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Crystalens problems

Crystalens inserted in non-dominate rt eye in early July at age 64. Left eye has small stable cataract and is 20/20. Rt eye was 20/25 previous to cataract.
Vision results were 20/20 mid Aug., but deteriated rapidly do to formation of scar tissue on nasal side of lens. Yag laser treatment eliminated tissue, but vision never improved much. Measures out to about 20/60 with poor dim light vision and somewhat distorted images. Bad flares and halos at night. Vision is unstable and changes constantly. Close vision is good but is also variable. Not a good result. Dr. offered lasik, but do to unstable lens and awful near vision forcast, I elected not to do it.
Elected to have Crystalens removed and ReZoom implanted next week. Dr. has long history of catatact surgery and is well known in this area.
Read on this forum about the difficulty of removing a crystalens. The Dr. has not discussed this potential problem with me, but I don't have any choice anyway. I am definitely worried about losing part of my eye tissue with the explant, and potential future problems because of this potential. I have been told this is not the first one he has had to remove, but mine has been in a longer time than any others he has removed. He has done all of the new lens' and likes ReZoom results the best so far.
I will not be doing my left eye until absolutely necessary. I hope the ReZoom in one eye will work ok, but after my first experience, I no longer believe the advertising and marketing hype of the cataract replacement lens industry. It doesn't always work out. Dr.and staff are very good to me.
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Avatar universal
A related discussion, Cataract Lens Replacements was started.
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A related discussion, YAG problems was started.
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A related discussion, researching lens implants was started.
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bbd
Hello to all,
Still in "research mode", after talking with three surgeons earlier this winter.  Crystalens, Restor, and ReZoom seem to be the predominant choices at this point.  I've seen one doc who does them all, plus Tecnis monofocals, and he did some of the FDA trials on the Tecnis multifocal.  If I can wait that long, the Tecnis multifocal might be a possibility too.  I've not read anything on these threads about Tecnis.  Does anyone have info on that?  I too am a "young" active 52, ski, hike, am at my computer for work and recreation (?), drive day and night, and would like to "have it all".
Also, earlier comments above have me wondering about how long to be out of my contacts prior to taking the refractive readings.  I wear multifocal gas permeable lenses; I'm getting the impression that this particular type of contact lens must be somewhat atypical.  These are sort of like the old "hard lenses" which actually caused some cornea misshaping.  When I talk to the surgeons about my contact lens history, none of them had indicated any particular requirement for being out of contacts, but then again, none of the docs themselves are the ones who deal with contact lens fittings for their patients.  It makes me wonder if they really know and appreciate the differences that may/may not be involved in a gas perm vs a soft contact lens.  That makes me real nervous.  I'd happily be out of my lenses for 30,60,90 days or whatever it takes to get the assessment right.  For you previous contact lens wearers out there:  what kind of contact were you wearing, and what were you told about being out of contacts prior to assessment?
Thank you all.  These forums are a world of help and support.
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This morning started having more extreme double vision.  Strong ghost image to the left of real image.  Last three days, a mild ghost image was above and right of real image.
Exam showed more change in lens position so, they scheduled me for followup surgery Monday to recenter and suture it in place.  Doc said this is quick procedure and not to get too concerned.
I am hopeful this will close the book on this experience which began last July and has been mentally draining and very expensive for me and my insurance company.

  
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Avatar universal
I am probably late for the question about your physical activity. It shouldn't affect your eye, but you should check with your surgeon, if you did not already. As for the Alphagan, yes it will lower the IOP (intra-ocular pressure) which will help with the healing and bring your pupil down just a bit, which will help with the halo/glare/aberrations you may be seeing at night. Glad things are going better for you. Should continue to improve.
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Hi..Yes go to Kerry Assil. He is awesome. He has a very kind and compassionate way of explaining things. He has experience with ReSTOR and ReZoom. You will be in good hands there.
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You are so kind.  I appreciate your concern and effort in this matter.  S. Monica is about 1 hour drive w/ traffic-- not really that bad.  Thanks for the info.  THe drive is doable.
I can't tell you have valuable chatting in this forum is/has been for me.  Nobody really understands these issues or concerns like someone who has gone/going through them. Thank you so much. I will keep you all posted.
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Had appt with Doc this afternoon to checkout ReZoom results at 7 days out from insertion to replace Crystalens.  Had great initial results for first 3 days and then developed an additional transparent image above the real image plus some nightime halos.

When he explanted the Crystalens, the capsule was no longer able to solidly hold the ReZoom so he positioned it in front of the capsule. I don't understand exactly what is holding it in place.

According to him, and I hope I got this right, there was some change or movement in the vitreous which caused the lens to slightly decenter. He wants to wait a couple of weeks until the eye settles down and then go back in and recenter the lens and hold it in final position with a "stitch". There was also a reference to the zonules when he talked about the stitch. I don't know if he used a stitch in last weeks op, and if not, why.

