Monocular Ghosting post cataract surgery

Indy, I think he mentioned 10 feet not 10 inches.

BTW, I have a Vivity with a -0.75 refraction suprise and my vision get sharp at about 22".

will do thank you for the info. the ghosting is driving me nuts. my friend had both eyes done with vivty, and is seeing great 4 weeks out. 20/20 far and 20/40 near. even a person is blurry to me at 5 feet.

Hi Randall, I didn't get the same lens, but I was disappointed in my outcome. I am -.50 D after surgery and really don' t see clearly at a distance or close up without glasses. I was suppose to see distance with this eye and talk about intermediate with my 2nd eye, I see distance better with my unoperated eye, but only slightly worse close up. I think you got similar results with -.0.75. I wonder if -1.00 would have been more in the in the ballpark of intermediate. Have you had both eyes done?

Hi Sandra,

I only had my dominant eye done with the Vivity and that eye that has settled at (-0.75 with 0.5 cylinder). I don't see clearly at reading distance (~14") but if the lighting is good, it's workable for short bursts.

After several weeks of post-op adjustment, I see quite clearly at 20" (computer distance) so I have that going for me 😃. Things start to get blurry again at ~4'. I need glasses to see TV subtitles clearly at ~10'.

I bought an eye chart to use at home and I am 20/40-50 for distance (depends on light and time of day.)

I am seeing another ophthalmologist tomorrow to get another evaluation and opinion for my other eye which has a cataract (and -2.5sph 0.5cyl)

@RonAKA advice, which I take seriously, is to go with a monofocal targeted for -0.25 for the other eye (to minimize the odds of hyperopia) which should give, if all goes well, me mini-monovision.

Best wishes and I'll keep you posted.

Hi Luigi, has your vision improved in the past couple of weeks?

Let us know.

I'm rooting for you.

what is causing the ghosting? this result wasnt expected by me, my doctor, or by two friends who have gotten vivity.

i had my retna checked, a refractory test, and eye measurement the other day. doctor said everything looked perfect. the doctor thinks my brain is having trouble focusing my eye and believes I need time to train it to focus. i e had cataracts since birth so not sure if thats the issue.

when i look through a pin hole with the surgical eye, the ghosting is gone.

hopefully it clears up. as of now ive had zero improvement with ghosting and near vision. i remain 20/200near post op. so discouraged right now. wishing i went with panoptix at this point.

i cancelled my 11/21 surgery and postponed until 12/18. also have a second lined up for 12/10 at MA eye and ear. just want to see good again. my other eye is almost completely fog at this point.

The Vivity is an extended depth of focus lens. The lens surface had a raised area which has a slightly different power than the rest of the lens. While this increases the distance over which you can focus, it essentially creates two images to look at, as best as I can figure it out. The concept seems to depend on the brain being able to choose the image that is in best focus and ignore the other. If the brain does not ignore it then it possibly shows up as a halo around the sharper image. The hope would be that over time the brain will learn to ignore the out of focus image.

I also have a Vivity and it took me a good 4 weeks before things became satisfactorily clear.

Luigi, did your doctor mention a "refractive surprise?"

wishing i went with panoptix at this point.

Perhaps. But you might have experienced another set of problems.

There is a difference between good decisions and good outcomes.

The Vivity was a good decision, you just have (for now) a not-good outcome.

So don't beat yourself up too much (like we all tend to do, me included) and give it more time.

This forum is an awesome source of information—and a special hat-tip to RonAKA who really knows his stuff!

Yes, hats off to RonAKA for sharing his knowledge with all of us. Yes, he really knows his stuff. Thank you RonAKA!

You are welcome. In the process of trying to help, it seems that there is more and more to be learned. Just a few days ago I learned that being far sighted if you are younger and have your natural lenses, is not that big an impact on distance vision. However, ending up far sighted with IOLs is not as forgiving...

