Eyesight Issues after Cataract Surgery

Your visual disturbance mirrors mine exactly. Have you achieved any resolution?

The issue of seeing the edge of the lens is usually labeled a "negative dysphotopsia" if you wish to search to find out more about it, and many people's brains eventually tune it out. There are various treatments proposed for those who don't, sometimes a 2nd piggyback lens is inserted, or sometimes a lens exchange helps. Most lenses are the same size, but not all, and the material and shape can make a difference.

Thanks to your response, I was able to take this knowledge into a consultation this morning. The surgeon told me I was more likely experienceing positive dysphotopsia (who knew?) and that yes, size and type of lens can be adressed, with an exchange ocurring usually within 2-4 months after cornea has healed but lens is not too well seated. He is not big advocate of the piggyback approach. We'll try a different lens in the left eye, and if more successful, decide then whether to reposition or exchange the other. BTW, he said if it hasn't resolved in one month, it isn't likely to do so. He said it's true that one's brain may adjust over time, but given my profession he could understand why such an extended orientation period is less acceptable than pursuing resolution. It does help to have information.  At least now we have a plan and I feel much more hopeful. Thank you, again.

Thanks, Eugene for your comments. Seeing the edge is a newer symptom for me and I can see AND feel it as I accommodate(close up). Originally noticed haze over left field of vision, the bright edge glare left periphery (like bright ice cubes). Unable to read eye chart due to bright glare in center of my vision. "Iol is perfectly centered" x 3 ophthalmologists, retina specialist x 2, and 2 neuro-ophthamologists. My surgeon has not offered aan exchange and I am tired of being told not to dwell on it. After 10 months, my vision is much worse than before surgery! Like you, I find lots of articles by reputed doctors about this problem. Acrylic lenses are thin and more flat so they can be folded and injectedthru a smaller incision. My brand has the highest index of refraction, more than a human lens, and flatter, leading to more aberrations. Top it off with a sharp, square edge,which is NOT decreasing PCO, and you get light reflections bouncing in, out, off edges and haptics, causing glittering rings of light constantly in my field of vision. Daylight or room light, always there! Glare now causing me to close left eye to read! Some docs are using mid-range silicone, rounded edges in place of this "Premium" lens. By the end of the day, my eye feels gritty, bigger and over-used. Still looking for surgeon to try the exchange. Being knowledgable about dysphotopsias is NOT causing me to have the symptoms, simply validating that this is a huge problem. My cataracts probably could have waited a lot longer to be removed. A pamphlet about possible side effects does not equate to informed consent!

Thanks for letting me rant...by the way, where do you live? I am in the Midwest. Best of luck with your surgery??

Hi, Ruth. I live in Iowa. As dilated as my right eye was after surgery yesterday, I could tell immediately that my peripheral vision had been restored. No lens edge, no negative dysphotopsia from ambient light, no shimmering nor shadows narrowing the field of vision, only the gradual diminution of the peripheral extremity as in the non-treated eye. I read all but one letter on the 20/20 line at this morning's follow-up. One thing, and it's not a complaint, only an observation: the light filtering of the two lenses is noticeably different. The acrylic had a blue light filter (the surgeon called it a yellow filter). The polymer lens also has UV filtering properties but white appears much whiter, blues are accentuated, and greens are less rich, which is to say a bit blue-ish. It makes the color difference between the new polymer and my remaining natural lens with mild cataract formation quite striking. If I were a painter, photographer or graphic designer this might bother me, but I'm far too grateful for having been relieved of the multitude of other disturbing visual problems to quibble about hues.

For three months I had a sensation that there was a foreign object in my eye. That feeling is gone, too. I have only a mild day-after-surgery scratchiness. According to the lens implant cards, both the acrylic and the polymer are 13.0mm x 6.0mm. For what it's worth, the new lens is a STAAR CQ2015A. My surgeon said it was his first lens exchange for the purpose of correcting dysphotopsias.

Wow! I am so, so glad to hear that your vision dysphotopsias are gone...really, I am jumping up and down????????. To have crisp, white, non-shimmering vision as it should be once a cataract is removed and to have that "something in my eye" feeling gone is what you deserve! Cudos to your surgeon for believing you and trying a different lens. And thanks for the info on the new implant. Can I ask if the old one was an Acrysof IQ SN60WF? I have an appt August 10 with a surgeon at a major university and will share your experience with him. Hoping to convey to him my distress with my worsening vision.