Not pleased about the requirement for another eye surgery session, but optimistic about getting back the excellent 20/20 vivid vision the ReZoom gave me for a few days even if it was not able to be placed in the optimum postion initially. This is a great lens and should be at the top of anyones list who is considering a multi-focal IOL.  It's not responsible for my current problem.

He gave me some eye drops called Alphagart P to use until next weeks appt. They're suppose to lower eye pressure and change the pupil size.

I'm really looking forward to getting this experience which started last July over with and enjoying a consistant visual outcome.  Wish the ReZoom lens had been available to me back then.  My left dominate eye has a small stable cataract and is still 20/20.  Hopefully, it will stay stable and will allow me to avoid anymore eye surgeries in the forseeable future.


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Avatar universal
I was curious and ran a mapquest from LA to Santa Monica.

A quick 20 minutes for an additional opinion would be worthwhile. I have no personal reference but from the article (see post above) this Dr. seems to have vast ReZoom experience.

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Avatar universal
I do not know California well.

You can search for a ReZoom doctor at http://visioninfocus.com/040.rezoom.asp

or take a look at the third article in the documents at;

www.crstoday.com/PDF%20Articles/1005/CRST10005_supp.pdf

It is by a Dr. Kerry Assil in Santa Monica. I don't know how far that is from you.  His contact info is in the article.

Good luck!



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Avatar universal
Exhausting is the right word.  I am totally spent on this decision.  I lost confidence in the Rezoom surgeon because he did not do my measurements w/ my contacts off for at least 5 days. He also pushed lasik as a way to "fix" any discrepancies.  This made me not feel confident w/ him. I understand the measurements are not exact at times. I need a surgeon in the L.A., South. Calif. area - I know there must be a surgeon that I  can feel confident with. I had a surg date set up at Jules Stein, cancelled it because I got scared and I didn't like the fact I couldn't meet the surgeon until 2 weeks before the surgery.  you saw a different eye MD to verify you even need cat. surg first.  Then they bring you back 2 weeks prior to surg and you meet the surgeon  and go through all the testing.  Jules Stein is at least a one hour drive one way and since I can't drive distances anymore, the whole thing felt overwhelming to me. I  am scheduled to have surg with the RESTORE lens the end of March out of desperation.  I figured some vision is better than no vision. It worries me that you say   patients are not seeing good distance w/ Restore. It worries me that there are some pt's who say they feel like they are looking through vasoline.  That would totally annoy me.
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Avatar universal
Rezoom lens replaced Crystalens on 2/22. On 26th starting seeing ghost image which is slightly above real image. Part of it is overlaying and part is above real image.  Lights at night also starting exhibiting this aberration.  Did not have this for first three days. Lights were pinpoint and all images were crisp with no aberrations.  This image gets larger and higher as objects move from arms length out to distance.
Is this what others have referred to as halos?  Since it is a faint image partially overlaying the real image, it makes it difficult to see crisply even though distance vision appears to be still good for real image.
I was reading with a little difficulty without glasses until this appeared.  Now I had to go back  to reading glasses.
Have others experienced this and did it correct itself after awhile?  I will not see doc for another checkup until 3/1.  Day after surgery, I was 20/25 dist. and 20/30 close.
Sight in low light and at night is also is not equal to that in my left eye.  Rooms and nightime vision are dimmer when using my rt eye only.
I normally do moderate workouts 3 times a week to keep in shape. Will the increased blood pressure and pulse rate from fast walking and weight lifting have adverse effect on implant settling in?
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Avatar universal
Good for you and your 1st surgery! As for your question/concern about things being better or worse after the 2nd eye....better is most always the case. Once the cataract is out of the 2nd eye and the brain now once again has 2 eyes to use that are balanced, the brain suppresses those unwanted halos, images, aberrations, funky things you see. Again as stated on this thread, noticeable not bothersome. Let us know how you do. Best of Luck for round 2.
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I know you must be exhausted with the contemplation of your decision. Cataract49 is right about his comments about the FDA approval without US clinical trials. There is data out there prior to FDA approval in the US last March, from Europe. Much more data has been gathered since FDA approval. The ReZoom is better than Array and it just needed to be as good as the Array to get approved. If you are a musician, intermediate vision is a definite priority for you. That is the strength of the ReZoom. Obviously you must have confidence in your surgeon and this one prefers ReSTOR. Only because he hasn't done anything else. I think Cataract49 is right on with his comments and think back as to how long and tedious his decision was. I wish you the best. Get as many opinions as you need until the majority rules, but go to someone who does them all, else how they be an expert or comment from personal experience, which is the greatest teacher. Best of Luck to you...keep us posted. More amd more of our ReSTOR patients are saying the reading is too close, too strong, the distance is muddy or like looking thru Vaseline, and there is no intermediate. The ReZoom gives you comfortable, good reading, good intermediate for those arm length tasks, and excellent distance vision.
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Great news for you. Glad it went well. It should get even better, but remain stable and not fluctuate like Crystalens vision does. Keep us posted.
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Had the crystalens removed yesterday and a 24 hour follow-up today. Surgeon reported all went well during the explant. He evidently removed the lens, but left the stablizing posts of the lens in, as removing them would be expose my eye to more potential capsule damage. They did not interfere will the ReZoom implant or function. This a very short discussion while I was on the table and under the influence of a relaxant, so I think thats what happened.
Today, I was seeing 20/25 distance and 20/30 close already. Need some more time obviousily to assess the longer term results and the dim light and night driving results. My eye needs to clear some more too.  So far the ReZoom results are good.
I am relieved this experience is over.  From the number of surgery tools he was asking for and the time it took, I know it was not a matter of fact eye surgery.
It's nice to be able to see well again even if it's only been one day.
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Avatar universal
By any stretch, I am no expert. I will try to express my reasoning but others on this site (surgeons and those who work for surgeons) seem to have much broader first hand experience.

