I had uveitis in my right eye and developed cataract because of using steroids. i had cataract surgery 2 years ago. I have very large pupil and this Alcon IOL gives weird look to my eye. it sparkles and shines under most light conditions. many people notice that and ask about that. i hate that feeling. Everytime doctor told me there is no lens that doesnt give that reflection. Recently tecnis synergy lens has been approved in USA and i heard that it doesnt give that glisten or reflection. I asked my doctor today and she said she doesnt have any experience with that lens and she doesnt know about its cosmetic appearance. Is there anyone with synergy lens here? i want to be sure that its true before talking to doctor again. thank you
You are possibly talking about two different issues. The material that Alcon has used for many year can develop very small voids which fill with fluid and can become visible when examined with a slit lamp used by optometrists. They very seldom cause any issues visible to the user. Alcon claimed it was a manufacturing quality control issue and they have solved it a few years ago. . The other issue that seems to be reported occasionally in social media is a "cat eye" reflection effect which is said to visible to others. It is claimed to be cause by the higher refractive index of the material used by Alcon. I have an Alcon lens and don't see, and can't create any such effect. I can't find sources other than social media that say it even exists. But, you seem to see it. . The Tecnis brand material is said to be free from glistenings. It has a slightly lower refractive index and again social media would suggest it does not have the cat eye effect. Alcon has a newer material called Clareon which is said to be free of glistenings. . This said do you have any vision problems? Is your lens just a monofocal or does it provide both distance and reading? The Tecnic Synergy is one of the latest multi focal lenses intended to let you see both near and far. It however like other MF lenses is susceptible to vision impacts especially at nights with halos, flare, and spiderwebs around point light sources like street lights and headlight of on coming cars. If you are considering an explant or replacement of the Alcon lenses you should consider the issues of the lens you put in may be worse than what you have now. Also consider that the explant process is difficult, expensive, and my have down the road impacts on your vision.
i have monofocal lens. My pupil in that eye is large and it makes it more visible to everyone. many people asked me about this sparkle. it looks like a diamond eye or terminator eye. i can myself see it in mirror everytime. Now my doctor has no experience with synergy lens and she doesnt know if that cosmetic appearance is true about that lens. I am just so worried because of this look and dont go to any gatherings any more.
I have also tried pilocarpine drops for pupil to make it smaller but that didnt work well for me. I got excited after i heard about synergy lens. but nothing happened
One possibility is that what is being seen by others is a form of positive dysphotopsia. It is most often reported as an issue to what the user sees, not what others see. It is aggravated by a large pupil and is not easy to solve. Silicone lenses may be better than acrylic lenses like the Alcon and Tecnis, but they have other disadvantages. My frank thoughts would be to be very thankful that the issue is not affecting your vision, and not worry about what others may see or think. In doing a bit of research you should probably avoid a multifocal lens like the Synergy or PanOptix and stick to a monofocal. That may be like jumping from the frying pan into the fire. Here is an article to google to get a bit of info on dysphotopsia. What you are describing sounds a little like negative dysphotopsia where light from a sharp angle to the eye is being reflected off the square edges of the IOL. Both the Alcon and Tecnis lenses use square edges to prevent PCO. It can also be aggravated by higher index material, which makes the lens thinner and possibly set further back in the eye. Both Alcon and Tecnis materials are high index, although the Alcon is slightly higher. High index material allows a thinner lens which makes insertion easier. . Review of Opthalmology Dysphotopsia: Not Just Black and White
Thank You so much for your time. everytime I try to be normal someone will point out that my eye looks strange, like diamond or terminator eye. Then again I get conscious. But you are right that I dont have any other issues with my eye. Your message really gave me hope and courage I needed. I might have more problems with multifocal lens. I will try to focus on positive side. Thank you so much
If you poke around reading the threads on this site you should find ones talking about positive dysphotopsia, and the issues they have with vision. That may be helpful in alleviating your concerns, as when it affects your vision it can be bad.
