Question: Approximately a year ago I had cataract surgery after having had LASIK surgery about 13 years prior. It's been a year now with my new lenses and I still experience the following symptoms at night: 1. all light sources display a flare at 12 and 5 o'clock, and 2. when viewing the moon, I see multiple images at both 12 and 5 o'clock. YAG did not help. What is going on?
Answer: You do not state whether you had cataract surgery with monofocal, aspheric, toric or multifocal lens implants and this might or might not be relevant. The fact that you had LASIK 13 years prior is possibly relevant in that if you did not have either custom wavefrontor wavefront optimized LASIK it is possible that you have some residual optical corneal aberrations from the LASIK that were not corrected as part of the LASIKtreatment. It could also be that the cataract surgery procedure induced these higher order aberrations including distortions called spherical aberration, coma and secondary astigmatism. Using an in office measuring system called an aberrometer, along with a corneal topography measurement-it should be quite possible to rule this in or out. This is the first place a refractive cataract surgeon can look. As you had a YAG Laser Capsulotomy with no improvement in your symptoms it would also be important to determine whether the lens implant is in the proper position in terms of centration. This too is a pretty quick clinical observation. If neither of these paths identifies the cause, then additional retinal testing might be considered. Now, if you have had an aspheric, multifocal or toric lens implant then it begs other questions that might relate directly to the lens implant design ad positioning. Once the cause is determined then your refractive cataract surgeon should be able to offer you possible solutions.
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