Thank you so much for getting back to me. I wish you best of luck with healing and hope others will read this and pursue a quality out come. Will let you know how my visit goes...fingers crossed!

That's exactly what my old implant card says! Acrsof IQ SN60WF

Thanks! Now rest that eye..

Hi Eugene! Wondering how you are doing after your lens exchange? Hopefully your vision is more "normal" now! Can I ask what color your eyes are? Wondering if this plays a role in dysphotopsias.

Thanks for asking. I have blue eyes. I couldn't say if that plays a role. Interesting question, though. My distance vision was 20/25 after one week. Near vision is slightly better now than 2-3 days after the surgery, but not great. Maybe a bit worse with the polymer than with the acrylic. I won't get a final scrip until 3 weeks, so it may change some yet. Color perception between the two eyes is still quite stark, due to no blue light filter on the new lens. I may ultimately be able to compensate for that somewhat with glasses optics. All things considered I am much better off with a full field of vision. The first lens was like Cyborg vision -- very sharp within a narrow visual field caused by the dysphotopsia in my periphery that created a blind spot. I could not stand the ever-present crescent edge in my periphery nor the magnified visual aspect ratio that made everything appear bigger and closer. It was claustrophobic. And of course it felt uncomfortable, like a foreign object in my eye at all times. So, is it perfect? No. I wish I could see colors the same in both eyes. Am I one of those people I hear about that doesn't need glasses after cataract surgery? No, I will need glasses or contacts to be pinpoint 20/20 and to read. But my vision is serviceable enough at 20/25 to drive, golf, and otherwise get around, and the exchange was clearly the right call for me. Had I known of all the possible eventualities, I would have waited until the cataract was more advanced before doing the first surgery. But we don't know what we don't know, and bottom line I'm grateful to have my peripheral vision back.

I think your vision will continue to improve as you heal and the difference between the two eyes must be very strange! Did you wear glasses before the surgery? I have to wear glasses due to need for prism, and actually just filled new prescription to help the vision I have now. Had hoped to wait until after exchange but reading, driving, etc is getting harder. Went to a new eye center and we were talking about being able to see my lens when I look in a mirror. Well, seems the ophthalmologist had just gotten an email from a colleague about that same issue...what are the odds! She actually took a special picture of my eye to send on. Great group of people, will pick up my glasses tomorrow. I see new surgeon on August 10 so wish me luck!

I asked about your eye color because I was reading about what the iris does where light is concerned. Found several articles that say people with light-colored eyes are more sensitive to light since the iris lets more light in compared to someone with brown eyes. So now I am wondering if acrylic lens, tinted yellow, that is flatter and has a higher index of refraction is even worse for blue eyed people...hmmmm. Will let you know how the visit goes. Keep healing and enjoying so much less visual "assault".

I did wear glasses before the surgery and was near sighted in both eyes about 20/200 so my distance vision right eye is much improved. You may be on to something re the yellow tinted acrylic. In terms of driving, I was very uncomfortable not being able to see peripherally out the passenger side window when looking ahead.Will be interested to know how you come out on the 10th. I will stay tuned here; I still have my left eye to deal with at some point!

Well, my appointment had to be rescheduled to Sept 8 due to change to surgeons flight schedule being changed....can't tell you how disappointed I am. Had my first surgery Sept 3 last year so it will be a year by then. When I read articles stating not to wait too long to do an exchange, I can't help but feel that I pursued that option responsibly and had anyone been really listening to the degree of visual disability I was experiencing, the exchange could have been much sooner. It is surely going to be more difficult now, as is mentioned repeatedly in scholarly articles about lens exchange. I am feeling very discouraged. My impaired peripheral vision with shadow +/or bright glare is making driving a challenge since I have to triple check to make sure I am seeing what is or isn't there.

