye surgeons vary in their ability to diagnose and treat problems with multifocal lenses.  You want additional opinion(s) from doctor(s) who is/are very experienced with these lenses.  It would be well worth your time to read thru the archives of this forum about this topic.  You'll find posts from people whose multifocal IOLs were successfully explanted after more than a year.  Two of these people traveled from the East Coast to Indianapolis to see Dr. Kevin Waltz; both raved about his expertise and skills.  (Dr. Waltz was initially recommended by a manufacturer's rep.  He has an early version of ReZoom lenses in his own eyes, so he has both personal and professional experience with multifocals.)

Conventional wisdom about your problem suggests that the halos/glare will diminish after a second multifocal lens is implanted.  This might be a good time to ignore conventional wisdom.  Best of luck!        

[James J Salz, M.D.]

night glare and halos are often noted following multifocals but it usually improves.  it is interesting that the sympotms are somewhat better when you wear glasses for the other eye. this implies it might not be entirely due to the multifocal lens.  it is not true that the lens cannot be removed so that is still an option.  if you are not satisfied with the answers from your original surgeon, get another opinion.