Flickering after Cataract Surgeries

I have the Tecnis ZA9003 IOL. The doctor that made the diagnosis was not a fan of its three piece construction and he indicated a lens exchange or a piggyback lens might be options. Hopefully, I can find out the cause of the lens dislocation, then have the appropriate surgery to remedy the issue.

It can't be a coincidence that so many others have posted the exact same symptoms. It must require the right lighting conditions to diagnose because I had at least four or five appointments with no luck, then one doctor nailed it immediately.

I've tried exposing myself to more light, but it only makes it worse. I think it has to do with changes in the light - that causes movement in the eye which causes the lens vibration and the perception of flickering.

Later near sunset there is no issue outside, also above timberline and in the forest I can actually go without sunglasses. Most other times I wear a cap and glacier goggles with full side and top protection.

The overall vision quality of the lenses is quite good, though there is a definite color shift to violet and I have a secondary cataract in one eye. I've read to hold off on the YAG procedure to clear that up as that will limit lens replacement options in the future.

The doctor that made the diagnosis was not a fan of its three piece construction

Not a fan of those wire things either!

I also have one additional factor - I'm 'only' 58 years old. About three years ago the cataracts formed as a result of a blow just above my left eye while playing basketball. I had vertigo for a few years, different that what is called 'Flickering Vertigo' on some web sites.

Hopefully now that there is a diagnosis it will be easier to find a cause. I think lens replacement is a last resort, but the doctor who did the diagnosis said that the three piece IOLs are easier to remove, you just snip the haptics, so at least there is that.

It is increasingly difficult to be indoors. Light from in back of me, light coming through windows, it's all bad.

I wonder if the diagram you posted is what happened to me. You know, I did do some research before the cataract surgery and had read that the three piece construction may not be ideal, but was told that was all they use and they have had no problems with it.

In retrospect, I should have done more research in advance. That would be my recommendation for anyone considering cataract surgery, even with the historically high rate of success.

Steve, what kind of IOL do you have?

I have Tecnis (now J & J) z9002 silicon lenses +13 strength for my -4.5d glasses. I think surgeon had higher $ margin to implant these older technology lenses. I had no idea there was different quality lenses. I simply requested the best single vision lens. Never discussed options. Trust is a lost cause. I think most all surgeons use acrylic lenses.

From what I could see, the place where I had my surgery done does one about every 10 minutes, so maybe there are lots of dollars to be saved using the older technology lenses. Interesting that you mention the Z9002 lenses and I had the Z9003 lenses.

It's worth noting that their doctors can find nothing wrong with my eyes, going on four months now and a doctor outside their clinic spotted the issue in less than a minute and confirmed it with a colleague, who saw the same thing.

I wonder what eventually happened to the other people on the patient.info site who have had the same symptoms? Has anyone else been diagnosed with Pseudophakodonesis and had a surgical resolution?

Whenever there is an issue and the clinic/surgeon who implanted the lenses keep saying all is fine one should get another outside opinion.

Hi Steve

Sorry you have this problem.

And very strange, because some people that have problems with acrylic lenses, wants to change into silicone iols, to get rid of their problems.

I guess it shows that there really are no rules in this game.

Funny, today I was looking for a large laundry basket that you couldn't miss.

When you refer to glare, I am wondering if you have the same symptoms as me?: Fluorescent lights are much too bright to look at for more than a second. Just being around them causes severe eyestrain that almost feels like a burning sensation. Distance is key, close is bad.

Sound familiar? If so, two years sounds like a LOT of time.

Yes I can look right at items on the shelf at a grocery store and the glare can be very distracting. (LED lights are no joy either.) Sunlight and incandescent lighting is no problem.

Also I also went to another ophthalmologist for all follow up even though it cost me more. Again trust was lost with the original Cat surgeon. Key learning is do a ton of research prior to surgery. I thought I did but not enough. I can live with this issue, as skiing without glasses and swimming with plano goggles is a joy.

One other thought, I do have some floaters that might also cause some distraction, but I don't think they are main issue with glare.

If you get a solution be sure to share!

Steve and MikeMess - have either of you gone to someone completely independent of clinic that did your surgeries? Is it possible the iol has become decentralized or one of the haptics is outside the bag whether right from start or over time?

Sometimes docs and clinics don't want to fully investigate or take responsibility. But if I were in your shoes I would want another full examination by someone else.

Hi, Sue. The doctors at the surgery clinic found nothing wrong, but an independent doctor made the diagnosis and verified it with a colleague in less than a minute. He gave me a referral and I also have an appointment with a neuro-opthamologist.

I have to wait six weeks as they are booked out and I'm a little concerned after reading an article:

https://www.reviewofophthalmology.com/article/saving-the-dislocated-iol

At the end the author cites the risk of delay as much tougher surgery. Crap, it took the surgery clinic 10 days just to get a referral right and that was only because I kept calling.

I have a feeling you are correct and one of the haptics is outside the bag or something.

It's just way too big of a coincidence for there to be so many posters with identical symptoms: Flickering starting in the left corner of the left eye, moving to the right and covering either eye eliminates the symptoms. Maybe I should just wear an eye patch.

If it helps wear the patch. I know another poster here Julielynn had a haptic outside the bag - original clinic kept saying all was centered and good but another clinic found the issue. If you have had a yag they can exchange that lens put. Hang in there . 10 days might seem long in your current situation but in the long run if it can be fixed you'll be glad you persevered.

You can look up Julielyn on the forums and read through her experience. It might be helpful for you.

Take care.