Post-Cataract Surgery Questions: Vision Clarity and Lens Performance

Q: Post-Cataract Surgery Questions: Vision Clarity and Lens Performance

Hello Mr. <br>Ming-Yun： The visual experience with multifocal intraocular lenses can vary from person to person; some individuals are very satisfied, while others may find it not as good as expected. <br>Regarding glare, if the pupil is larger at night, this condition may occur.

Questions after cataract surgery and lens replacement?

I had cataract surgery on my right eye three weeks ago, using Alcon non-diffractive multifocal intraocular lenses.
The doctor said the surgery was successful and my vision is 20/20.
However, when I intentionally use my right eye to look at intermediate distances, such as for the computer and car dashboard, things appear somewhat blurry.
My left eye has not yet reached the point for surgery.
Should I wait until both eyes are operated on to fully experience the visual performance of this lens?
My second question is, although the non-diffractive lens is supposed to reduce halos and glare, I still find the glare and halos quite significant, especially around streetlights, where I see a surrounding ring.
Is this normal?
Thirdly, the doctor suggested leaving my left eye with -1.00 diopters of myopia to enhance near vision.
Will this create any issues with binocular disparity?
Lastly, after changing the lens, will my myopia and presbyopia measurements change in the future, or will they remain fixed? I apologize for the many questions, and I greatly appreciate your time in responding.

Ming Yun, 40~49 year old female. Ask Date: 2023/09/22

Dr. He Jianxian reply Ophthalmology

Hello Mr.
Ming-Yun: The visual experience with multifocal intraocular lenses can vary from person to person; some individuals are very satisfied, while others may find it not as good as expected.
Regarding glare, if the pupil is larger at night, this condition may occur.
Considering leaving one eye with a refractive error of -1.00 diopters after surgery is an option that can be considered, and it generally does not cause significant issues.
After the lens replacement, the refractive error is typically stable, but over time, there may be slight movement of the lens, which can lead to minor changes in the refractive error.
Dr.
Jian-Hsien Ho, Ophthalmology Department, Nantou Hospital.

Reply Date: 2023/09/22

More Info

Hello! Thank you for your detailed questions regarding your post-cataract surgery experience. It’s great to hear that your surgery was successful and that your vision has improved to 1.0. Let’s address your concerns one by one.

1. Vision Clarity and Performance of the Intraocular Lens (IOL): After cataract surgery, it is common for patients to experience some fluctuations in vision clarity, especially if only one eye has been operated on. The brain needs time to adjust to the new lens, and if your left eye still has cataracts, it may contribute to the perception of blurred vision when using your right eye for mid-range tasks like looking at a computer screen or a car dashboard. It is possible that once your left eye is also treated, your overall visual experience will improve, as both eyes will work together more effectively.
2. Glare and Halos: You mentioned experiencing significant glare and halos around lights, especially noticeable with streetlights. While the Alcon non-diffractive lenses are designed to minimize these effects compared to other types of lenses, some patients may still experience them, particularly in low-light conditions. This phenomenon can be due to several factors, including the healing process of the eye, the quality of the lens, and individual sensitivity to light. If these symptoms persist or worsen, it would be advisable to discuss them with your ophthalmologist, who may suggest additional treatments or adjustments.

3. Left Eye Myopia: Your doctor’s suggestion to leave your left eye with a slight myopia (100 degrees) to enhance near vision is a common practice. However, it can lead to a disparity in vision between the two eyes, known as anisometropia. This condition can sometimes cause discomfort, difficulty in focusing, or visual fatigue when using both eyes together. It’s essential to monitor how you feel with this setup, and if you experience significant discomfort or visual issues, you should consult your eye care provider for a reassessment.

4. Changes in Prescription After IOL Implantation: Once an intraocular lens is implanted, the prescription for distance and near vision typically stabilizes. However, it is essential to note that the natural aging process can still affect your eyes over time, potentially leading to changes in your vision. Conditions like presbyopia (the gradual loss of the eye's ability to focus on nearby objects) may still occur, and you might require reading glasses in the future, even if your IOL was designed to reduce the need for them.

In summary, it’s not uncommon to experience some visual disturbances after cataract surgery, especially when only one eye has been operated on. Your brain will gradually adapt, but if issues persist, further evaluation by your ophthalmologist is crucial. They can provide tailored advice and solutions based on your specific situation. Thank you for your questions, and I hope this information helps clarify your concerns!

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