IOLs and Large Pupils
Posted , 4 users are following.
In my readings, it seems there are no good choices for people with large pupils like myself - high myopes have big pupils. I'm not talking about you cool summer breeze kids with -3 and -4D eyesight, I'm talking Double D-igits. I have had halos and starbursts at night my whole life, which I assume is due to my pupils expanding beyond the soft contact "lens" part that focuses my vision. It seems that no IOL will be free from artifacts in people like me, including monofocals. Part of me wonders if I should just get a multifocal since I already know the life of halos and starbursts; I wonder if it would be 100x worse with the IOL, or just like regular life.
Does anyone here have bazoomba pupils with their IOLs? What is your visual experience like?
0 likes, 16 replies
soks Lunabug
Posted
night time is the worse. the entire iol lights up with the boundary well defined illumination.
ad12345 Lunabug
Posted
If I were you, I'd do the following - fly to Belgium, Europe, to prof. Marie Jose Tassignon and have the BIL lens implanted. It doesn't have any bigger diameter, but it's a completely different design. At least you will always be PCO free for the rest of your life. The rest of opacification will cover your outer pupil. If you don't like the lens, it is super easy to exchange it as there are no haptics. Another option is to go to Germany and have Aspira-aXA inplanted. It's the only one which has 7 mm optics. Both of them are hydrophilic. If you don't want to fly to Europe, I'd probably go with Alcon Clareon. I have Tecnis monofocal and it destroyed my life completely.
soks ad12345
Posted
this is great advice.
Lunabug ad12345
Posted
Thanks for responding. What is the BIL lens? I also can not find contact info for anyone in Germany regarding the Aspira. Alcon has high refractive index and I don't want robot eyes.
ad12345 Lunabug
Posted
Bag-in-the-lens. From my expirence, any lens, except silicone, is reflective. Mine is 1.47 index of refraction vs. Alcon 1.56, still you can see a flash of light. Besides, rebot eyes would be the least severe side effect you can end up with, trust me, I know what I'm talking about.
Lunabug ad12345
Posted
You get robot eyes with a tecnis iol? you are the first person who reports this that I have spoken with.
Aspira would be great but i dont speak or write German and cant find surgeons who use it.
Sofport is silicone and offers full 6mm optic field. Might be a good middle ground.
soks Lunabug
Posted
what is your mesopic pupil measurement?
Lunabug soks
Posted
7mm
soks Lunabug
Posted
thats huge. mine is 5.5 and i am struggling.
Lunabug soks
Posted
mesopic is night time right? which lens do you have and what are your issues?
soks Lunabug
Edited
symfony. the entire lens lights up. ues mesopic is night time.
Lunabug soks
Posted
i have circular starbursts now with my high myopia. i have my whole life, probably because my pupil dilates outside the ring of sight my contact lens gives. it sounds similar to what you have now, so maybe thats what i will end up with. Also Tecnis only gives 4.9 mm of optical field due to the thicker lens design. Alcon and Sofport give full 6mm. No 7mm here in the states. Do the miotic drops help enough at night time for you?
soks Lunabug
Posted
the miotic drops help with the light effects but they make everything dark.
will alcon not cause issue for me at 5.5? what about Zeiss?
contact lens is as big as the iris. that is around 11mm. so 7mm dilation should be smaller than your contact lens.
Lunabug soks
Posted
I used Pilocarpine in the past so I know about the dimness. But brimonidine doesn't constrict the pupil as harshly so it is less dim.
i dont know about Zeiss, thats an EU lens and i am in the US. i cant really answer what would work for you, just that tecnis optic field is smaller, despite technically being 6mm, because its thicker. Alot of surgeons do the Sofport as a lens exchange for dysphotopsias. But its silicone so if you are higher risk you take the gamble on not needing future retinal surgeries - silicone lenses dont agree with silicone oil. Silicone can also be prone to pitting with YAG. But its a gentle IOL and silicone I'm told by other people who have it gives a natural clear vision, similar to wearing contacts or glasses. Not hyper 4D sharp.
To be honest, there are a lot of people who have bigger pupils than you and dont have issues. Did your surgeon say your symptoms are solely due to pupil size? I told my surgeon i was scared about my night time pupil size and he said, "Why? its only 7mm." This did not reassure me because I am convinced i am somehow smarter than the surgeon (I'm not) but i did find it interesting he wasn't worried. im still worried.
Ask your surgeon about SofPort. Alcon is 6mm but gives you robot eye. I'm self conscious but you might not care.
the contact lens only has the Rx part in the small center of the lens bowl...right? if not then i have no clue why i see starbursts!
soks Lunabug
Posted
multiple surgeons (3) have no idea why i have issues.
i am not bother by spider web or starburst. the starbursts have gotten worse probably due to untreated PCO.
i can squint and look at the light and see the rings on the iol and i see more rings in the area where the edge arc starts. so the iol is not centered for constricted pupil. they cannotmdo anything about it.
i dont care about how the sparkle or diamond that may appear to another person. but i care about time related glistening of acrysof.
what does optical field mean?