Hydrophobic acrylic and dysphotopsia

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Hello all,

few months ago I had implanted a very popular lens, a Tecnis ZCB00 monofocal. It's pretty similar to the Acriysof monofocal lens: same material, same squared edge, the refractive index is lower: 1.47 against 1.55 of Acriysof's. And heard of this problem by many Acriysof lens patients, in many forums: side-flickering, edge glare.

This lens is causing my very bad internal reflections, probably caused by the non-water material and its squared edges causing irritating internal reflections. 

I'm wondering if changing the lens with a high-water content hydrophilic lens with rounded edge could solve the problem. Anyone has similar issues? 

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5 Replies

  • Posted

    Honestly, from what I've read, most IOLs cause some issues like the ones you describe and supposedly the brain learns to tune them out after a while. Doctors should be warning patients about it ahead of time. It's up to you whether or not you think you'll be able to adjust after a while. Also, read this article (I haven't read the whole thing or looked for Part 1 yet) "Square-Edge IOLs Part II: Dysphotopsia"

    • Posted

      It's also possible that you have posterior capsular opacification (PCO) that's causing your problem (it's treated with YAG laser). Ask your doctor if you have it.

    • Posted

      Nope, my capsule is still clear. My doctor says he has no explanation for this. He uses the same lens for every patient. I think it's the square edge, because at night I can see the famous glare-like arch on the side of my eye and with light from the side it's very strong.

  • Posted

    Reviving an older post, but I am almost three months in with a Tecnis ZCB00 in one eye and have the same issues. I even see this glare on icons on my PC monitor that's more in my periphery (I use three) and have the curved arch effect during the day when passing objects with a significant contrast difference.  

    I had the posterior capsule cut during implantation (this was done during a vitrectomy) so that's not a cause and also means I had little to benefit from a square edge design.  

    I also have very bad star bursts so all told not great result given I went monofocal to reduce the chance of visual issues. The surgeon has suggested a piggy back lens to help lens edge issues but right now I need to get my other eye done (vitrectomy and IOL again) and he's said I could try another design of lens but says I may swap some issues for others.

    A final issue I have is with using a contact lens on this eye as there is a circular area of blur and ring of light around the edge of my vision.  With multifocals contacts its a little better probably due to the lens breaking up the effect and I have no idea is this is related to this specific IOL/square edged or not.

    I've come to the conclusion that all IOLs have issues but the impact varies significantly between patients, so no matter how well we choose surgeons and lens types there is still a fair bit of luck involved. 


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