What causes light lines after cataract surgery? (+3 reasons)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss the reasons that make you see diagonal light lines after a cataract surgery. We will also discuss your lifestyle choices that may increase the incidence of seeing light lines after cataract surgery.
What causes light lines after cataract surgery?
The following table describes the reasons causing light lines after cataract surgery (1):
| Characteristic of light line | Reason |
| Glare | High refractive index of intraocular lens (IOL). |
| Starbursts and light streaks | Backscattering from the IOL combined with microsaccades. |
| Light arcs | Perception of the edge of IOL at night by the patient. |
| Haloes and rings | Caused by multifocal IOLs that produce hales around the natural or artificial light. |
| Light flashes | Peripheral light ray reflection from the IOL’s edge. |
Post-cataract surgery, about 67% of the patients experience positive dysphotopsia. However, it usually disappears within a few weeks. Only 2.2% of the patients have reported persistent positive dysphotopsia up to 1 year after cataract surgery (1).
What postoperative factors cause light lines after cataract surgery?
The postoperative factors, selection of the lens and IOL design might cause light lines after cataract surgery.
- Refractive error: Refractive surprise, that is the deviation from the targeted angle, can cause light lines after cataract surgery.
If the incidence angle of light rays onto the IOL exceeds 35° off the visual axis, it might cause an internal reflection that can project onto the temporal retina as a light line (3).
- Intraocular lens selection: In the case of diffractive multifocal IOL, slight tilting may cause positive dysphotopsia and light line formation.
According to one of the clinical trial data, the ovoid-shaped IOL caused light lines in the majority of the patients (n=289) (4).
- IOL design: Sharp-edge IOLs increase the chances of seeing haloes as compared to square-shaped IOLs and round-edge IOLs (5).
- IOL scratches: Damaged and scratched IOL can cause light lines, blurred vision, and impaired night vision. In this case, the damaged IOL should be immediately removed (6).
- Posterior capsule opacification: It is a postoperative complication of cataract surgery and occurs due to the cloudiness of the lens capsule over time.
- Pupil size: A larger and wider pupil often exposes the IOL’s edges to more light rays. This causes arc-light patterns and glare due to internal reflections (5).
Which other factors cause light lines after cataract surgery?
After cataract surgery, the patient should not use previous spectacles or contact lenses. The following factors might cause light lines after surgery, including:
- Spectacles: If the patient requires prescription spectacles following cataract surgery, they will most likely be different from the one the patient was using before the surgery.
Typically, the patient has to wait up to 6 weeks before receiving the prescription spectacles and resuming wearing glasses. After surgery, the patient is also advised to wear protective glasses till healing.
- Contact lenses: Like spectacles, the prescription of contact lenses will also change after the cataract surgery. Incorrect usage might cause light lines.
The patient needs to wait for one month or several weeks before starting to wear contacts. Consultation with the ophthalmologist should be done before resuming contact lenses.
- Artificial lashes: They might interfere with the light entering the eye and cause light lines after cataract surgery.
It is advised not to wear artificial lashes for four weeks post-surgery.
How light lines after cataract surgery can be minimized?
Although, an opthalmologist is the best judge in selecting the perfect IOL for cataracts, some of the suggestions to reduce the incidence of light lines after cataract surgery include:
- Equi-biconvex IOLs: These IOLs cause less internal retinal illumination because they enable inner-reflected rays to fall on the retina in a more dispersed way.
- Acrylic IOLs: These IOLs are more flexible and allow minimal light line formation after cataract surgery.
- Round-edge IOLs: These designs can reduce the incidence of positive dysphotopsia.
- Diameter: IOLs with 7 mm diameter are known to cause less incidence of light line formation (7).
As a pharmacist in the optic section, most of the patients complain of light lines and blurred vision after cataract surgery. There is no pharmacological treatment for it and you must visit your opthalmologist for better clinical interventions.
It is important to note that some drugs might also cause vision problems, such as antidepressant drugs like Lexapro. Therefore, your opthalmologist would be the best judge of your underlying condition.
The clinical interventions are made on an individual basis and the severity. Sometimes you might need an IOL change, especially if the previous IOL was damaged. The light lines disappear after some time.
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References
1.-
Pusnik A, Petrovski G, Lumi X. Dysphotopsias or Unwanted Visual Phenomena after Cataract Surgery. Life. 2022 Dec 24;13(1):53. https://www.mdpi.com/2075-1729/13/1/53
2.-
Khoramnia R, Auffarth G, Łabuz G, Pettit G, Suryakumar R. Refractive outcomes after cataract surgery. Diagnostics. 2022 Jan 19;12(2):243. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870878/
3.-
Erie JC, Bandhauer MH, McLaren JW. Analysis of postoperative glare and intraocular lens design. Journal of Cataract & Refractive Surgery. 2001 Apr 1;27(4):614-21. https://www.sciencedirect.com/science/article/abs/pii/S0886335000007811
4.-
Masket S, Geraghty E, Crandall AS, Davison JA, Johnson SH, Koch DD, Lane SS. Undesired light images associated with ovoid intraocular lenses. Journal of Cataract & Refractive Surgery. 1993 Nov 1;19(6):690-4. https://www.sciencedirect.com/science/article/abs/pii/S0886335013803367
5.-
Holladay JT, Lang A, Portney V. Analysis of edge glare phenomena in intraocular lens edge designs. Journal of Cataract & Refractive Surgery. 1999 Jun 1;25(6):748-52. https://sciencedirect.com/science/article/abs/pii/S0886335099000383
6.-
Cole SC, Werner L, Schwiegerling J, Crandall A. Visual aberrations in a multifocal intraocular lens with injection-related scratches. Journal of Cataract & Refractive Surgery. 2014 Nov 1;40(11):1913-8. https://journals.lww.com/jcrs/abstract/2014/11000/visual_aberrations_in_a_multifocal_intraocular.24.aspx
7.-
Bonsemeyer MK, Becker E, Liekfeld A. Dysphotopsia and functional quality of vision after implantation of an intraocular lens with a 7.0 mm optic and plate haptic design. Journal of Cataract & Refractive Surgery. 2022 Jan 1;48(1):75-82. https://www.sciencedirect.com/science/article/abs/pii/S0886335000008567
