IOLs and transistion lenses

[Richard123]

I have developing cataracts and will need IOL replacement in the near future. I was considering monovision with the regular IOLs or possibly the Crystalens, Rezoom, or Restor lenses as an alternative. If I were to achieve some independence from glasses with one of these lenses, the ONLY thing I would miss about glasses is the transistions feature of automatically darkening outdoors.
I have searched the internet but cannot find any indication that this kind of feature is available with IOLs. Is it?
If not, why not? Since it seems to me that it would be tremendously advantageous, is there some technical reason it cannot be done?
Thanks
Richard

[Forum-OD-MP]

no.  it is not available.  there is no photochromic IOL or photochromic contact lens.

as to the specifics on why its not available, i dont know but i'd guess its a manufacturing problem or a lack of perceived demand or both.

[jmbesq]

I suppose if you thought the feature was so valuable, you could get a set of transition glasses with no Rx in it (or if you do need some refinement, get that Rx in it).

[Belledonna]

Did you check to see if contact lens ,worn on the outside of the eye, come in transition lens? That would seem like a more doable invention ,especially since they already come in colors.

[Ag-i-doc]

there is no photochromic contact lens.  the only photochromic lenses are in glasses.

[Richard123]

Thanks to everyone for the information. I did find one reference to a new photochromatic IOL on the web at this address:
http://ascrs2006.conferencefilms.com/acover.wcs?entryid=073946
but it is a video about an IOL that changes from clear to a blue light blocker when exposed to UV rays, thereby giving better vision at night than an IOL that had the blue light blocker all the time, if I am understanding it correctly.
Not the darkening transition (spelled it right this time) effect I am looking for.
So I guess it is possible to do this sort of thing in an IOL, just not available at this time. Probably because of lack of demand as the moderator said.
But I, for one, would be interested should it ever become available. But with my cataracts advancing, if it ever does become available, it probably would not be in time for me.

[hud]

very interesting video, but I would like to know why you want the transitioning. If it is for comfort from bright lights, I can totally empathize as I have always had wimpy eyes in bright sunlight. If you are concerned with retinal protection from harmful radiation, the AcrySof ReSTOR already provides this. I must point out a few facts that need correcting in Dr Mamalis' video.
1. Blue-blocking is a misnomer, as there is no reason for it. We all need to see visible blue light.
2. AcrySof ReSTOR is the only multifocal lens that FILTERS light waves in the UV and high energy blue spectrum, mimicking the natural pigment of a 25 year-old human lens.
3. Dr Mamalis subjected the Medemmium lens to UV radiation only, to produce the transition to yellow. Studies have shown that after removing the patient's cataract and its natural filter subjects the retina to potential damage from UV and blue wavelengths.
4. All IOL's currently filter UV radiation, only AcrySof lenses offer both UV and blue-light protection.
If you are a candidate for ReSTOR lenses, you may use traditional sunglasses outside for comfort only, but avoid the "blue-blockers" as they would unneccesarily double the filtration, which could compromise your visual performance. At the same meeting, a German doctor presented a comparision of clear and yellow lenses. He too, incorrectly termed the AcrySof lenses as "blue-blocking", when in fact they are, blue filtering.
http://ascrs2006.conferencefilms.com/atables.wcs?entryid=075830

[Richard123]

My interest in a photochromatic IOL was for comfort and convenience only.
I currently wear progressive lenses (varilux panamics), with the transitions feature, all the time.
I find it very convenient to go outdoors and not have to manipulate sunglasses or sunglass lens attachments to my glasses. I thought that if I was able to achieve even partial glasses free vision with an IOL that it would be convenient to also be free of sunglasses and sunglass manipulation when going from inside to outside and vice versa.
I am a total amateur at this and didn't even know what blue blocker or blue filtering was when I ran across the video. Thanks for your information on that.
I will need IOLs at some point but I am just now starting to find out about the accommodating and multifocal ones and trying to decide if one of them would be right for me.  

[Iaen23]

I had cataracts since age 28 (now 66) from Prednisone & always had to have sunglasses.  Amber did the best filtering for me.  In the last month I have had both eyes operated & monofocal IOLs put in.  The photophobia is gone with the old, opaque lenses.  It is a pleasure to go without shades, squinting etc.  Hope you find the same.

[Richard123]

Thanks, I hope so.
Now that I have read a little more about the multifocal and accommodating IOLs, I have questions about the nighttime haloing that is talked about.
Is this a single halo around lights, or is it multiple halos?
Given that the multifocals have a series of concentric rings, is it a halo for each ring?
And what about the crystalens. Also haloing? If so, a single halo since it does not have the concentric rings?
Is there haloing with all IOLs, even the monofocal ones?
Does anyone know of any pictures posted on the web that simulate what it looks like for the various lenses?
Lots of questions I know. Any information would be appreciated.

[Highsound]

This is the best description I can give you of the halos. A headlight has a light ring about 3 diameters out and it is as bright as the headlight. Inside the ring, there are a couple of lighter rings. That's alot of light coming at you on the highway. In time the circle may lessen in intensity or degrees covered. There is also a solid aura which will eminate out from all other light sources, like a bleeding out of the light's color but less bothersome than the headlight halos.
Not everyone gets them. I didn't until decentering started. Another patient with Rezoom one month out I talked to said she saw only a quarter circle of halos and slight ghosts. Nothing she couldn't ignore.  Trust me you don't want to take a chance with the Crystalens. I had one for months and at one to two months it was seeing great except for close before it displaced. It's a lot harder to fix it than the others. It also has limited UV protection
so you need to always wear sunglasses outside. It's visual image outside is not as clear or sharp as the Rezoom either. Even with my problems, I would go rezoom again. Get the best most experienced doc you can find to do your op, don't select based on price. Good luck.

[hud]

all implants report some degree of halos. The multifocals have a higher incidence, but tend to fade in time. Ranking from worst to best in terms of persistent halos, studies have shown : Array, ReZoom, ReSTOR, monofocal (including crystalens).

[Highsound]

HUD,
What studies are you refering to and where can one get access to them? I've been all over the internet for months looking for information. Read every article in the opthamology magazines and sites and never saw any reference to any comparison study.
The Crystalens never gave me halos just starbursts and flares which would extend almost across the entire lens. Not as disruptive as the halos, but still a lot of extra blinding light to deal with.