Starbursts, Halos, Glares, etc before surgery.. Better now with new IOL?
Posted , 18 users are following.
So everyone talks about the halos, glares, flares, starbursts that EDoFs and Multifocals can cause. However did most of you not have these issues before lens exchange?
I have those issues now with my cortical cataracts and astigmatism. Starbursts are what bothers me the most, it is "moderate" but I can still drive. I am hoping no matter what IOL I choose, it will get better. If it gets better than I will be happy, but any chance it could get worse?
Could anyone share their before and after surgery experience?
Thank you
1 like, 68 replies
at201 coppp
Posted
There is no direct relationship between the "before" and the "after" issues of glare, halos, starburst etc for a specific individual.
The "before" issues are there because of the cataract in the natural eye lens, how well it can focus, astigmatism etc.
When the natural lens is taken out and replaced with an IOL, all these issues are due to the characteristics of the IOL.(and not the natural lens) and how well it works together with the rest of the eye. Some issues such as starbursts can happen with any lens, if the IOL prescription is not perfect. Others such as halos or glare tend to be worse with multifocal lenses or with the Symfony lens than with good monofocal lenses. Of course, there can be other issues such as reflection off the edge of the IOL (depending on its design), differences in the probability of developing PCO with different IOL designs etc. Overall, a good monofocal lens with a correct prescription still provides you the best chance of avoiding the night vision issues.
coppp at201
Posted
Thank you for your advice, I wouldn't mind mild night issues since what I already have I feel is moderate. Anything better than that and less dependency on glasses is what I am hoping for. Seems to be so many different results tho, reading the forums and picking a monofocal vs Symfony, like someone said below is like rolling a dice...
Sue.An coppp
Posted
The glare and starbursts are much better now that I am 9 months from first surgery. I do see the concentric circles and for me this is manageable. It would be nice to have best of both worlds but I knew there was a compromise to make.
Not everyone wants that trade-off though so you’ll have to weigh the pros and cons for yourself.
If you drive a lot at night this might be more than you want to deal with. I know pilots cannot get EDOF or multifocal lenses due to night time flying they do.
There is a new EDOF atLARA which isn’t available yet but from what I have read looks like their is more range of focus and less halo. If you can hold off you may want to read first hand patient reviews on that IOL.
Sue.An
Posted
coppp Sue.An
Posted
Sue.An coppp
Posted
betwixt coppp
Posted
coppp betwixt
Posted
No to which question?
I'm assuming - No, a new IOL did not help with starbursts/glare/halos
susan44499 coppp
Posted
I didn't have them before or after. I didn't have cloudiness either. They just couldn't correct me to 20/20 anymore. I think just to 20/40 or 20/50.
Today the optometrist told me some cataract patients have such haziness and halos that they need surgery even though they still test 20/20.
coppp susan44499
Posted
I don't have cloudiness either, but prescription glasses can't correct my 20/30 - 20/50 vision. But I do have moderate starburst, then mild halos and glare. What IOL did you go with?
derek40125 coppp
Posted
In my case, the cataract increased headlight glare at first and I would say that there were many similarities between what this looked like and some of the sketches/images I've seen of a "starburst" except that the vertical rays of light emanating from the light source didn't extend out as far. As the cataract worsened, the overall haze or Vaseline-effect started to dominate and the glare from light sources wasn't really the main issue caused by the cataract.
I went with a true multi-focal IOL, Restor 2.5D, but I'm hoping an upcoming EDOF IOL design (with reduced concentric rings) will be available before I need my second eye done (as I do notice the dip in vision between the focal points). The main artifact I see is a halo around light sources at night. This is caused by the out of focus near-image overlapping the in-focus distance-image. It's simply a small, fuzzy ring of light around a bright point light source. I had nothing like this before surgery. I even tried multi-focal contacts (some of which are similar in design) in an effort to experience these halos in advance of the surgery but had no luck.
I have to say that the halos are pretty small in diameter (due to the lower add power) and really aren't bothersome. Lights just look a little different than they do in the other eye. The other artifact I notice is edge-glare which occurs when light strikes my eye close to perpendicular to the direction I'm looking. I first thought that this was due to the different focusing rings inherent in this IOL design but some other people with monofocal IOL's have edge glare issues too, so maybe it's unrelated.