My understanding is that AMO used the Array clinicals treating the ReZoom as an upgrade. Thus they did not need to go through costly FDA trials on an already approved product. This to me did make good business sense and did not effect my decision at all.

In the end it was my desired results and the technology itself of each lens (ReZoom vs ReStor) that helped me decide. I listed my decision factors in the post above. That does not mean that my choice is the best choice for you.

I tend to look past the brochures and advertisements and look deeper at a product, how it works, and why one product may be better for me than another.

I am fortunate to have a very experienced, world class, and nationally regarded refractive surgeon. His practice takes a brand neutral approach and he allowed me to work through the decision process in my own time frame(8 months, starting my research shortly after FDA approval of ReZoom/ReStor).  

These lens' are still new for many surgeons and so experience and actual results rather than clinical trial results are only now emerging.

Sensing the struggle you have, I do wish you well.






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Avatar universal
Thanks for the article references.  I read them.  It is perplexing to me how AMO doesn't have a U.S. clinical with rezoom.  The AMO rep never showed my surgeon any clinicals when he was trying to sell him REZOOM just 3 weeks ago.  WHY?  That doesn't even make good business sense. Having been a former pharm rep I know,  you need proof sources to sell. Trust me, I am trying so hard to get over this fact because I get sad when I  think of losing my intermed. vision as young as I am.
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Avatar universal
I have empathy for your situation as an ophthalmologist. The technology is first generation, it is good but not a substitute for being twenty or thirty. I listen to my patients when it comes to choosing an IOL since I have no bias on the lens I implant. It makes no difference to me as long as I feel the results will be the best possible. As long as the patients expectation is set properly not one person has results unhappy with results.

Explants are tough when the capsular bag has fibrosed the IOL in place. I explant them within the first few weeks for optimal results. It is hard if not impossible to predict who will fibrose and have problems. I am sorry to hear about your problems and your anxiety. Good luck to you.
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Avatar universal
My research and the results reported by others from the ReZoom implant are the reason I want to have it replace the Crystalens after it is explanated.
My expectations were high when the Crystalens was originally implanted and the vision I had one month later was stunning. I was very pleased.  I still don't understand what happened to cause the lens to decenter or shift position later and cause the vision problems I am having now. My research has found that the Crystalens is potentially subject to "capsular contraction syndrome" which after several months can cause it to decenter and vault forward in the capasular bag. If this happened to mine and the Yag laser treatment did not correct the lens position, then I believe the only recourse is to remove it or live with it. I can't live with the visual aberrations and poor distance and night vision, so out it comes and in goes a Rezoom.
As long as no damage is done to the capsular bag during the explant, everything will probably work out ok.  Unfortunately, it just can't be lifted out easily after it has healed into the bag. Somehow, it needs to be separated from the capsule tissue without disturbing the surface of the bag, so there is a good stable surface to mount the ReZoom on.  To say that I am concerned is an understatment.  
If any eyecare professionals monitoring this forum can offer any insight into this procedure, it would be appreciated and might alleviate my concern. The clinic has not discussed it with me, so they may consider it not to be a problem due to the expertise and experience of their Dr. and did not want to cause unnecessary concern or maybe I'm just magnifying the issue.
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Avatar universal
i hope it will work as well...good luck
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Here is a link to a series of articles that I found very useful.

Rezoom, ReStor, and Crystalens info included.

I hope this helps!

www.crstoday.com/PDF%20Articles/1005/CRST10005_supp.pdf
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