Positive Dysphotopsia after Cataract Surgery

Hello @bobbyo

Could you please advise if you managed to solve your problem. as I have the same issue and my operation was 2 months ago

Also do you have info about the model of the IOL and size you used in your Eyes ?
Thanks

Hi @melhefnawy

First, note that both of my IOLs are for far distance correction only.

As I said, my RIGHT eye cataract surgery was done 1/26/23 and I had significant PD for about 4 months. I pushed for a round-edged IOL and my surgeon used a Bausch and Lomb model: PC LI61A0, power 13.5D, length 13.00 mm, optic 6.00 mm. When I got to a couple or 3 months post surgery and STILL had severe PD, I was so discouraged. Needless to say, I was elated when PD resolved at 4 months!

My LEFT eye surgery was done 12/15/19 and they used an Alcon AcrySof model: SN60WF, power 12.5D, length 13.00 mm, optic 6.00 mm. As they told me many times, this is a very popular square-edged, one piece, IOL that they use on 98% of their patients. From the date of surgery, there was severe temporal PD and that has never improved.

I wish you good luck.

Thanks @bobbyo

It is good that your second operation is OK now, hope the first eye is getting better.

I'm 46 years old , My IOL is for far distance also, and the IOL is Alcon AcrySof model SA60AT which is power 12D, length 13.00 mm, optic 6.00 mm and square-edged,

I have some questions may be you went through them during your search for solution:
- Does any doctor say that you really have positive dysphotopsia (PD) , anyone can physical examine that ? as I went to 3 doctors and all of them said they can't see anything and everything seems OK.
- My symptoms mainly in the room light (strong room light), I feel as someone use reflective mirror and reflect the light to my eye , by searching and reading I have concluded this is PD, but still no doctor confirm that this is PD, so I'm thinking is there any issue can cause this symptoms aside of the PD ?
- If it is PD, does anyone suggest to you to change the IOL size in the second eye, as per my reading this problem may come because the pupil size is large , so why you did not use IOL larger than 6mm in the second eye ?
- PD are very annoying , but do you have any info if it is harmful to they eye , retina and cornea , I mean if I managed to stay with it and don't take any action , does it hurt my eye in the future or it does not have any bad effect ?

I'm sorry for the many questions, but I really need to find out what is the problem before going for the second operation especially that I may not find all the IOL options in my country.

Thanks again for your reply and have a nice day and good luck

You ask a lot of great questions.

Below, in order of your qs:
- It’s true, they seem to avoid the term. Although, when I brought it up they said that only a small percentage of patients (like 2%??) get long term PD. I tell them, “well, I got it 100% of the time.” I think they like the overall safety and general success of their “go to” lenses. They hang on their contention that there’s no way to predict who will get PD.
- I don’t know what other condition might make someone prone to PD.
- I tried Vivity to shrink the pupil and assure that the IOL was bigger than pupil. But, PD remained unchanged.
- I don’t know of PD being harmful to the health of eye.

As said, I’d still hope that yours, being just 2 months post surgery, will resolve through “scar tissue” growth, neuroadaptation or whatever.

Good luck to you!

Certainly!

"Flickering lights after cataract surgery, such as the peripheral light streaks and night glare you're experiencing, can be distressing and impact daily activities like driving. While it's frustrating that local surgeons are hesitant to consider an IOL exchange, it's essential to continue advocating for your needs.

In addition to the suggestions mentioned earlier, some individuals have found relief through techniques like relaxation exercises or using tinted overlays on screens to minimize glare from electronic devices. Experimenting with different lighting conditions and avoiding overly bright environments may also help alleviate symptoms.

Ultimately, finding the right combination of strategies to manage your symptoms may require patience and persistence. Continuing the conversation with your eye care provider and seeking second opinions if necessary can be crucial steps in finding effective solutions. Wishing you strength and perseverance on your journey toward greater comfort and clarity of vision.

I just saw this thread.
How about Christmas tree lights? They are almost doubled with all the rings around each light!

Thanks to all who have posted on this site, which was helpful to me as I started my own search. If you are considering a lens exchange, I'd like to recommend Dr. Robert Fish at Colorado Eye Consultants. Last Fall after cataract surgery on my first eye I was rattled by positive dysphotopsias with indoor lighting. The IOL was a Vivity, acrylic. Two local ophthalmologists and one optometrist discouraged a lens exchange, saying it was too risky. I read whatever pertinent studies and literature I could find online, reading among other things that timing was important. Eventually, I learned of Colorado Eye Consultants. Four months after my initial surgery, Dr. Fish replaced the acrylic Vivity with the Bausch & Lomb L161A0, which is silicone. For the first couple of weeks I had peripheral sparkles but none of the penetrating arcs and streaks that had been so upsetting. The sparkles then disappeared. Because a toric L161A0 isn't available, I still need correction for astigmatism, which to me is a minuscule trade-off. Needless to say, I'm elated with the success and hugely grateful to this surgeon.

What a great story! You informed yourself and found a “true” specialist so that you could have a better quality of vision and, thereby, a better quality of life.

I remain baffled that so many cataract surgeons pooh-pooh PD. But, being baffled did me no good, being persistent DID. I’m very glad I requested and received a better IOL for my right eye cataract surgery and because of that have no PD!

ag3,

Did you consider LAL - that would "fix" astigmatism and have allowed adjustment following IOL implantation?

Expensive, but not sure much different than Vivity.

I'd heard of it, but hadn't considered it. My original inclination to keep it simple has been reinforced by my recent experience. It is Dr. Fish's opinion that it was the acrylic material and not the extended distance of the Vivity that was responsible for the positive dysphotopsias. Nevertheless, choosing a monofocal lens in the first place would have given me more options.