I know for myself that this is very true. I was very farsighted before my cataract surgery. I'm talking +7 and +8. Wore really thick glasses & distance was never really a problem. Reading was a problem though. After my cataract surgery, my reading was brought down to +2.50 but now I am slightly nearsighted & distance vision is blurry. I have a multifocal in my left eye with lots of ghosting & a monofocal set for distance in my right eye. So now driving is a struggle for me. It never was a problem before cataract surgery. So it helped in my near vision but made my distance vision worse. My recommendation is to do lots of research on your own & ask your surgeon lots of questions before having cataract surgery.

Be careful what you wish for. You might end up with regret. I had to get cataract surgery for right eye (Toric Eyhance). To get out of glasses I decided to do my good eye with PanOptic. It was a mistake. I got PanOptic in my left eye 04/2021. I can read type but difficult due to ghosting double images, glows and/or halos. It is irritating to read text on computer, phone and subtitles on TV. Glasses help a little for intermediate/near vision but only if looking through very bottom reading part of trifocal glasses. Glasses can’t help with TV. Ghosting is very annoying with contrasting values (white text on black, or dark on light). Discovered glasses give me better distance so I wear them all day. Optometrist says I am 20/30 without glasses but cataract doc says I’m 20/20.

Night glare is what many people complain of with PanOptic. I can live with the weird spider web of concentric circles glaring around car headlights at night but some can not. Car light glare seems to be a wider ratio on cars at a distance and glare ratio reduces as car comes closer.

My goal was to not wear glasses and my good eye is not so good anymore. Sorry to hear about your eye. Doctor now says try office glasses for computer work or get vitrectomy to get rid of eye floaters. 3-retinal doctors say floaters probably are not the reason for ghost double images. One retina doctor warned me about having a lens exchange after YAG and vitrectomy. He recommends vitrectomy after lens exchange. I had YAG both eyes shortly after cataract surgery. Cataract doctor now recommends iol exchange with monofocal. I asked if Vivity lens would would work. He thinks I might end up with same visual disturbances. Everything is a gamble, has risk and quality trade-offs. I don’t know what to do. Has anyone had this problem with PanOptic and exchanged for Vivity? Did anyone ask for their money back?

I am so sorry to hear about your situation Darlene. I really feel for you. I had a Technis multifocal put in my left eye first. Surgeon messed up his measurements for that eye. I had to have PRK to correct that. Then he did the YAG surgery. I was not at all happy with the outcome. The ghosting is horrible so I know exactly how you feel. I also see glowing around light sources & halos & distorted contrasting values. I know I made a mistake going with a mutifocal. My main goal was to be able to drive. I also have a lot of floaters in that eye which doesn't help. Vitrectomy is not a good option for me since I already have a tiny hole in my retina from many years ago. I could possibly end up with a detached retina. I believe your ghosting in not being caused by the eye floaters. They are annoying but I had them before cataract surgery. My ghosting is definitely caused by the Technis multifocal lens. Surgeon told me so & also recommended a lens exchange with a monofocal to diminish the ghosting in that eye. I have decided that it's too risky for me so I am now trying to get some glasses to help with my vision. Also, do not get a vitrectomy unless absolutely necessary as it will tug on your retina. Also get more opinions about having a lens exchange after YAG because the bag that holds your new lens is gone so the exchange might not be as stable as the first lens that was put in. My personal opinion is if you want to be glasses free, there is a tradeoff with the multifocal lenses as the clarity is reduced. Some people can tolerate & others can't. I happen to be one who can't. I really don't know what to tell you about getting your money back but I know you paid out of pocket for those premium lenses. You would need to talk to your surgeon about that. Seems to me your insurance would cover the monofocal lens exchange but I'm not sure. I did go with a monofocal in my right eye & there is no ghosting whatsoever in that eye. The clarity is like day & night between the multifocal & monofocal. Had I known, I would have opted for a monofocal in both eyes & saved me some money & alot of grief. I hope things work out well for you whatever you decide.