Here is a thread to look at. But, take note that many of the issues (halos, flare, spiderwebs) described in this thread are really issues caused by multifocal lenses, not true postive dysphotopsia which is caused by the lens edge reflections. . https://patient.info/forums/discuss/iol-exchange-positive-dysphotopsia-726497
ok im checking it. thank you so much.
The other issue that seems to be reported occasionally in social media is a "cat eye" reflection effect which is said to visible to others. It is claimed to be cause by the higher refractive index of the material used by Alcon. I have an Alcon lens and don't see, and can't create any such effect. I can't find sources other than social media that say it even exists. But, you seem to see it.
Ron if you watch Dr. Shannon Wong's new video on YouTube called Synergy v Panoptics at the 30:10 mark he not only acknowledges this cosmetic effect but he even shows it. As the person moves their eye around you can see a brief flash of the Alcon IOL reflection in her left eye. It's a real thing. Yes it's purely cosmetic (no effect on the patient's vision) but it's not a myth.
What I have been looking for is a research type report on the issue with some explanation of what causes the effect, along with some statistical data on how often it is seen and in what specific lenses. So far I have not seen anything like that. I found one report that showed multiple very small reflections in the eye that probably are only visible with a slit lamp examination by an optometrist. The article claimed it was a method to determine if the lens in the eye was a natural lens or an IOL, in situations where the patient doesn't know -- dementia or the like I guess.
what you experience is called diamond eye. it is different from glistening which has been a defect in the alcon iol material as reported in the past. it is not known if it is still an issue as it take some time to develop. the wong video someone mentioned shows the damages lens.
if you have no other visual issues then you have a rich man's problem.
All of Alcon lenses have a high refractive index of 1.55 so you will always have the diamond eye if you use Alcon. Tecnis has a lower refractive index around 1.43-47. No diamond eye. The closer you can stay to the natural lens of 1.41 the less likely you get diamond eye. Glistenings are accumulations on a lens over time that may or may not affect vision.
if you exchange your lens ask what the refractive index is. Remember, all of Alcon's lenses have the ability to produce this effect.
There is little research because the majority of cataract patients are elder and less likely to complain/notice/be in multiple frequent social situations. As far as quality control, it is low on the totem pole of concerns for surgeons so they likely dont bother to warn patients. Or maybe they arent aware of it because patients arent informing them for reasons - see above. As younger patients continue to receive cataract or lens exchange surgery i suspect this will become a more well known issue.
wow really you should see my eye and there are many videos on youtube showing that reflection.
i asked my doctor and she said she doesnt have any experience with new synergy lens and she said that is multifocal lens which might give me other problems. Mine is more visible because of large pupil in that eye.
I know you are right. everytime when someone tells me that my one eye looks unusual and shining more than my other eye that is when i get conscious and find it hard to make eye contact. But im trying to be thankful and positive. thanks
I agree with you. Doctor always tells me that im young and under 40 thats why im more concerned otherwise this effect is normal. I asked her so many times in start that what can I do to get rid of this she said nothing can be done and she also prescribed me pilocarpine to make my pupil smaller but that doesnt work for 2-3 hours in my case and i was scared to use it so much so left it. I hope there is any mono focal lens that doesnt have this cosmetic problem as doctor said multifocal is not good for me.
Sofport IOL is silicone monofocal and wont have the diamond eye. Tecnis has a monofocal too that wont have it.
It is insult to injury to not be told of this and then told your feelings arent valid about it. Talk to your doctor about these other lenses. Get informed, weigh the risks vs benefits and make your own decision.
I think you are making some over simplified assumptions about lenses that are not correct. Probably close to 50% of the lenses in North America are Alcon. Perhaps 40% are Tecnis. I don't think it is reasonable to say all Alcon lenses are bad. It is kind of like saying all Fords are bad vehicles and all GM's are good.