IOL exchange experiences only - if you exchanged multifocal/premium lens to a monofocal

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Please share your experiences in getting your lens exchanged - before, after vision, surgery complications or recuperation experience etc 

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  • Posted

    interested to hear responses here.  I had the Technis ZLB00  placed in my left eye June 2016.  That is multifocal with a +3.25 add.  My results according to surgeon were good but to me poor.  I can see 20/25 or 20/30 in distance depending on the day in this eye. I see all of line 20/50, then 20/30 with the effort with maybe 1 0r 2 letters on 20/25 and then most of  20/25 with pinhole and light for near with big effort.  I have to use +2.50 readers for small letters unless light is bright like outside.  Vision near when reading with this new lens eye is a lighter gray than black and letters have a double/graffiti effect of distortion always.  Possibility of having 2 eyes in this predicament kept me from having the right eye done.  

    I have had 2 secondary opinions, one saying the capsule cut may have been too large. Both say the lens is perfectly centered.  I was myopic prior and could read without glasses nicely distance was poor. Fear of surgical complications and being even more unhappy with monofocals kept me from the prospect of exchange.   

    Night driving has halos, concentric circles as expected.  I did not have my right eye done, it has a small cataract and can read 20/25 with distance around 20/80.  point of focus luckily is now about the same for both eyes making this doable.  A small speck of cell was left in the center of the lens and am told to expect a YAG capsulotomy at some point to remove. I have held off doing this in case I need an exchange to monovision, though I think the time is past for safely proceeding.  So responses here will be helpful.  

    Originally I wanted the Symphony lens, it was not approved in USA until 2 weeks after my surgery and was told it wasn't good for reading and what I wanted.  However, from most of these postings, it looks like it may have been a better answer.  

    At this point my right eye is my saving grace, making night driving possible with glasses and a combined good vision for computer use when reading.  

     

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    • Posted

      Just out of curiosity are lens exchanges only approved when changing to monofocal lens?  Or could you exchange yours to a Symfony?
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    • Posted

      Sue, that’s a good question and I wondered about it myself especially after reading excellent results achieved by people like you. I know you have great distance and quite good near vision but how about halos and glare?

      One the problems I mentioned to my doctor was halos and glares. That’s more typical of Symfony and other multifocals due to their inherent design. So he suggested exchanging to monofocal ( but not before having me try many contact lens combinations and asking me to just wait it out). Monofocals are cheap, so that makes economic sense for him too, as I believe exchanges are responsibility of doctors, not insurance companies. 

      Also, if my doctor knew what went wrong with this Symfony would he try to correct it next time. He doesn’t seem to know, at least he hasn’t told me that he does. Infact, when he redid my measurements to plan for the exchange, he said it’s still coming to the same number (18D for IOL) as the Symfony. 

      So... I don’t know. Any suggestions?.

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    • Posted

      That’s Ok Sunny.  Strange when doctor did measurements for monofocal they are coming to same as the ones for Symfony.  Did you get a Symfony toric?  Is it possible lens rotated and it is astigmatism causing the blurriness?  

      My 2nd eye was done Aug 21 and there has been definite improvement in the starbursts and glare.  That first month I was very tense driving at night and often counted on passenger to help me out!  Especially ark roads with no overhead streetlights.  Glare from oncoming cars then was blinding.  That has completely died down and there is some glare but I can manage very well.  But as the glare and starbursts diminished now I see the light concentric circles around certain lights (not every light). Even as I walk at night thought I would see the circles around Christmas lights on people’s homes but I don’t - no glare either just pretty and normal Christmas lights.

      I am beginning to think the more on target the iol power is the less glare and starbursts one sees.

      Have you definitely decided to do the exchange Sunny?

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    • Posted

      Yes, I got symfony toric but I don’t have astigmatism left. my prescription is -1.00 spherical only. 

      Not yet decided on the exchange. I have appointment with a different doctor tomorrow. Will see what he says.

      No responses in this forum from those who actually had an exchange confirms that it is pretty rare and has to be a good reason for that. 

