2nd Opinion report after cataract surgery complications in first operated eye

[Cam5151]

Its been a few months since I last posted here and 2 months since I saw a surgeon for a second opinion for my post operative problem with Vivity IOL implant in my LE. (Oct 2021).  I appreciate Dr. Hagan's advice to seek 2nd opinion and I want to share my experience with the community.
To recap, I was unhappy with the quality of vision in my LE with the Vivity lens implant. Complications included  dysphotopsia , halos and glare around lights at night and driving was difficult.  I did not have the expected distance vision clarity and need corrective glasses for night driving, however, the light disturbances are still present, which I realize cannot be corrected by glasses.  My near range is "better" than before in my operated LE.

I was scheduled for second cataract surgery on RE with the same Vivity lens soon after my LE was done . Since I did not want to risk the same outcome, I cancelled the surgery.
After several appointment delays  for a second opinion (due to surgeon and myself getting covid last winter), I was finally able to see him for a second opinion in mid April 2022.

Below are his findings, quoted verbatim  from his report in a letter I received soon after my appointment.  
"On examination, the visual acuity was 20/20 in the right eye and 20/25-2 in the left eye with correction.  I refracted both eyes with a prescription slightly different than what you were wearing and when I put this in front of you with  split prism to separate the two eyes it was clear that your right eye (non operated eye) actually sees better best corrected than your left eye does with the implant in it.  Your cornea was clear.  Anterior chamber was deep and quiet. The intraocular pressure was normal.  In the right eye, you had a moderate nuclear sclerosis and some cortical spikes in the visual axis.  
In the left eye, you had a posterior chamber lens, a Vivity 19.5-diopter lens.  The lens was in at the capsular bag, however, the anterior capsule and posterior capsule were fused behind the optic from 10 o'clock to 6 o'clock pushing the lens forward ever so slightly on that side that I think is contributing to a slightly myopic outcome here.  You are about -0.75 diopters myopic in this eye (but we refracted you at -0.75 -.50 at 60 degrees).  Dilated exam was healthy and unremarkable.  Your macula looked fine.  You did have a posterior vitreous detachment in the left eye.
My impression is that you have a slightly myopic outcome with the Vivity lens post LASIK that is partially because of the lens power, but I also think because the lens is partially in front of the anterior capsule on the nasal side.  I think your three choices are to do nothing and just update the glasses, to have cataract surgery in the right eye with a different lens that will give you a better quality of vision and be more targeted for distance, or to exchange the lens in the left eye for something else and I would consider either an Eyhance or SofPort.  At any rate, we can certainly stop and pause and think about what you wish to do before doing anything, here is no rush.  I will be happy to see you back in for to six months. If you have any questions, do not hesitate to contact me."
I hope my post helps others here.  And again, I thank Dr.  Hagen for his detailed responses and insights with the complications I experienced with Vivity lens.  And especially his advice to see another surgeon.  As you can see, there is NO RUSH for me to have second surgery; and further I am grateful to have avoided a 2nd surgery with Vivity lens, a lens this surgeon does not have a high opinion of to begin with.

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

Thanks for the update

[Cam5151]

Thank you for the link to your paper on LAL lens.  
I am seeing a 3nd eye surgeon for another opinion regarding my situation as the 2nd surgeon I consulted with in April 2022 does not use LAL lenses.

I am looking forward to learning whether or not LAL lens will be a good choice for me, in my still un operated right eye, especially since I have had lasik.

As an update, I am post op one year with the Vivity lens in my left eye (Oct 2021 surgery).  
My vision has not improved with regard to positive dysphotopsia and poor night vision.  I had a less than optimal distance outcome with the Vivity lens as well.

I wear corrective glasses however night driving is still very difficult since the glasses do not correct the halos in my LE and I have cataract in the center of my RE.  
I really do not want to risk another surgery with a lens exchange surgery in my LE, so the decision for my RE has to be well researched and thought out.
I appreciate your guidance and knowledge Dr Hagen.  Your insights have helped me tremendously in the past. If you have any thing to advise me of at this time I appreciate it.  
I will keep the community updated.  

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

I'm sorry, I have taken this conversation about as far as I can. I wish you the best possible outcome.