Blurry Vision after Cataract Surgery
A patient undergoes cataract surgery. The surgery is completely routine, a PanOptix Trifocal Intraocular Lens (IOL) is placed into the eye.
Recovery is completely normal and routine. However, after 3 months, the patient is having difficulty seeing. The patient sees glare, cloudiness, almost a faint haze akin to looking through a dirty or foggy pair of glasses.
The lens itself is perfectly well-centered. The patient has a completely normal looking eye.
Shining the light at a specific angle, the concentric rings that are etched onto the surface of the PanOptix lens are visible
These rings diffract light and allow a patient to see at different focal lengths (hence, multifocal IOL).
A fine, white, web-like sheen is visible behind the lens - this can lead to glare and decreased vision after cataract surgery. This is referred to as a PCO (Posterior Capsular Opacification)
What is a PCO (Posterior Capsular Opacification)?
A PCO is considered scar material that develops and grows behind the intraocular lens after cataract surgery.
A PCO may occur in 5-20% of cases after cataract surgery, and may be noticeable as early as 1 month after surgery, to years later.
Solution: YAG Capsulotomy
Your ophthalmologist uses a YAG laser (Yttrium-Argon-Garnett) to break up the PCO, and polish the lens. The laser is used to create an opening (capsulotomy) behind the lens.
Haloes after cataract surgery
So suppose our same patient has NO PCO, but says the issue is haloes and starbursts at night time.
These visual phenomena are known as dysphotopsias with cataract surgery. They may be due to the lens, the cornea, or other parts of the optical system that make up the eye.
The patient notices starbursts at night
Solution: Taken on a case-by-case basis.
Different types of IOLs will cause varying levels of haloes. In general, diffractive multifocal IOLs, often trifocal IOLs, such as the PanOptix and Zeiss AT-LARA will cause greater haloes/starbursts around lights. These are a form of optical aberration, and they are due to how the lenses diffract light in order to allow a person to see with a greater range of focus.
The best solution is to take each person suffering from haloes on a case-by-case basis.
Ultimately, every person’s visual needs are unique and different. If ultimately, the IOL is unable to provide a patient with an acceptable quality of vision, then an IOL Exchange surgery may be required.
Car Headlights simulation (monofocal lens)
Car headlights simulation (Vivity EDoF Lens)
Car headlights simulation (PanOptix Trifocal Lens)
Many patients with a trifocal lens will often choose to exchange the lens with either a monofocal, or a Vivity (EDoF) lens.