Two EDoF lenses - do night time issues get better or worse when second lens put in?

I thought i read it gets better, as brain can more easily adjust to eyes working the same way. But read from someone on here that Dr said artefacts would intensify? Perhaps they intensify in short term but then adaptation speeds up. For those of you with 2 EDOFs, I'd be interested to hear experiences Thanks

having had one done and will eventually need other done, this is my biggest dilema. with one lens by other eye seems to counteract the worst of the starbursts and halos at night. but i worry two similar lenses would be worse. looking forward to hear from double EDOF patients

The brain seems to have significant ability to select the best image from both eyes and to some degree ignore the poorer image. That is basically how monovision works; one eye gets used for closer up, and the other for distance. I currently have a significant cataract in one eye and 20/20 in the other. I pretty much don't notice it, as I guess my brain is choosing the image from my good eye... . The issue I see with an EDOF lens in both eyes is that they may have the same issues at the same distances and conditions. In that case the brain is choosing between two images that are essentially the same. . One option that is used in some cases is hybrid monovision. That is where the dominant eye (ideally) is corrected with a distance monofocal lens, and the non dominant eye is fitted with a EDOF lens. The prospects for this seem better. The distance lens should be very good from about 4 feet out to infinity. The EDOF would cover the whole range but would be better closer up. In this situation your brain gets to pick the best image from the distance that is needed. The question would be whether or not the brain can ignore halos and flaring etc that are associated with EDOF lenses. Essentially can it use the distance monofocal at night for better vision and ignore the EDOF?

Hi Anne - I have 2 EDOF lenses - implanted July and August 2017. My cataracts were bad in both eyes when i was diagnosed (best corrected with glasses was 20/60 RE and 20/50 LE). I did not see well with cataracts. I had RE done first and right from day one could see very well 20/20 - reading distance was more than I expected. Hold reading material at 11 inches. Night issues were noticeable. Glare that did subside in 6 months. the big concentric circles I see have never gone away. The inner circles are more vibrant whereas the outer ones are very faint. There were 6 weeks between my surgeries. I am not sure due to the cataract in LE that it compensated much for the EDOF RE. after 2nd surgery I did see much better with eyes working together. Reading distance improved. With one eye done that reading distance was arm's length but once 2nd eye had the surgery that shortened it to 11 inches (ie i can thread a needle or repair tiny screw in my sunglasses) all without glasses. This is great for hobbies I have. Night time did not get worse for me but as mentioned that could be because i had bad cataracts both eyes.

I guess it will be up to you if you want a monofocal in other eye to mitigate the concentric circles or the benefit of having better near vision with both eyes with an EDOF lens.

Feel free to ask any questions - I am happy to help any way I can.

Thanks Sue. I am getting Lara in non dom eye next week, and thinking ahead to what to do for dom eye shortly after., depending on outcome for first eye of course. If night vision is not an issue, ideally I'd like Lara in both eyes to get more near. But that's a big If!

Hi, it's really the night time issues I am asking about. I'll find out the answer to your question very soon next week, but going from what James says it sounds like ayes. I'm trying to find out what happens when the second edof goes in

Hi James, yes me too , sue answered but as her cataract in second was bad anyway is not a fair comparison, as she says. If no response I'll be asking Dr next week as have to make a quick decision. Will try to remember to answer the question myself onn this forum!

Yes, I understand your question. Assuming you have a cataract in the eye you are going to have done, then the cataract itself could be causing some of the halo and flaring of lights at night. The cataract comes out, but the EDOF lens will introduce a new source of flaring and halo effect. The question then becomes whether the IOL side effects are worse than the cataract effects. My thoughts are that the IOL is not going to be as bad. And the cloudy, blurry image should be much improved. . My point was that nothing is going to change in your first IOL eye. If there are halos and flaring of light it will still be there. If the second IOL does the same thing, then your brain has no better image to choose from. My thoughts would be (cataract aside) there will be no change in the side effects - not worse, not better, when you go from one eye to two. . It seems to me that there should be no reason to rush from one lens to two lenses. I believe it takes about 6 weeks for an IOL to settle down. That would appear to be the minimum window to wait before making the second eye decision.

Yes all big "ifs"

Questions I did struggle with. Unfortunately impossible to try out more than one scenario so will never know if 2 different lenses would be better than what I have. I am satisfied with how it turned out. Whichever way you decide don't look back as it will drive you nuts

HI Anne, I had one EDOF lens (Technis Symfony) put in and I had major night time vision issues with huge starbursts and concentric circles as soon as I opened the first eye. I was told they would go away after a neuroadaptation period so I go the second one done in 2 weeks. They never went away in the first eye and are just as bad after 1 year. The same for the second eye - just as bad and never went away. No neuroadaptation for me! However, it didn't get worse or intensify just was the same in each eye. It seems it all depends on the person as most don't have any problems and if they do it goes away or subsides. Good luck and best wishes. Boston Paul

