Ghost Images with Tecnis ZKB00 (+2.75add) Multifocal Lens
Posted , 5 users are following.
Has anyone experienced a ghost image issue with this lens, or any other multifocal lens?
I had one of these implanted in my right eye in December 2019 and have always had this issue, which very annoyingly, wasn’t on the list I was given of possible downsides to multifocals. My left eye doesn’t have this problem, but has a different MF lens (Tecnis ZXT225) to correct astigmatism.
I initially reported this six weeks after surgery, as being a major issue when watching TV, where there is a ghost image to right of main image:
Such as with a white shirt, followed by dark clothing, where this produces a low level white overlay along the vertical edge of the dark clothing or where there is a white background (say a shirt) followed by dark clothing to the right.
It can also be seen on our digital clock: Where this produces a smaller ghost image to the right of a numeral, with the ‘baseline’ as the main image.
This has never caused any problems in daylight, but initially, driving at night was not possible, as I was effectively seeing two road signs at about 100m (plus all the usual expected problems, such as halos). However, in the last few months there has been a change, where the ghost brightness has dropped and it has gone out of focus. A recent night test run as a passenger, showed that the ghost was no longer a problem for driving at night. Surprisingly, there were no problems with headlamp glare halos, etc.
Unfortunately, this improvement has not been enough to stop the ghost from still being a major issue for watching TV,(particularly 3D Blue Ray discs), so I would also expect this to be the same in a cinema (whenever we get to see a film at one again!).
I enclose some simulated photos to give some idea of what I am seeing: The first one shows the TV and clock at about 3.3m away and the 2nd is a cropped image to highlight the effect on the bark clothing of a newsreader
.
1 like, 6 replies
RonAKA johnkm4547
Edited
Sounds like a job for the GhostBusters! More seriously I have not had that issue with my IOL lens. Prior to having the cataract removed I was seeing double images somewhat similar due to the cataract. A cataract is not possible now you have a lens in place. I can't think of a reason why you would have it now, other than that the lens potentially has moved out of position. There is a @rwbil here that I recall has that specific lens. Hopefully he may have some thoughts on the issue.
rwbil johnkm4547
Edited
I am sorry to hear you are having ghosting.
Yes, I have the Tecnis +2.75 MF in one eye. I don't get ghosting, but do have other issues including floaters after surgery. But overall happy with that IOL. It is much better than my vision with cataract and I can see close and distance.
If you follow this forum and other similar ones not everyone gets optimal outcomes. There are just so many factors like pupil size, astigmatism, brain neuroadaptation and so forth.
Hopefully doctors are getting better at predicting which patients will do well and which ones will not.
This is why some doctors only do monofocals as they just don't want to take the "Extra" risk.
What has your Opthmalogist said? I would strongly suggest getting a 2nd opinion from a top rated Opthmalogist.
If in the US, What state do you live in?
If you have not had YAG you could get it extracted though that comes with risk.
I can only suggest seeing several Top Rated Opthamologist. I prefer the ones that do clinical trials and write paper but check Castle Connolly Top Doctors for ones in your area and research them. And make sure they are Tecnis MF experts also. You can also go to JNJ site and find the doctors they recommend. I would do this first before any decision is made.
soks johnkm4547
Posted
i see this with tecnis symfony.
johnkm4547
Edited
As this is my first time posting on here, please forgive me if I mess up the ‘reply’ format, but I thought it best to try to do a single reply to all of you at this stage to avoid repeating myself:
First of all, thank you very much for responding to this query. So far, I have found very little on this issue and absolutely nothing involving this particular Tecnic multifocal IOL.
First of all some further information to explain why I am on here:
I live in the UK near Southampton and only four of my local contacts have had cataract surgery, but as monofocal IOls are provide free of charge on our National Health Service, multifocal IOLs are not that common here. So only one of my contacts has had a multifocal IOL implant (four/five years ago, via the same company who have done mine). It was his positive experience that convinced me that this was worth spending money on, as he soon got over all the expected (and listed) side effects and, most important for me, he has never experienced any ghost image issues. Unfortunately, he moved house in 2019 and cannot find the details of the IOLs he had implanted, so I have no idea if any of his two were the same version as mine.
