Positive Dysphotopsia after Cataract Surgery

Posted by bobbyo @bobbyo, Oct 30, 2021

I’m 62 and had my left eye cataract done in December 2019 and still have significant peripheral light streaks and night glare and starbursts while driving (positive dysphotopsia). Makes me a little “white-knuckled” when night driving and is maddening overall. Local surgeons are not inclined to consider an IOL exchange and neither am I, at this point.
With that, has anyone:
- experienced dissipation of dysphotopsia symptoms as time passed?
- tried photochromic contacts or glasses and had success?
- other actions that helped you?

Thanks for any input!

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@westchesterbaba

I am new to this site, and am getting lots of valuable information.
On 3/6/23, I had left eye cataract surgery, and opted for the standard J&J DBBOO IOL as recommended by my surgeon. The result was Positive Dysphotopsia which went from a single "bar" (on a clock, it ran as 10 to 4). The surgeon who did my husband's two cataract surgeries did my Yag, and was optimistic that he would solve my PD. Following a corrective Yag surgery on 5/25, the PD is now an X.
I sought a second opinion with a Wills Eye Surgeon who said he would have recommended the same IOL.
I've read that this IOL has an edge that can result in PD. So, it's a roulette wheel as to who is impacted.
I am in a holding pattern on my right eye cataract.

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I developed the same (maddox rod effect?) recently. I'm also in a holding pattern with regard to yag and second eye. How have things progressed with you?

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It's good to know the blurriness improved. 🙂

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@bobbyo

Read back to sbvrd’s May 23rd entry and link reference. Many commonly used lenses are notorious for leaving the patient with some halos and not the “cleanest” night vision. Need to find experienced surgeons who are willing and able to optimize your vision result.

See sbvrd’s doctor references too. In hindsight, I should have read much more about the surgery pitfalls and found a more sympathetic and helpful surgery group.

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Hi Bobbyo,
Read back to sbvrd’s May 23rd entry and link reference...
See sbvrd’s doctor references too...
I tried accessing sbvrd's entry, links and doctor references by adding sbvrd to the search box without success. Could you let me know how to find these resources?

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@tillymack

Hi Bobbyo,
Read back to sbvrd’s May 23rd entry and link reference...
See sbvrd’s doctor references too...
I tried accessing sbvrd's entry, links and doctor references by adding sbvrd to the search box without success. Could you let me know how to find these resources?

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I did find Sbvrd's entry, links and resources. Thank you. I assume Sbvrd is no longer reading the forum but wonder how he/she is doing. Do you know which of the doctors he/she lists were helpful?

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@tillymack

Hi Bobbyo,
Read back to sbvrd’s May 23rd entry and link reference...
See sbvrd’s doctor references too...
I tried accessing sbvrd's entry, links and doctor references by adding sbvrd to the search box without success. Could you let me know how to find these resources?

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@tillymack, I believe you may be looking for this comment, where @sbdvrd included a PDF of a journal article titled "Surgical management of positive
dysphotopsia: U.S. perspective" See their comment here: https://connect.mayoclinic.org/discussion/positive-dysphotopsia-after-cataract-surgery/?pg=2#comment-710737

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@tillymack

Hi Bobbyo,
Read back to sbvrd’s May 23rd entry and link reference...
See sbvrd’s doctor references too...
I tried accessing sbvrd's entry, links and doctor references by adding sbvrd to the search box without success. Could you let me know how to find these resources?

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Hi tillymack,

As I had said, Dr. Safran in NJ was helpful to me (via emails). Check out pertinent youtube surgeries on his website. I don’t know about the other doctors that sbvrd mentioned, but I’d say to search them and their practices online. And, of course, read all you can on Maddox rod effect and other prospective causes of long term dysphotopsias.

Since, as I understand it, you have a significant PCO that worsens your vision, you may not have any other choice than yag capsulotomy. I’m thinking that millions of people have had these with success. But, of course, not all surgeries are successful!

Ask your surgeon about the risks of the yag surgery causing additional dysphotopsias AND look for a second (or third) doctor’s opinion. Good luck!

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@bobbyo

Hi tillymack,

As I had said, Dr. Safran in NJ was helpful to me (via emails). Check out pertinent youtube surgeries on his website. I don’t know about the other doctors that sbvrd mentioned, but I’d say to search them and their practices online. And, of course, read all you can on Maddox rod effect and other prospective causes of long term dysphotopsias.

Since, as I understand it, you have a significant PCO that worsens your vision, you may not have any other choice than yag capsulotomy. I’m thinking that millions of people have had these with success. But, of course, not all surgeries are successful!

Ask your surgeon about the risks of the yag surgery causing additional dysphotopsias AND look for a second (or third) doctor’s opinion. Good luck!

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My second opinion surgeon says that it's not possible to know in advance if a patient will be made worse following the yag procedure. My original surgeon says it will not as long as the opening is made large enough.

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NdYAG laser surgery for PCO is very safe - and, many ophthamologists discuss these as almost common, and successful - and, the only procedure that will resolve the issue.

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