Thanks Paul - that is really helpful. After the first one is done I will assess the night time issues (covering up the normal eye so it's not masking symptoms), and if it's a problem I will press pause on the process and wait to see if improves rather than rush to get same in lens in second eye (risking it never improves) , or settle for a mono in second eye (when if I'd waited it might have improved enough to give me confidence in getting EDOF in both). Nice to know, in your case at least, it didn't get worse or intensify when the second one in - that's really helpful, though I accept of course it's not the same for everyone. D day is tomorrow, so am starting to get nervous - therefore not going to look at this forum again for a long time, as it has the habit of inducing a new paranoia every time I do !

sending good thoughts your way Anne - all the best for a successful surgery. really do think part is neuroadaption and the other is your individual personality in regards to night vision. Over the years as i have seen some complaints about day vision - come to think this is also how well surgeon calculates and nails the target. Better that is the less night and day vision issues are - except those whose pupils dilate beyond the edge of IOL. So unfortunate as it makes me wonder why IOLs do do come with bigger diameters so thst doesn't happen.

Anyways really hope all goes well for you. Post an update when you can.

All the best

Sue.An

Hi Sue, thanks for the kind words. Tbh I'm not much into social media and didn't realise how much it bucks you up to get a good luck message from someone you've never even met! So far thrilled, I was exclaiming to the Dr secretary as I talked to her on the phone the next day that I coukd even see the eyes on the squirrel I was watching from upstairs window. Near not super but I knew it wouldnt be. Played piano for an hour today with new eye and just contact lens in old eye, no reading glasses. If second eye goes a s well I will be very very happy. Only problem now is struggling with the gap between ops. Due to a, variety of events which I won't bore you with, it is now six weeks. Good to give Dr chance to adjust second refraction if required, but difficult for me. I had a dummy lens put on one side of my glasses but I just can't tolerate the difference, made me feel quite odd. It seems OK with contact lens in other eye though. I work in IT and need good computer vision, in what is a very dry contact lens unfriendly environment... So I shall just have to wear contact lens as much as poss, probably be working at home soon anyway if things go the way the media seem to think... Thank you for the thoughts again

do you regret the surgery ? do you see better after surgery ? how you see your smartphone ? working on pc? watching tv in dark room ?

Welcome Anne - so very pleased that things are working out well for you. I too had a 6 week wait between surgeries. Managed by poking a lens out of my glasses - not ideal but i did get through it. Although it seems a long wait it does have advantages - allows first eye to completely heal and surgeon to adjust 2nd eye and you'll be finished all those drops on one eye.

It is so great to be able to see again details that were a blur before.

Have you decided on a lens for your second eye?

Yes with all this virus scare going on I suspect many of us would prefer to work at home!

Stay healthy and keep safe.

Sue.An

My glasses are rimless! Hence the dummy lens.... However you've just given me an idea.. I do have some very out of date glasses with rims, I will try poking lens out of them and see if that >s better. I would like another Lara, so happy with it... I want to see on the night time situation before 100% sure. Effects are the re, but they're really not too bad. Stupid question, but do you know if I have to spend hours driving (or rather being a passenger!) around at night to learn to ignore, or will normal daytime adaptation help with night time adaptation too.?

Dear The Lion Artist, I don't regret surgery. I had a rare fast growing posterior cataract thought to be a result of concussions when I was young from HS and college football so it had to be done. The regret is the type of lens I chose doesn't work well with my brain as far as night time side effects. The beautiful thing is I can see amazing! 20/20 distance, no problem reading computer, phone or TV at night. I'm typing this with no glasses and the only help I need is weak reader for very fine print. So the chance of giving up great vision in return for better and safer night driving is my issue. Paul

Hi Anne - Not sure how to answer how neuro adaption takes place. Everyone's brain is a little different. I could see well within 24 hours so I resumed a lot of my normal activities right away which included walking with my neighbor every night. I did not see the concentric circles for 2 weeks so I was thinking I got lucky and would not see them. Turns out glare was worse those early weeks which hid the circles. Once glare subsided I began to see them around certain lights (bot every light source) I also have to be a certain distance away to even see them. To be honest the glare was worse for me than the circles. I would go abput your normal routines. As your brain gets used to the new normal (that usually see many changes in 6 months but your vision can still improve up to a year or 2). As with all things there will come a day you need to head out at night to pick someone up or run an errand and you won't even think twice - when that day comes you'll know you've adapted to your new way of seeing.

I heard Lara provides more near vision than Symfony. You will get the most benefit once 2nd eye is operated on with another Lara. I read with my elbow bent just like I did before needing this surgery.

Hope it works out to pop a lens out while you wait.

Sorry to hear the struggle you are going through. The best is often the enemy of the good. It is difficult to trade what you have - especially since day vision is so good.

At least if you go that route you may be better with a mix and match and do one exchange and that monofocal could minimize the effect of the premium lens.

All the best

i am 33 year old and i have cataract congenital i am scared when i hear negative thing on multifocal I'm afraid to chose the wrong lenses