Had Tecnis ZCB00 monofocal implanted 12/13, OD. Lens power 16.5. Target -0.50.
This eye (OD) is dominant.
Pre-op Snellen was 20/400 uncorrected, 20/60 with -10.0 soft contact lens. That's a darned thick contact lens!
Post-op Snellen showed 20/30 uncorrected, 20/20 with -0.50 refraction.
My good eye uses -0.50 and gets 20/20. So I now have perfectly balanced vision.
Wow. Just wow.
Although I have 20/20 technically, my severe OD pucker makes bino vision tricky. OD images are very wavy horizontally and vertically. OD images also very misshapen, like a fun house mirror. OD images at least 30% larger than OS. All contributes to bino diplopia. Sometimes fusing is acceptable (for now). Other times this dominant OD eye - with brand new IOL - takes over and I see two distinct and separate images. One very good and normal. Other very distorted and bigger. Two phone poles, one normal size and straight. Other one wavy and huge. Etc. That gets me dizzy, queasy.
Wearing -0.50 in my other eye balances me out and is better, but still not good. After about 6-10 hours I feel tired with very slight headache.
Next step is OD ILM peel. Then wait for photoreceptors to relax. Will be year before max relax reached, I'm told. Several very useful threads on this site about ILM peel. So glad I found this place.
I do have some rings from headlights, street lights, Christmas tree lights, candle light. The rings are only half circle and quarter circle, not complete circles around the light sources. They went away about 12 hours after the surgery. Came back next morning before my "next day" post-op visit. Surgeon said IOL was centered. Said dilated pupil can cause rings. Said the eye drops I'll be taking for next 6 weeks (some drdops stop after 1 and 2 weeks) can induce rings. Said wait and see.
This color drawing shows exactly what I see looking at a bright green computer LED "on" light in a completely darkened room. The rings are as bright as the green LED. The translucent haze that fills the half and quarter "pie shapes" is much lighter in color. The rings are always as bright as the light source. Haze always lighter in color and translucent. Rings and haze diminish in intensity as ambient light increases, but still visible around Christmas tree lights in daytime with drapes open and room bright from sunlight.
Color drawing, rings and translucent haze:
I've read how light refracts off the straight, vertical sides of square edged IOL's and causes positive dysphotopsia. Tecnis frosts those straight vertical sides to reduce pos dysp.
1. What reason besides dilated pupils would cause these rings to appear?
2. Why do these rings appear as only half and quarter circle rings, not full circle rings?
3. Does brightness of the rings, and their perfect quarter and half circle shapes, indicate I'm seeing IOL edge?
4. Why are the half pie and quarter pie shapes filled with translucent haze?
This slideshow has great pictures and explanations about pos and neg dysphotopsia. Pics/slides pertinent to dysphotopsia noted below:
slideshare (dot) net (forward slash)laxmieyeinstitute (forward slash) dysphotopsia
Slide #15: ARC
- Patient perceiving the edge of the IOL, which only happens at night
- Usually resolves over time, especially if the capsule overlaps the IOL edge
Slide #27: PCO
- Square edge IOL reduces risk of PCO, but increases chance of dysphotopsia
Slide #28: Other causes
- Pupil size
- Cornea curvature
- Index of refraction off IOL material
Slide #29: Edges matter
- Truncated posterior edge offers barrier effect to epithelial cells
- Sloped edge minimizes internally reflected rays that form arc like images
- Rounded anterior edge minimizes mirror effect
Slide #47-48: Comparison of various IOL’s
- Eyes implanted with Tecnis ZCB00 showed less neg dysphotopsia
- Hydrophilic acrylic IOL’s had more dysphotopsia than silicone IOL’s
- Hydrophobic acrylic IOL’s had less dysphotopsia than hydrophilic acrylic IOL’s
- Hydrophobic acrylic IOL’s had less night time halos, glare, than hydrophilic and silicone
- Increase in optic-haptic angle caused increase in night time glare, halos, rings around lights
Slide #50: Negative dysphotopsia
- Not attributed to edge design
Much thanks to everyone and Dr. Hagan in particular, who kept telling me it wasn't that hard. He was right.