The quick summary is that, for me, I would go with this lens or an EDOF like Symfony again over a monofocal. I can't imagine my distance vision being any better than it is now (consistently 20/15) and the night halo's don't bother me at all. Edge glare may or may not be related to the IOL choice but it's not enough of an irritant that I wouldn't do it again (if it's IOL related).
rpk0925 coppp
Posted
I'm sorry to say that I had NO issues before cataract surgery. Since cataract surgery, I think I have all of the night time issues (glare, starbursts, halos, spiderwebs, glow around light images on a movie or TV screen). For what it's worth, I only have one eye done so far and that eye has a Symfony lens. I am currently weighing my options on what to do with my 2nd (still natural) eye. I would not start out with a multi-focal lens again.
michael85451 rpk0925
Posted
i have a similar scenario as you. i did one Symfony eye about 6 weeks ago. same night issues and glow around screens. i scanned the forums and the atLARA seems like an improvement, but how do you decide what the best option is? i worry that if i dont do the other eye with the same symfony lens, there might other issues as well. have you decided what you'll do?
rpk0925 michael85451
Posted
Hi michael85451 ... No I haven't decided what to do yet. I keep hoping a bolt out of the blue will hit me and I can say "That's it!", but that hasn't happened yet. Briefly, I went to a surgeon for a 2nd opinion (at about the 3 or 4 month mark) who told me that if he was in my shoes, he would go for another Symfony lens in my unoperated eye. He told me that he thinks they need to work together and that after a month or so, *most* of the artifacts I'm seeing will go away (the key word being *most*). But then when I saw the surgeon who did the actual surgery (at about the 6 month mark), he suggested that I go with a mono-focal lens in my unoperated eye, saying that if I'm not happy with the Symfony lens, why continue with it. He said that he has had 5 to 7 patients (I forget the exact number) who weren't happy with their Symfony lens (in both eyes) and opted to do lens exchanges from Symfony to mono-focal lenses. Those patients were content after 1 of the 2 Symfony lenses were replaced and didn't feel a need to have them both exchanged. So the options he gave me were to have a non-focal lens in the operated eye (set for either near or far ... my choice). From there, I could see if that combination was working for me or not and decided whether to go farther or stop at that point. Or, of course I can still have another Symfony lens implanted in the unoperated eye. It all seems so complicated to me. So no, I haven't decided yet ... I find the whole situation overwhelming right now.
rpk0925
Posted
Sorry for the typo in my last post. Where I said "So the options he gave me were to have a non-focal lens in the operated eye (set for either near or far ... my choice).", I should have said "So the options he gave me were to have a MONO-focal lens in the operated eye (set for either near or far ... my choice)."
Sue.An rpk0925
Posted
If it helps - reading became easier with 2 Symfony lenses. The night time concentric circles didn’t change. I think the amount of residual astigmatism combined with any refraction error brings about the other undesirable artifacts (screen glare, blur, glare) but couldn’t tell you if those 2 issues are any better or worse than a monofocal lens. Although I do lean towards it is worse with a premium lens simply because the expectation is glasses free (or rarely used). With a monofocal lens one complements with glasses anyways so those 2 things get corrected that way.
How is your reading with the Symfony eye? Perhaps a monofocal targeted for half a diopter in would complement it well and you’d still be glasses free most of the time and night issues better?
rpk0925 Sue.An
Posted
Sue.An ... You touch on part of what has me puzzled. I don't understand which artifacts I'm seeing are a result of the Symfony lens (which will be permanent) and which artifacts might clear up in time, regardless if the lens is a Symfony or mono-focal lens. I also don't understand to what extent (or even if) glasses can further improve vision after having Symfony lenses implanted. I think I understand that the concentric circles will never go away ... but not sure about anything else I'm seeing. I also get the feeling that my night vision is darker/dimmer now than it was with my natural eyes, though I don't think I can prove it. But it scares me when I think that if I have another Symfony lens put in, that my vision could get even dimmer at night. (I still do a fair amount of night driving ... which is one of the ways/times I notice how dark things are. Other times are in dimly lit places like theaters or even bars).
As far as reading goes, I feel like my natural eye is saving me there. My natural eye is nearsighted, which (in my mind) is allowing me to get away without wearing glasses all this time. If I close my natural eye, I can't read almost any close up print with the Symfony eye with clarity. With just my natural eye, I can read fairly small print. With both eyes together, I think I'm seeing a little bit better than when I only use my natural eye. (........ You throw me off when you talk about targeting a monofocal for half a diopter in. I still don't understand many of the technical terms thrown around in this forum ... like diopter ... and how those measurements work).
Thank you (all) for your help.