Your reply to donsabi was excellent on so many levels and honest. Hopefully it will help others make a more informed decision about having cataract surgery, especially if their vision is only marginally impaired with the cataract. I am hoping you will continue to heal well. I do know that glare at night is reported often after surgery and some people were sunglasses to decrease it....another side effect that is glossed over by some doctors and the pamphlets they hand out.

Will keep you posted about my quest for quality vision.

Hi Eugene! Just to let you know the new eye surgeon did an itrace, new to me. It measures 3 layers of vision. Showed my left cornea slightly fuzzy but significant abberations at lens level. Can't see Glistenings but suspects that is the case. Also, first time anyone did a dry eye test! I think it's more than one problem, especially as it started within 3 months after surgery. Will be more complicated now that it is a year. Agreed to try an exchange, discussed risks, scheduled for October 11. Finally! Just wish the original surgeon had offered to help. This surgeon uses two different lens brands, one of which is the AcroSof. I am choosing the other one because I STILL see perfect rings as I look out at my world. No comment by him. If the ring is gone after my left eye is done, then I think it would be obvious that the model of lens was the problem. I did catch him mentioning that he would want to save the lens to send back...hmmm, are these types of problems he has been seeing with this lens? Anyway, I am scared because it is more involved but I can't even read with my left eye open, so I am willing to count on his expertise. Glad to finally be doing something! Hope you are adjusting to your new lens? Let me know. Will keep you posted!

Ten days after the replacement, the capsular bag started to opacify. Apparently this happens, but usually not so quickly. Two surgeries no doubt sped it along. They open the capsular bag with a laser. I have to wait three months until the lens is seated. For now, night vision is poor because of the streaking and smearing of lights and I can't drive at night. So the saga continues. I'm scheduled for Oct. 24. So far, my God-given moderately clouded natural lens was superior to either the AcroSof or the Staar. Who knew. The AcroSof seems to be a favorite choice among surgeons. It has a blue blocker, which my Staar does not have. I see colors differently with the right eye now, which is strange. But I do have a panoramic field of vision and my periphral vision is restored. So we solved one problem and created  two more. The problems can be chased for only so long, because corneal cells are lost each time the eye is opened up. Anyway, I'm hoping the lazer works and I'll wear contacts to address the monovision because there's no way I'm doing the other eye until the natural cataract progresses to the point of real problems. Maybe never.

Hi Glen! I am so sorry to hear that your night vision is so affected after your lens exchange! It does seem like the issue of PCO after surgery is no better with the new lenses. I agree that it could be the two surgeries so close together but have read that it can occur fairly quickly after only one surgery. Could it be each persons body responds differently to a foreign object placed in the eye? Just about everyone seems to need the Yag laser.

I also have some PCO in my right eye as the new doctor found. This is my better eye. It was mentioned off and on beginning at 3 1/2 months post op, but then Not by other consulting doctors. Go figure. I think I mentioned the Glistenings before that are Still a problem for many IOLs, especially the Alcon Acrysof. He doesn't see any but would not be surprised to find it on the explanted lens. Makes me wonder if PCO AND Glistenings are present on my "good" eye. I have asked him to use the AMO lense.

And I totally agree about wishing I had known all the problems before doing either eye as I, too would have waited much longer. A cautionary tale for anyone contemplating cataract surgery. I will let you know how my surgery goes, and would like to know how you do after laser treatment. Thanks for sharing your experience!

Hi Eugene.

Good to know that you improved after replacement .

I had my left and right eye done using same lens AcrySoft IQ. My right eye was done before two days and I think I am facing the same discomfort with both eyes but with the right eye now I feel it more.

What I am seeing is like a dead area like a black crescent shaped area on the end of each eye, and it changes in size with my eye muscles movements as well.

Is this what you used to experience?

What is the type and brand of the replacement lens you used? Is it Alcohol as well?

Wish you all the best

Thank you for the useful information!

Hello Eugene, is it your lens made of Collamer? Could you tell us what sort of dysphotopsia you had with the bloody acrysof? 

Eugene,  I just read your post from about two years ago, where you mentioned you had an exchange due to negative dysphotopsia.  I was wondering if you can tell me which lens you received that relieved the negative dysphotopsia symptoms.  I have been looking for someone that had negative dysphotopsia and actually found a solution.  Thank you so much for sharing this information with me.