LI61AO Sofport IOL

Tecnis 1-piece

Safran is the best at dysphotopsia. What are your symptoms of dysphotopsia?

Thank you for letting me know that about Dr. Safran. My symptoms are glare, halos, starbursts, and monocular diplopia. I am stressed because it's easiest to exchange an IOL early on and it will be a month before I can see him. I asked if I could get on a waitlist if they got a cancellation sooner and the receptionist was very nice but basically said people don't cancel. An important factor in choosing a monofocal IOL over a premium IOL was to be able to drive at night as my husband can't see well. I do not believe the problem is pupil dilation because, although faint, I can see the artifacts at times during the day when driving.

Deb03 Could you let us know about your appointment outcome with Steven please? I do consider him as my "next" surgeon, but I live in Europe, so it's quite complicated. Thanks.

Yes I will! Not sure why, but my comment to soks is waiting to be moderated, but will repeat some of it here.

I am 57 and do not believe pupil size is a factor in my case. I have trace PCO. No yag. My left eye is definitely worse, but I do have symptoms in both eyes - glare, halos, starbursts, and monocular diplopia. How far out from surgery are you?

1 year.

Is your positive dysphotopsia gone when you flash more light? I mean it goes away in my case when there's more light, pupil-size dependant.

No. I did try Lumify drops (.025 of brimonidine tartrate) which didn't help. I can also see it at times during the day, although it's faint. I also sat parked in front of a bright street lamp one night and it didn't go away. I am still somewhat early in the healing so it could go away. In your case, I don't expect it will without intervention. Have you had a YAG?

Lumify works for me for 3-4 hours which is more than enough but it has preservatives BAK so don't like it.

Try Pilocarpine 0.5%. That's what I am using. It hurts but works. No side effects so far.

I think that the nature of Positive Dysphotopsia is that is starts from day one post op and not resolves. Actually it got worse one month out from the surgery. I mean, my night vision (beside completely dark rooms) was excellent witihin the first month, but then it started to be a nightmare. So if there're some changes, I'd assume it may only get worse.

*doesn't resolve, sorry

I really don't think it's pupil dilation in my case. I think it's a combination of the acrylic, high refractive index, and higher IOL power.

I'm also considering exchanging my multifocal to LI61A0 with Safran. I saw him last year in 2018 and he said he could do it for me with "low risk". I've had my IOL for 12 years and I've also had the YAG capsulotomy. I'm dealing with similar positive dysp. issues (ghosting, monocular diplopia, fog around text, arcs of light due to internal reflections off the IOL).

Keep us posted on what you decide to do. I'm still thinking about going forward with the exchange (possibly in late 2019)

That's great that he can exchange it after so many years. How old are you? Do the miotic drops help with your symptoms?

I'm 29. I had original cataract surgery back when I was 17. I actually haven't tried the drops yet but I just got an Rx so I'll be trying them soon (although I don't have high expectations because inducing miosis with a bright light doesn't seem to help)

they should make a 7 to 8mm iol for younger patients. how have you been dealing with the issues for this long? i think you will be surprised with what the drops can do.

In my readings, the article "Newer generation IOL platforms designed for high-quality visual performance after cataract surgery" talks about a few things (including the new Tecnis Eyhance mono-focal, which potentially could dominate the mono-focal category), and the great results with Tri-focals.

But it also mentions one company introducing a 7.0 mm optic IOL to minimise dysphotopsia and is a particularly suitable treatment option for large pupils. It's a 7.0 mm optic IOL.The IOL is the ASPIRA-aXA (by HumanOptics).HumanOptics is a German company, and the ASPIRA IOL seems to be available in Europe only.

7mm iol would be deadly. it could also have more space for additional near. eyhance would still be 6mm so would be somewhat problematic but hopefully it can get rid of the multifocal abberations.

This is what they say. Thanks for sharing the information. This will be great for younger and large pupil folks. It is monofocal only at this time.

XL optic: pseudophakic reliabilityLarge pupils

The ASPIRA-aXA is also an ideal treatment option for patients with large pupils. In these patients, the mesopic pupil width often exceeds the diameter of the IOL optic. Off-axis rays are scattered on the edge of the optic or pass the IOL and strike the retina as stray light. The result can be an increased incidence of dysphotopsia. With a conventional 6.0 mm optic, the patient could be affected by edge effects or other light phenomena.

APPROX. 20%

SCOTOPIC PUPIL

DIAMETER ≥6 mm

APPROX. 10%

MESOPIC PUPIL

DIAMETER ≥6 mm

The ASPIRA-aXA with its XL optic is an ideal treatment option for large pupils.

Where one company goes, others are sure to follow! So hopefully this leads others to consider larger 7 mm optics for those who need them. But probably years away.

