IOL edge reflections (multiple concentric arcs), considering secondary IOL
Posted , 3 users are following.
A few years ago I had cataract surgery on the NHS and got a spherical IOL with squared off edges. I am relatively young for cataract surgery and have quite large pupils. After the surgery I suffered various strange optical effects, the worst of which is multiple concentric arcs around light sources at night, which I believe is caused by reflections off the edge of the lens. The arcs are very bright and sharp compared with normal night time vision and the effect when there are multiple light sources is quite debilitating. The surgeon said this would resolve after a few months, but it never did.
Recently I had cataract surgery on the other eye, privately this time, and got a toric lens with a rounded off edge. I have zero problems with this lens and absolutely love it (the lenses are the same size and material by the way, they’re both 6mm acrylic). I’ve begged the surgeon to exchange the NHS lens for one of this type, but he says removing the old lens would be too risky and won’t even consider it. I’m kind of annoyed that the NHS would use a spherical lens with square edges on a patient with severe astigmatism and large pupils, but as exchanging it isn’t an option I’m considering a secondary toric lens instead. As well as having astigmatism, I’m also hyperopic in that eye, so my secondary lens would have a positive sphere. I’m therefore thinking that it might help slightly with the edge reflections as it would focus any light coming though the pupil away from the edge of the primary lens slightly. Does that sound right?
0 likes, 5 replies
soks Whisker
Posted
which lens did you get?
Whisker soks
Posted
The new one that works great is an Alcon AcrySof IQ Toric. Looking again at the specs for this, it looks like it also has a square edge design. Not sure why I'm getting all these crazy arcs all over the place with the old lens but not the new one if they're both square edged.
Can't find the information card for the old one just now, but it was an Alcon too.
soks Whisker
Posted
i see the arcs in my left eye which has the Symfony IOL. they become full circle when it gets very dark.
Myope_PSC Whisker
Posted
Here's an old post by peter1110 https://patient.info/forums/discuss/piggyback-lenses-vs-lasik-lasek-smile-670054?page=0#3271081 that indicates the piggy back lens didn't help with the halos he saw.
It seems that square edge design IOLs have a lower incidence of PCO occurring after surgery but have an increased chance of dysphotopsia compared to round edge design IOLs.
There are probably other posts about piggy back lenses on this forum but it's not an easy forum to search.
Whisker Myope_PSC
Posted
Thanks for the link. There are some messed up eyes on this forum, makes me realise I'm not doing too bad.
The only reason I thought the secondary lens might help with the arcs is because mine would have a positive sphere and would therefore focus light toward the centre of the primary lens and away from the edge. The arcs are a binary on/off thing, when my pupil reaches a certain size - bang- my vision is suddenly full of arcs all over the place. When the pupil shrinks down below a certain size they're gone as suddenly as they appeared.
My optometrist told me that pupil size decreases with age, and looking at the figures this is quite a significant effect. I do have unusually large pupils for my age, but I'm hoping that maybe within 10 years my scotopic pupil size might drop below the lens size and the problem will resolve itself - it's good to have something to look forward to. Still want my astigmatism and hyperopia fixing though, so any other experiences of piggyback lenses would be helpful .