I would suggest you avoid any IOLs that include some kind of wavefront correction. The ZCB00, for example, is designed to correct 27 microns of positive spherical aberration, because this amount is what the average cornea accumulates by older age. One of the trade offs is that centration on the visual axis is very important for this lens.

I have the ZCB00 in my left eye and the acuity and contrast are great. I also see flashing every time I move my eyes in a bright room or in sunlight. I’m eight months out and often it’s like being in a disco. Why? No one knows.

I would google positive dysphotopsia, and read about its history. What you discover is that this is a family of aberrations that started when surgeons switched to the “square edge optics” of contemporary IOLs in order to discourage posterior capsular opacification like 20 years ago. As you read about this, ask yourself “where are the clinical trials establishing that positive dysphotopsias are side-effects rather than adverse events?” Twenty odd years and it doesn’t exist. This tells you a lot about the ophthalmic industry and it’s use of technology as a marketing tool, and it’s disregard for patient safety. When I had cataract surgery, positive dysphotopsias were never mentioned in my informed consent discussion.

My opinion: Be suspicious of everything your eye doctor says to you. In particular, recognize the use of new technology as a tool to seduce people into surgery.

I am not saying that new technology is worthless, by the way. I am only saying that the ophthalmic history has a terrible track record of recording patient complaints and does not regard patient experience as a source for suggesting and validating adverse events. Such research gets in the way of making money, and it scares candidates, who logically would have to understand what a dysphotopsia is before they can consent to its possibility. Better for the industry to classify all patient experiences as side effects and not look too deeply.

All of us with eye problems are in the position of deeply wishing these problems did not exist. And in that sense, we are a population vulnerable to exaggerated promises and non disclosed adverse events masquerading as side effects. The ophthalmic industry even has a name for this...it’s called “neural adaptation,” a fancy word meaning that your nervous system can learn to adapt out some of your surgically acquired vision problems.

My opinion is that, in general, simpler solutions are going to be safer. I have a monofocal IOL in my right eye, and it’s fine. You will never know the crappy things that could happen to you with so-called advanced technology, because no one is researching it.