Non surgical management of starburst dysphotopsia 6 months after cataract surgery
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I have basic acrylic monofocal IOLs and have had starburst vision since the surgeries 6 months ago. I have tried drops with no success and neuro adaptation has not happened! My doctor does not recommend lens exchange. Has anyone found any non surgical management that helps? I can't drive at night which is why I got the surgeries in the first place. Thanks for any input!
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RonAKA burgal
Edited
I have a basic monofocal in both eyes with one eye having an AcrySof IQ from about 2 years ago, and the other having a Clareon now implanted for 1 year. I have monovision which makes it more difficult to compare the eyes, but last night I was driving with prescription glasses on which corrects both eyes to plano and pretty much eliminates any astigmatism. I normally drive without glasses. In any case, I compared both eyes as carefully as I could while driving. My observation was that there was no difference between the eyes. And if you refer to the figure below, I have zero halo effect as illustrated in the top A frame. I have very close to zero glare (fog effect) as illustrated in the bottom frame. However, I do have the starburst effect as illustrated in the B, middle frame. If I had to rate it compared to the example image, I would say the extent when the light source is a very bright LED type headlight (blueish) or LED bright tail lights, or LED traffic lights is about 75% of the sample image in size. It is certainly noticeable, but not really distracting. When the lights are the more traditional and older incandescent type the size of the starburst is probably reduced to about 25% of the sample image. What is interesting is that if you look at the starburst spikes very carefully, they have colours in them that kind of dance up and down the spikes of light. It makes me wonder if chromatic aberration may be involved somewhat. If so high refractive index IOL material as is used in the AcrySof and Clareon may be part of the cause. But most IOLs are fairly high in refractive index as that allows them to be made thinner and more flexible so they an be inserted into the eye while causing less damage. Don't know if that is part of it or not.
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In any case I don't have a solution for you, but I thought it might help to know what others are seeing. I do not find this degree of starburst to be at all distracting. It has probably been 5 years or so since I had vision not affected by a cataract, so I find it hard to compare what I have now to the natural eye without an IOL.
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burgal RonAKA
Posted
That's a good representation of what I see in the starburst image. It seems to overwhelm my vision when it's the newer LED lights. My doctors can't find anything obvious to tweak. Apparently I have little or no astigmatism. Thanks for the thoughtful reply.
RonAKA burgal
Posted
I was driving again last night and noticed one more interesting effect. In the case of LED traffic lights, as I mentioned above I see the starburst effect and not the flare (fog). However, last night I noticed that as you get closer and closer to the traffic light the starburst goes away and then I can see a bit of the flare or fog. I have no idea why this would be.
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I don't believe I would be confident that a lens exchange would change anything. With a monofocal lens it would seem to be something other than the lens itself.
burgal RonAKA
Posted
Yes I've noticed the same effect. I see a haze around interior lights... maybe it's just starburst seen up close?
ad12345 burgal
Posted
What are you going to do? Leave it that way?