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    • Posted

      Not sure if it is rate but it does carry additional risk and not all surgeons will do it.  My own told me flat out before lens selection that he does not do

      Lens exchanges so I would hav to find someone else if I went that route.

      I do know of one person on these forums that had a successful lens exchange (one eye) and it was done by a separate specialist than the one who implanted the original IOLs.  Her 2nd eye had a YAG done (which original doctor said would help with glare - and it did not help).  I haven’t corresponded with her in a while so not sure what happened  with 2nd eye.  

      Is there a way for you to see about getting your 2nd IOL to complement 1st eye and see how that works before deciding you want an exchange?

      Also how well have you researched your surgeon as I am assuming you are going with same one that implanted your Symfony.  Is it worth going to another expert for 2nd opinion?  I cannot stress enough that it is surgeon’s skill that accounts for all the difference in the outcome.  We do research on the various lenses but most of us have a blind trust that surgeons are experts and all equal.  Nothing could be further from the truth.

      We all work at different companies and know there are staff that know their stuff better than other fellow employees and if we needed something in our own fields we know which we’d go to.

      I actually spoke to 3 separate patients of my surgeon before my surgery.  2 with monofocals and 1 with Symfony- all were pleased with their results.

      I came to the conclusion that no matter which lens I chose I was going to be OK.  I was still nervous- but I was confident in n my choice of surgeon.

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  • Posted

    I have had an IOL exchange five weeks after my initial cataract operation.  The refraction was off and I was not happy and I also had dysphotopsia.  The surgeon acknowledged the refraction problem and suggested I do the exchange.  I did the exchange and was very happy with the refraction outcome,  however, the dysphotopsia was still there.  I have been struggling with this issue since September when I had this exchange.  My original surgeon was experienced in doing exchanges but had no experience in dysphptopsia.  I have done a ton of research and went to multiple surgeons and I am contemplating a second exchange.  I was recommended a surgeon who has tons of experience in exchanges and dysphotopsia but I admit I am nervous about going for a second exchange which is scheduled for next week. I do believe that doing exchanges must be done with a doctor that has a lot of experience doing them.  My first one had no issues at all and I did get a much more comfortable refraction outcome.   I may consider postponing the next exchange.
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    • Posted

      Hi esa77583

      I think you are wise holding off on a 2nd exchange - especially since you are much happier with your vision after the first exchange.  Negative or positive   dysphotopsia can occur for a number of reasons - not necessarily due to type of IOL.  Pupil size too can account for this.  The younger you are having this surgery the more your pupil dialates and can extend beyond the IOL which is 6mm (some are smaller than that).  As one ages pupils dialate less which is why negative dysphotopsia tends to diminish over time.  

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    • Posted

      Hi Esa - thanks for sharing your experience. Could you share your location details and if possible doctor details also? I recently learnt that if your original doctor isn’t offering the exchange for free, the insurance won’t cover the cost of getting it done somewhere else because it’s ‘optional’ and not medically necessary - they believe glasses should fix the issue. Any comments on that?

      I am in Tampa, Florida,  btw. 

      Thanks. 

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    • Posted

      My first lens was the AcrySof monofocal.  The second lens was the technic zcb00 monofocal.  I live in New York.  First exchange was done by the one that did the original surgery.  He does exchanges but since he was not familiar as to what is good for dysphotopsia,  he told me to get another opinion for that.  The surgeon possible doing the second exchange is from New Jersey.  He does lots of difficult cases and exchanges.  I have positive and negative dysphotopsia.  I see the arc shadow and have some glare and shaking light in specific situations,  such as fluorescent etc.  the second surgeon is pretty sure that a si,I one lens the Bausch and Lomb sofport will diminish a lot of these aberrations because this lens has a very low refractive index.  I am less fearful about the exchange itself then what my refraction result will be.  My first outcome was so bad that it scared me.
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    • Posted

      Tecnis is a great lens. I did another exchange because of dysphotopsia and now I have a B&l sofport silicone lens.  

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    • Posted

      I don't get it. You say Tecins is a great lens, but it caused you dysphotopsia and you had to make another exchange. I does not make sense at all..

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