Crystalens Positive Dysphotopsia

[perfluoron]

I had a Crystalens implanted 8 months ago in one eye following a vitrectomy. I'm still suffering from veiling glare day and night due to the IOL. I use pilocarpine to help, but I don't like the drugs side effects. I've already had a YAG capsulectomy treat and the IOL is not tilted. Is there anything else I can do? Would a piggy back IOL potentially help or maybe a pupilloplasty? I'm not ready to fully change out the IOL as my vision is otherwise good.

[NJMOptom]

I'd recommend you ask your doctor about using Alphagan drops (Brimonidine) as an alternative to pilocarpine.  It has less side effects overall, and if the drops improve the halos and ghosting at night then and you are otherwise happy with your vision, then that's great.  It's a trade-off between the ability to read without glasses and the night-time halos/dysphotopsia.  

The only way to remove the halo and ghosting permanently is to replace the IOL, but this is more difficult to do after the YAG capsulotomy is done and the risks of changing the IOL need to be carefully explained to you beforehand.  
NJMOptom

[Babywhisperer]

I've been living with positive dysphototopsia or at least that's what I think it is,although my eye doctor hasn't specifically said the actual words, now since my cataract surges in October and November do 2013! I have had several YAG procedures done on both eyes and just recently had another YAG done on my right eye with very little relief at all! My right eye just isn't right and  I can't  even  tolerate driving at night due to the halos, glare, light sensitivity and haziness around the lights and really bad star effects too! Its so frustrating and depressing for me and its driving me crazy!!! I dont t know what else to do or where to go for help. I have tried all of the suggested eye drops and every one of them burn my eyes to where I cannot tolerate using the drops. If anyone has any suggestions of knows of anyone that may be able to help me, I would appreciate it. Im at my witts end and have been told I just have to live with it!! Oh, and I have closeness and distance vision which I did not have in the beginning and only wanted distance! Please email me at: ***@**** if you have anything you can pass along to me. I would be ever so grateful!

[JohnHaganMD]

I would suggest you contact and go to see Sam Masket MD in Los Angeles CA
http://advancedvisioncare.com/physicians/samuel-masket-m-d    Dr. Masket is one of the world's leading experts on positive and negative dysphotopsia. Some success has been reported by amputating the nasal part of the IOL optic

[SoftwareDeveloper]

Obviously consulting an expert would be best, though at a very minimum I'm wondering if Babywhisperer has ever gotten a 2nd opinion. Just like another odd post from someone else recently,she is claiming to have had "several YAG procedures done on both eyes", when the odds are minuscule of even needing a 2nd YAG. It isn't clear if those YAGs were done for something unrelated to PCO, or if the treatment of this doctor is questionable, or we are being given inaccurate or misleadingly incomplete information possibly due to miscommunication with the patient.


Her profile goes further to claim: "several YAG procedures done on both eyes also and just recently had another one done on the right eye and they removed the capsule completely from what I understand! ". It isn't clear what is meant by that since presumably by default the original IOL was placed in the bag so it isn't clear if that involved another IOL  replacing that one or what is going on.

The reference in the post to "my eye doctor" and no mention of any other doctors at least hints at the possibility she has stuck with one doctor despite all these problems, and what sounds like questionable treatment.


This statement: "Oh, and I have closeness and distance vision which I did not have in the beginning and only wanted distance! " is somewhat ambiguous since it seems to potentially be missing words. It may have meant to say "have poor close and distance vision". However due to the comment "only wanted distance" it suggests that it might have meant "good close and distance vision" as if she were complaining about having better near vision since she didn't want it, which seems odd.  It isn't clear if she has a monofocal IOL (since her profile and post don't actually mention which IOL, even though she posted on a page that was started about the Crystalens) and monovision or what. Presumably if she had a premium IOL she would have needed to consent to paying extra for it (and if she got one without consent, most people wouldn't have been going back to the same doctor). It seems doubtful she could have been given a crystalens by accident (e.g. an IOL meant for someone else) that would have given her good distance vision.

[JohnHaganMD]

All reasonable comments. Not every posting her makes sense or is factual. Sometimes the explanation by physicians is not done or not clear, sometimes the retention or understanding is inadequate.

[CBCT]

Hi,
I had serious day and night glare from my Crystalens. Like you, I had YAG, no tilt, and tried pilocarpine.  After waiting a year, I had a mono focal lens  exchange.  It was a good decision for me.  If you choose this route, find a top notch surgeon who has exchanged Crystalens as that model has unique haptics (the hooks that keep it place).
Good luck!