Understanding Light Effects After Cataract Surgery

What You Need to Know About Halos, Glare and Starbursts with Modern Premium Intraocular Lenses

Cataract surgery has evolved dramatically over the past decade. Today, it's no longer just about removing a cloudy lens—it's an opportunity to improve your overall quality of vision and reduce your dependence on glasses.

With the introduction of premium intraocular lenses (IOLs), many patients can enjoy excellent distance, intermediate and functional near vision. However, one of the most common questions patients ask before surgery is:

"Will I see halos around lights at night?"

The answer is: possibly—but probably far less than you might expect.

Modern premium lens technology has significantly reduced unwanted light effects while maintaining excellent visual performance.

What are light effects?

After cataract surgery, your eye's natural cloudy lens is replaced with a clear artificial lens called an intraocular lens (IOL).

As your brain adapts to your new vision, you may notice certain optical phenomena, particularly when driving at night or looking at bright lights.

These include:

⭐ Halos

A soft ring or glow surrounding bright lights such as headlights or streetlights.

✨ Starbursts

Light rays or spokes extending outward from a bright light source.

☀️ Glare

A general brightness or washed-out appearance around intense lights.

These effects are normal and can occur even in people with healthy natural lenses. Most patients experience them only mildly, and they usually improve as the brain adapts to the new optics—a process called neuroadaptation.

Not All Premium Lenses Are the Same

Earlier generations of multifocal lenses created multiple focal points using diffractive rings.

While these lenses provided excellent reading vision, they were also associated with:

• More noticeable halos

• Reduced contrast sensitivity

• Greater night-driving symptoms

• Loss of a portion of incoming light due to diffraction

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Today's newest premium lenses use entirely different optical designs that greatly minimise these issues.

Two of the most exciting examples are:

• TECNIS PureSee™ (Extended Depth of Focus) by Johnson & Johnson Vision

• RayOne Galaxy™ by Rayner

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Both represent a new generation of premium refractive lens technology designed to provide excellent vision while reducing unwanted night-time visual disturbances.

TECNIS PureSee™ – Extended Depth of Focus Without Diffractive Rings

The TECNIS PureSee™ EDOF lens extends the eye's natural range of focus without using diffractive optics.

Instead, it creates a smooth, continuous range of vision from distance to intermediate and functional near vision.

Benefits include:

✔ Excellent distance vision

✔ Crisp intermediate vision for computer work

✔ Functional near vision for many everyday tasks

✔ Outstanding contrast sensitivity

✔ Very low glare sensitivity

✔ Excellent performance for night driving

Clinical studies have shown that:

• Approximately 93% of patients report either no halos or halos that are only mildly noticeable

• Nearly 97% would recommend the lens to family and friends

• Most patients experience night vision comparable to that of a standard monofocal lens

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One particularly interesting advantage is that halos may actually become less noticeable when the pupil enlarges in dim lighting, making the lens especially attractive for patients who frequently drive at night.

RayOne Galaxy™ – Spiral Refractive Innovation

The RayOne Galaxy™ uses a completely different approach.

Rather than employing diffractive rings, it uses an innovative spiral refractive optical design, allowing light to be distributed smoothly across multiple distances while avoiding the light loss associated with traditional multifocal lenses.

Advantages include:

✔ Smooth vision from distance to approximately 35 cm

✔ Excellent binocular near vision

✔ Zero diffractive light loss

✔ Halos significantly lower than traditional trifocal lenses

✔ Excellent option for patients who previously underwent LASIK

Clinical experience has demonstrated that:

• Around 50% of patients report no dysphotopsia (light effects) whatsoever

• The remaining patients typically report only very mild symptoms

• Severe halos are extremely uncommon

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Because all available light reaches the retina, patients often report excellent image quality and contrast, even under challenging lighting conditions.

Why Do Light Effects Improve Over Time?

One of the most fascinating aspects of vision is the brain's ability to adapt.

Following cataract surgery, the visual system gradually learns to ignore small optical imperfections.

This process—known as neuroadaptation—usually occurs over several weeks.

Typical recovery follows this pattern:

Weeks 1–2

Some halos or glare may be noticeable, especially at night.

Weeks 3–6

Most patients find that halos become much less noticeable as the brain adapts.

Around 3 months

Vision is typically stable and comfortable, with the vast majority of patients reporting that any remaining light effects are no longer bothersome.

If symptoms persist beyond this period, they are often due to treatable causes such as:

• Dry eye disease

• A small residual spectacle prescription

• Posterior capsule opacification ("secondary cataract")

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These conditions can usually be managed successfully.

Can I Still Drive at Night?

For most patients, yes.

Both the TECNIS PureSee™ and RayOne Galaxy™ have been designed specifically to minimise night vision disturbances.

Although mild halos may be present initially, most patients return to comfortable night driving within a few weeks.

If night driving is an important part of your lifestyle, your surgeon will help determine which lens is best suited to your visual needs.

Will I Still Need Glasses?

One of the main goals of premium lens technology is to reduce dependence on spectacles.

Most patients can comfortably perform everyday activities—including driving, using a computer and many near tasks—without glasses.

However, very small print, prolonged reading or detailed close work may still require reading glasses for some individuals.

No premium lens can guarantee complete spectacle independence for every patient, but modern designs provide an excellent balance between visual freedom and optical quality.

Choosing the Right Lens for You

There is no single "best" intraocular lens.

The ideal choice depends on:

• Your lifestyle

• Your occupation

• Night-driving requirements

• Reading habits

• Previous eye surgery

• Overall eye health

During your consultation, Dr Mark Deist performs a detailed assessment of your eyes and discusses your visual goals before recommending the lens that best suits your individual needs.

The Bottom Line

Modern premium cataract surgery offers more than just clearer vision—it offers the opportunity to enjoy a fuller range of sight with fewer visual compromises than ever before.

The latest premium lenses, such as the TECNIS PureSee™ Extended Depth of Focus and the RayOne Galaxy™ Spiral Refractive IOL, represent a significant advancement in lens technology. By avoiding traditional diffractive optics, they provide excellent visual quality while keeping halos, glare and starbursts to a minimum.

While mild light effects are a normal part of the healing process, they are usually temporary and become far less noticeable as the brain adapts. For most patients, the benefits of improved vision and reduced dependence on glasses far outweigh these short-lived symptoms.

Considering Cataract Surgery?

If you're exploring your options for cataract surgery or premium intraocular lenses, Dr Mark Deist can help you choose the solution best suited to your lifestyle and visual goals.

Dr Mark Deist📍 Sandhurst Eye Centre53 Saxon Road, Sandhurst, Sandton, 2196

📞 011 217 7520✉️ deist@icon.co.za🌐 www.drmarkdeist.com