The issues were tolerable until I had the YAG laser & vitrectomy surgeries in 2013 (6 years after original cataract surgery). I think my lens could've been slightly tilted from those surgeries (and since I have a ReZoom multifocal IOL it's very important that no issues exist with tilt and centration). I've been dealing with these heightened dysphotopsia issues since 2013 and they've honestly just gotten worse & worse with time. The biggest issue for me right now is lights above my head... this problem didn't present until around 2015 or so..... lights entering my eye at a specific angle cause a terrible reflection that are in front of images (see attached photo simulation below). If I angle my head a certain way or avoid difficult lighting situations I can manage but it's very annoying to deal with (day & night). I actually turned down a job offer last year because the ceiling lights were too bright for me to manage.

I just tried the Alphagan 0.2% drops for the first time today and wow! The reflections from lights above my head are completely gone!!! I still notice halos and fog around white text but honestly these are secondary issues compared to the reflected lights in my eye. This is definitely making me second think the IOL exchange because my current lens is 6.0mm and the Sofport AO is also 6.0mm (which means my larger pupil might also cause reflections like I experience today). I do feel a little dopey from the drops but maybe if I keep taking them I can permanently shrink my pupil? One can only hope

I will post after my visit. I did see my cataract surgeon last week for the first time since the surgeries. He diagnosed PCO - 1+ (Mild) in RE and 2+(Moderate) in LE. I am less than 3 months and 2 months post op with an IOL that is supposed to rate well with regards to PCO (Alcon SN60WF). He also diagnosed 2+(Moderate) Blepharitis in both eyes. He suggested doing a YAG for PCO and if that didn't work, then Blepharitis treatment. I said I'd prefer to work on the Blepharitis. I was amazed that he was so willing to try a YAG procedure. From my experience, and all that I've read, I don't think there is nearly enough emphasis placed on dysphotopsia. I'm 57 and want to be able to drive at night - safely. That was a good part of my reason for choosing a monofocal IOL. I am looking forward to my visit with Dr. Safran.

Just read your reply about the drops. Glad they are helping!

i feel a bit sleepy too with alphagan. one surgeon did tell me to take it twice daily for a year to permanently reduce pupil but i didnt want to do it until my other eye is done. try to get preservative free alphagan.

at 10 months i have pco at 2 in left eye. i am not going do YAG yet.

at 10 months i have pco at 2 in left eye. i am not going do YAG yet.

"at 2", what does that mean? Are there units to measure how bad a PCO is? 😃

There is a grading scale from 0-4 with 0 being no PCO.

i think it becomes worse because of PCO.

Hi @gmag21, I'm super interested in your case. Safran in NJ said you can have an exchange AFTER capsulotomy, and after 12 years? Could you tell us more about what was said?

I had an IOL exchange with Dr. Safran last month. I did not discuss post YAG with him, but while I was there he did comment how he does exchanges years down the road.

he was The only one to figure it out that I had PVD and an astigmatism. I had massive floaters and after an explant of the technician and she lands with the Sofport monofocal I still had problems. What the last doctor did was scuffed the lens so now I have streaks but SAFRAN did not notice that until I complained about streaking and then when he looked through the microscope he said probably from the vitrectomy and all the cloudiness and floaters he couldn’t see that. I now need a third implant. The LI 61 is a very good lunch

i just had a vitrectomy and LIR for astigmatism on an eye that had a tecnis lens which horrendous for me. I did not go to safran for the explant as the appt was way out and this lens was in my eye for 3 mos and i could no t see near mid or far. Btw, Im a professional portrait/ figurative painter that does high end shows and details in my work. This idiot Dr Patel from Atlantic Eye in NJ did the explant for his mustake of uding multifocal on a patient that not only had huge floaters with PDD and in the sigmatism but he never even caught that he told me I had dry lol. SAFRAN said you don’t have dry I know exactly what you have. After months of not seeing after the explant SAFRAN did at the track to me with this LIRR and I could see clear but I have streaks of light. It appears the last guy scratched the second implant so it has scratches on it and SAFRAN said he didn’t catch it and he would explant this lens and put a new one in if it affecting my vision. I can’t drive at night BTW because of this

vitrectomy typo there

Hi, can you please explain your symtoms?

I have done an exchange from vivity to sofport and I have alit of streaks in front of my vision when it gets dark and light hits the eye. I only get the streaks when light hits the eye in special angels. I dont have streaks or halos around lightsources. Its more like flare/streaks all over my field of vision.

Dr. Safran is not user friendly. He has no communications skills and is not professional. If he were the last eye surgeon on the face of the earth, I would go without surgery. He does not solve problems, he directs patients in a mono path, regardless how a patient lives. Patient input or questions are disregarded or he whines about your asking too many questions or taking his time. this Dr sees between 50 to 60 patients per day. It is not possible to deliver quality care with this volume. find another surgeon.