To date I have not had any corrective laser tweaking and this was discussed at the last consultation I had with the Optometrist in early October, where I also reiterated that fixing this ghost image problem was the most important issue. But as with previous consultations, he couldn’t see any visible reason for me to suffer from ghosting. So he finally decided to refer this to the company head office and the surgeon who had operated on me.
It then took over two months for them to come back to me to say: “the ghosting that you report is related to the multifocal lenses and the only way to eliminate all of that, would be to explant them and replace it with monofocal”
This is the reason I am on here, in the hope of finding more answers, as I am having the greatest difficulty accepting this explanation, for two reasons:
1.If ghost images are a known issue with the Tecnis ZKB00, why wasn’t it listed in my Optometrist company information pack, or in the Tecnis Patient Information Brochure? After all, this does have a major impact on TV viewing, particularly when viewed at the same distance on a smaller screen than 65”, where objects have a complete ghost image alongside them. I really can’t belief that many people would find this acceptable if it was a ‘normal’ and so would certainly have expected to find many complaints about it.
2.I mentioned in my 1st post that something has changed about the ghost image over the last two months, where it has become less bright and more out of focus. Referring to the clock picture (which was a fairly accurate simulation at the time), the ghost has also shifted to the left, now partially merging with the main image. But they interesting point, which is why I don’t buy their explanation: I have recently found that if I blink (I may have to blink a number of times before this happens), the amount the ghost is out of focus changes, while the main image remains sharp.
Therefore, could it be something on the cornea that is causing this problem and not the IOL?
There is one more odd effect that I have noticed with the ZKB00 in my right eye which may, or may not be connected: If I move something with a sharp edge (like a sheet of paper), horizontally across in front of my right eye from my right to left, there is a point where the ghost disappears completely and only the main image remains.
Question: Does anything like this happen with the Tecnis Synfony IOL, which I assume is newer and ‘should be’ a better version of the ZKB00?
PS: I had ‘floaters’ to some extent before surgery, but they were never a real problem. I still have them now in both eyes with different IOLs, but again, not a problem.
rwbil johnkm4547
Edited
A certain percentage of people just do not have success with defractive lens. Some have to get them explanted.
My only advice is discuss the issue with a Top Rated Opthmalogist who does a lot of Tecnis premium IOls. I don't know the best way to find such a doctor in England, but I did a quick search of articles on CRSTEurope and found some that have written article. Also saw there is an eyenews UK. You can also look at the organization like ESCRS. I try to find ones that were involved in the clinical trials and have a long history with the IOL I am interested in.
Many times the articles will include their email and you can email them and see what they say.
You can also go to clinical trials and search for studies done on your IOL by doctors in UK.
Lastly contact JNJ and see who they recommend in that area.
johnkm4547 rwbil
Edited
Thank you, that is very helpful, I hadn't thought of looking at clinical trials, or studies and will do some research.
Apart from the Chinese bug messing everything up, it is extremely frustrating that none of the wide range of diagnostic equipment can see the problem. In October I wore contact lenses for a few hours to confirm the laser tweaking prescription needed to improve close up and distance. While wearing these and looking at the clock, the ghost image had moved slightly to the left, so that less of the left hand side of the ghost can be seen but, there is now a second ghost image, projecting slightly below the main digits.
However, both ghost images are at lower brightness than the single ghost, so this did result in a ‘slight’ viewing improvement when watching TV (3D, or normal 2D), but not enough to clear the problem.
Unfortunately, I can't wear contacts for very long, so I unable to check further.
As a result of wearing the contacts, I was offered the option of having that done and accepting the result, or an explant to a monofocal. Currently, the UK is in lockdown (again), so I don’t think anything is going to happen in the next few months, giving me plenty of time to do more research. At least I will have been vaccinated well before I need have a face to face consultation about this again!