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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@bobbyo

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!

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I'm so very, very glad you have no PD Bobbyo. Going into the lens exchange I'd remind myself of your initially having PD with the second lens, and then having it resolve in 3-4 months. It was a relief that I had none, but your information would have helped me weather a similar situation. So thank you for having continued to write!

I failed to mention some things of significance. On my querying Dr. Fish, he estimated that he did 10-15 lens exchanges a year. That's in comparison to 5 over the entire career of a middle-aged surgeon I consulted who advised against it. Further, Dr. Fish guessed that of all those, about 15 had been for those with PD, all of whom had either had dramatic reduction or disappearance of all PD, and all had been happy they'd had the exchange. He is a relatively quiet person in my experience and didn't offer any of this information without being asked. Virtually everyone I came in contact with at this well-run clinic had praise for him, saying he gets the lens exchanges from all around. He is also a cornea specialist.

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@ag3

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.

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Yes. LAL is also a monovision lens - of silicon, vs the far more common acrylic.

Don't LAL and Vivity cost about the same?

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@adf13840

HI @frankmiramonti. I recently had surgery in Kansas City with the Light Adjustable Lens and am having the exact same negative dyspotpsia issues, as well as the lens jiggling, flickering, etc.

May I ask who did your lens exchange? I, too, am thinking of traveling to see Dr. Safran, as I do not want to do anything to this lens that will make things worse or make it harder to explant/exchange.

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Hi, I hope you have had improvement since June 2023. I did not realize that you could get dysphotopsias plus flickering with the LAL. I am scheduled to have LAL surgery in May in Kansas City. I am wondering if you would share who your ophthalmologist was that did your surgery. I have done so much research and I am not sure I am doing the right thing. Thank you for any help! There are so many questions about the LAL.

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I had laser cataract surgery on one eye four weeks ago and still see a stream of light at an approximately 45 degree angle through led and other bright lights. I was given the impression that this would dissipate in time and therefore proceeded with cataract surgery on the other eye last week. I now see, at times. a horizontal streak of light and some hazing around some lights in that eye, although it's less bothersome and may be fading and I am only out a week from that second surgery.

Another surgeon who examined me the day after my second surgery, informed me that the J & J Enhance lens used was smaller than my natural lens and that the capsule holding the lens would likely shrink over the next few months possibly correcting the issue. But he also noted that there was or could be (not sure exactly what he said) of a wrinkling in the capsule (or maybe the lens, not sure) that was causing the light streaking.

In any event, he told me that if the 'light issue' didn't resolve within 3 months, the issue could be addressed by the Yag laser.

I wonder:
1. if others have had their 'light issues' whether due to wrinkling or otherwise self-corrected within months;
2. if not, whether they adjusted to it over time as opposed to taking a risk with the yag laser; and,
3. I wonder if this occurrence was due to having my cataract surgery done by laser as opposed to the more traditional manual method

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