Multifocal Lens Implant Vision Problem

Question: My father had cataract surgery and multifocal lens implant about 18 months.  He is 85 and active and is still having problems seeing with the lens implant that was used.  He has symptoms that sound like a decentered or dislocated intraocular lens implant.  The eye doctors at the facility had some problems inserting the lens implant at the time of surgery causing swelling to occur. They told him this would get better over time and that his vision would improve. Swelling went down but vision did not improve.  He has returned for several visits and they tell him everything is fine, but his vision in the eye is still not correct.

Could there be a problem with the lens implant or some other issue that they are not discussing?  I am planning to visit the doctor with him in the next 2 weeks and wanted to know if there were other questions I should ask or if there is anything that can be done to correct the problem.  He can't drive at night and they have told him to get regular glasses to correct the vision problem.

Answer: Unfortunately it is impossible to know from your description the actual nature of the vision problem. Is it glare, halo, blur-at what distances-far, near, intermediate? You state he cannot drive at night-why? Glare-halo-blur? Or something else that might suggest a problem not with the lens implant itself but perhaps with the capsule left in place to support the lens implant.  Was the cataract surgery itself complicated-was the capsule ruptured? You state there was “swelling”.  Where was the swelling-the cornea or retina? As you can see there are MANY questions that need clarification through a clinical examination and then explained to you as the reason for your father’s difficulty with the multifocal lens implant. Or, it just may be possible that this is as good as his vision can be with the multifocal lens implant as, depending on the  type of multifocal lens implant, they do often present a number of potential vision compromises which are exaggerated if the  lens is not centered perfectly. That said, you certainly should be present and discuss the possibilities with the cataract surgeon after the next visit and exam.  If the discussion does not give you a reasonable explanation and path to improvement-if possible-then find the best cataract surgeon in your area and schedule an appointment for a second opinion.

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