Question: After cataract surgery that was to correct both near and far vision I am having trouble with far vision and have terrible glare and halos when driving at night. I have an astigmatism in that eye and my distance vision is not good. My near vision has improved. It has been suggested that I have a laser treatment in that eye to get rid of the astigmatism. The after affects of laser seem to say I would still have halos at night and perhaps blurry vision as I have now. Would this be a treatment that I should consider or are the possible side affects not worth it.
Answer: Unfortunately your question leaves out a number of key details that would allow us to offer a direct response so we will try to respond in general terms. First, if you had preexisting astigmatism before your Cataract removal it certainly would need to be corrected during or after your Cataract Surgery in order for you to get the best possible vision. Astigmatism for people with Cataracts can be corrected by using an astigmatism correcting toric lens implant, by using a secondary procedure called Limbal Relaxing Incisions (LRI), by having a Corneal Laser Eye Surgery procedure such as LASIK or by wearing eyeglasses with the correction for the astigmatism. You have to correct the astigmatism by one of these methods if you want to get the best vision correction after Cataract Surgery. Although you do state that as part of your Cataract Surgery your vision was to be corrected for both far and near, you do not state whether that was done with Monovision Cataract Surgery or a Near Vision Presbyopic Correcting Multifocal Lens Implant or an Accommodating Lens Implant.
Depending on the type of Multifocal Lens Implant, there may be predisposition to cause glare and halo side effects-in many cases these complaints resolve as patients adapt to the vision with the Lens Implant. In some cases patients do not adapt to the glare and halo and the Lens Implant needs to be removed-but this is only in a very small percentage of instances. Nonetheless, you do NOT get good vision with Near Vision Presbyopic Correcting Multifocal Lens Implant or Accommodating Lens Implants if there is uncorrected astigmatism.
Further, the glare and halo could be caused by a number of other factors that would require careful examination. So, you have to have the astigmatism corrected AND you have to discuss the annoyance of the glare and halo with your Cataract Surgeon as this may simply be due to adaptation and self limiting or may have another cause that needs to be addressed. If after discussing the situation in depth with your Cataract Surgeon you still do not feel comfortable, it is completely appropriate to get a second opinion prior to electing another surgical procedure. If you seek a second opinion you might want to make sure that it is with someone who is BOTH a Cataract and Refractive Surgeon and thus has the breadth of experience in both surgery areas of Surgery and LASIK Surgery.
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