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Is Tecnis worth waiting for?
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Is Tecnis worth waiting for?

I have cataracts in both eyes, but the left one has become worse due to using Pred Forte drops for shingles two years ago.  I am 59, very nearsighted, have worn glasses since 1st grade & contacts for 35+ years.  Currently, I am using a -5.0 lens for my near vision and -6.5 for distance vision.  I also have astigmatism.  Both eyes are "undercorrected" because my OD feels that any greater difference between the two would make it difficult for my eyes to work together.  My bifocal glasses provide better vision, and I find I am wearing them more and more frequently.

Last year, I consulted an ophthalmologist associated with my OD's practice, Dr. Lisa Brothers-Arbisser, about having cataract surgery.  I understand that she is well-regarded in the field.  However, I decided to wait because I wasn't having so much difficulty with my vision that I was interested in chancing all the compromises involved with the IOLs available at the time.  I felt that by waiting, perhaps there would be advances in technology that would resolve some of the problems that concerned me, e.g., halos, glare, difficulty with night driving, etc.

Does anyone have any idea when the multifocal Tecnis IOL will be available to the general public and will it address the issues mentioned above?  Is there a "downside" that I haven't heard about?  If I have the surgery now, what IOLs should I consider?  My OD says that Dr. Arbisser's multifocal preference would probably be ReStor, but that it doesn't currently come in the strength that I would need, probably a 7 or 8.  Does that leave ReZoom as the only/best option for me?  If I am going to have the surgery, I really want to be done with glasses and contacts for good.  I do quite a bit of needlework and reading and would like to continue that without the need for reading glasses.

In re-reading this, it almost sounds like I want the "perfect" solution, and I guess I do.  Since I understand that implanted IOLs are not normally replaced just because a newer, better product comes along, I want to make the very best decision I can.  My eyes have been so bad for so long that I get very nervous at the thought that I might have to contend with the additional problems some of the current IOLs entail.  Any input from professionals or patients on this forum that can help me with this decision will be appreciated.
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Avatar_n_tn
dont know.  hopefully the surgeons and reps will respond to this one...sorry!
11 Comments
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Avatar_f_tn
I can really appreciate your concerns.  I'll be needing cataract surgery in the next year (only on one eye) as a result of vitrectomy surgery, and I also have moderate/severe myopia with astigmatism.  The Tecnis multifocal IOL is expected to get FDA approval in late '07 or early '08.  However, from what I've been reading, it may not be the best choice for high myopes with astigmatism like us.  In one online report, a German surgeon who had implanted many of these IOL's stated that they were "most effective in hyperopic and emmetropic presbyopes."  I've read similar comments from American cataract surgeons about the Restore IOL.  There's a lot of good information available online, and it's probably wise to learn as much as you can before undergoing surgery.
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Avatar_n_tn
Right about the timeframe for Tecnis multifocal.

If you are on the computer (intermediate vision), which obviously you are, ReZoom is better than Tecnis multifocal or ReSTOR. Tecnis multifocal will give that stronger near for reading, but ReZoom does just fine for near and gives outstanding distance vision, crisper than ReSTOR. Also ReZoom is available from +6.0 to +30.0. In this case, waiting based upon your lifestyle should not make things better, if you are ready to proceed otherwise. You could also seek 2nd opinion if you wanted by Dr Prem Virdi or Dr Navineet Borisuth in your area if that would make you feel better. They each have experience with multifocals.  Good Luck!
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Avatar_f_tn
A report from the March 2006 meeting of the American Academy of Cataract and Refractive Surgery (ASCRS) is available at www.eyeqreport.com (report #5).  It contains the latest news about multifocal IOLs.  Apparently, the current trend is to implant a different brand of IOL in each eye.  But keep in mind that none of these multifocal IOLs corrects astigmatism.  It's worth reading the surgeons' postings at www.eyetowncenter.com (specialty discussion Cataract/IOL).  Dr. William Stewart indicates that even the smallest amount of astigmatism results in problems with Restor, and he feels that more patients do better with monovision.  The only IOL that seems to consistently receive favorable reports is the single focus Tecnis.
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Avatar_n_tn
Mixing IOL technologies is OFF-LABEL for all implants. I would have it done if the surgeon and surgery center would offer to do it for FREE as part of a clinical study. But until it has been proven in peer-review journals, it is experimental at best, irresponsible at worst.
Check you local paper, there are medical studies that offer free treatments for any guinea pigs willing. Why pay to have an eye surgeon play with your vision?
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Avatar_m_tn
Looks like PUD is back. Rick Milne won best paper at the recent ASCRS meeting in San Francisco on this blended technology. Best paper out of quite a few entries. The recent Eye Q report addresses this topic which was the hottest topic at the meeting. This means it is now mainstream ophthalmology.
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Avatar_n_tn
Nice touch, keeping it professional with name-calling. "Best paper" is like calling "The Da Vinci Code" fact. It is very interesting, but still patients should ask to have their IOL's mixed FOR FREE, as it is experimental. These IOL's are in their first year, for pete's sake.
Are you a healthcare professional recommending OFF-LABEL practices? This isn't a rare cure for cancer, that we need to exhaust all possibilities NOW. People shopping for body parts on forums like these need safe advice.
eyecu, please post your name and address and occupation, if you're so confident of your OFF LABEL recommendations; the personal injury lawyers may wish to contact you.
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Avatar_m_tn
Read the post from Young Cat in another thread. Call Dr. Milne and speak with him. I am not recommending anything. I am sure he would love to discuss this with you from his clinical perspective.
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Avatar_n_tn
There are many things that are done every day that are off-label. We do cataract surgery on children, when indicated, on young adults for trauma, when indicated. This is all "off-label". That does not make it wrong. Sometimes, when a patient comes in with an IOL from another surgeon, another city, often the patient does not even remember the surgeon, much less a way to get the records so we can "match" the IOLs, we proceed with what we think is best for the patient. Plus some IOLs are not even manufactured anymore. So to say that mixing and matching tecnologies is experiemental or irresponsible is not only strong, but wrong. It may not be mainstream, but it is up to the surgeon, not "financial advisors" or whatever you are, hud to decide.

In the early days of LASIK, when years and years of RK patients had been performed (on one eye) or even on both eyes, LASIK would be performed on the fellow eye or as an enhancement to the original RK. This is the same thing, "mixing/matching technologies. It became mainstream. We learn from our experience and what we learned was that mixing and matching often works not only just fine, but better in some cases. The brain cancels out the different phenomenons it sees to creat better "neuro-adaptation.

We have instructed our patients that enjoy this website and find it helpful to disregard your Alcon biased statements. Go back to your stock prices.......
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Avatar_n_tn
go "learn" from your "experience" on somebody else's guinea pig. Unless it's a cure for untreatable cancer, I'll stick with the FDA approvals.
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Avatar_n_tn
Your comments are amazingly off base so much of the time. No wonder you are getting slammed by so many people on this website, whether they are patients outside the eye industry, eye industry people, or physicians, including opthalmologists.

You talk about guinea pigs and body parts. You should be ashamed of yourself!!!
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Avatar_n_tn
no need to get personal. Your bedside manner is lacking, as I am a patient who is very happy, and knowledgeable, and, yes, biased. ReSTOR is the HD of lenses, ReZoom is Hi-Fi, and crystal is analog. Can they all work? Yep. Can they be messed up? Yep. This will be settled as the cream will rise, and average surgeons drop out, and the best technology will prevail, but the others will still be used to some extent. Classic market dynamics.
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