Poor night vision post Lentis M Plus lens insertion

[tyrotrainer]

I had Lentis M Plus multifocal lenses inserted 4 and 6 weeks ago respectively, after being diagnosed with cataracts. My day time vision is amazingly good at all distances, however as soon as the light level drops, eg indoors, my distance vision beyond around 2 metres becomes blurred - night time driving is impossible. I also experience glares, halos and starbursts, but I was expecting these - not the blurred vision. A week ago I posted how good these lenses are, but the low-light blurring problem did not seem so bad then - now I find driving is simply to risky for me to contemplate - I spoke too soon.....It's ironic that my night vision in the rear view mirror of my car is perfect at night, but forward vision is extremely blurred - it's a shame I can't reverse everywhere!

I assume it is a function of my pupils dilating and thus destroying my depth of field. I have two questions:

1. Is this a function of the healing process, and Icould I expect my pupils to adjust over time?

2. If it is not going to heal over time, is it possible that these lenses are too small for my eyes and will need to be explanted?

My present situation is desperate because I am virtually housebound in the evening as I need a car to go out - there is no public transport where I live and taxis are costing me a fortune.

Thank you, and advice would be gratefully received.

Roy

[tyrotrainer]

Hi Greetz, yes....get Pilocarpine eye drops....my surgeon recommended 1% drops 3 times a day...effect is amazing, perfect focus at night and only small halos. I also use artificial tears between drops to top up...they help focus. A huge improvement even without drops...my brain IS adapting. Good luck and let me know how you get on.

[Herbaliser]

Hi Tyrotrainer,

I have also received a lens exchange with the Lentis Mplus 2 and 3 weeks ago. The effect by night and day that you describe is exactly the same as i have. Perfect during a sunny day but at night blurred further then 5m and the halos and starbursts of the streetlights are blinding.

I was wondering if four you, after +-9 weeks of placement, the effects are getting better?

Greetz from Belgium

[tyrotrainer]

Many thanks for the reply

[Christopher C Shen, MD]

Multifocal lenses have various zones within the implant allowing focus at different depths of field.  The reason why you're likely noticing difference during daytime and nighttime is due to the fact that in dark conditions, your pupil is more dilated therefore, exposing a larger central area of the implant.  There is often an adaptation period for the eye/brain to figure out where to look through these lenses in different settings and activities (much like bifocal glasses or monovision contact lenses) You may want to check with your surgeon to see what the adaptation period is for these lenses since some could be on the order of months rather than weeks.