Results of 1st. Multifocal

[Hoddy44]

I had the Restor lens (28 power) implanted on Thursday in my nondominant eye.  The aurgey and recovery period have been painless.  Although I only have the Restor in my nondominant eye and an uncorrected dominant eye that is about 20/200, I have not worn glasses since before my surgery and I am determined never to wear them again.  I am now glad that I chose the multifocals.  Here is my current vision status with the Restor and the non-corrected eye:
- near vision - I am able to read newspaper print and smaller.
- far vision - Seems to be OK (have not measured).
- lights and halos - Some the first day, but getting better each day.  Certainly not worse than what I used to experience before the surgery.
- intermediate vision - Probably the weak point of the Rstor, however, I am typoing this on a laptop.  Should improve with time.
-  lighting - The Restor seems to require more light for reading than previously.
I'll be having the second surgery shortly.  I'll probably stick with my plans to have a Rezoom inplanted to maybe improve the intermediate vision and low light reading.  It is not entirely clear than these issues wouldn't resolve themselves with another Restor since the uncorrected eye that I use is so bad.  Any thoughts about this?

[Forum-OD-MP]

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[K-D]

Great news Hoddy!  Sounds like you are doing great.  No psychedelics.  Fantastic!  Hoddy, the only thing that I can tell you is that my Rezoom is great for intermediate vision, and reading in low, artifical, light. Not good in bright light. So, sounds like you would have the bases covered, if a refractive, and defractive lens,  is not a prolem for you. Best of wishes to you!

[JodieJ]

I'm glad to hear that you're doing so well.  From what I've read, people with ReStor/ReZoom implants seem to be able to capitalize on the unique strengths of each lens, but you'll have to evaluate your own situation.  In any case, I hope your results exceed your expectations.

[K-D]

Sounds great!

[JodieJ]

I hope your situation with floaters has improved.  What a bummer!  How are you doing?

[K-D]

Jodie,

How nice of you to ask. Thank you! It has been such an anxious time.  The worst part is the black ring, Weiss's ring, that keeps coming across my field of vision.  The PVD happened the last part of Aug.  Yesterday, for the first time, I noticed that the ring is getting fainter.  It has not dropped out of my field of vision though, as well as a large piece of gel, and a strand that also came with the PVD.  But for the first time, I am hoping that maybe, someday, it will completely disappear. I have a least some hope now.  Floaters sound so benign, but they can make a person a wreck when they are very large,from a PVD.  I appreciate your kindness! Thank you again!  And hope you are doing great
Kady

[K-D]

You ain't a kidding.  I know how hard you tried to decide on your doctor and lens, as did I.  I was so glad to read your first post.
I could relate more to a poster that wrote, " I am in the state of shock. I see psychedelics."  But Hoddy, I am into my 8th month post surgery, and the psychedelics are actually . after all these months, starting to improve a little.  Now I am hopeful that maybe even they will diminish in time.  Can at least hope. I guess the multifocal is very different for the brain to compute.

[sandy243]

Hoddy, great to hear your good news. (K-D, also glad to hear the floaters are getting somewhat better. I was actually afraid that I might see the floaters I have, lots of them, better and be bothered, but not so.)
Everything I've read, both here and other places, says that vision with the implants, whether both the same type or two different as Hoddy and I have (will have, right, Hoddy?) takes several months for full visual improvement. I believe it, too. I'm still seeing halos, but not as bothered, for like you, Hoddy, I had such bad vision before with nearsightedness and cataracts that these halos are smaller and "prettier" than the old ones! I went on a trip this weekend with a friend to a conference, and was able to see all of the slide presentations, read all of the articles, worksheets, etc. with little or no trouble. I have a little "ghosting" in the ReZoom eye, which is not really that noticeable and less so when the ReStor is also used. As a teaching psychologist, I can tell you that the brain will adapt, more and more each day. Heck, I was cleaning off the stove this evening and asked my husband what happened to the stovetop--there was a fine, tiny scratch on my nice, white stovetop. He looked at me with what could only be described as a somewhat pitying look, and said, "Honey, that's been like that for a long time now." Oh. And dang, when did I get so many freckles!? (I refuse to call 'em age spots.) Hang in there, Hoddy! You, too, K-D! I'm loving my new eyes!

[K-D]

Sandy, that is so true.  The brain seems to keep on improving my aberrations.  Not gone.  But getting smaller.  My halos used to cover a whole car. Now just huge headlights.  But improvement.  Still have the large circles and spokes with vertical lighting though. And Hoddy, that is also so true.  I had vision without glasses my whole life, so aberrations were a hugh upset for me.  But with vision like yours, I am sure no aberrations would be upsetting.  And with the second implant, they say it even improves.  Unfortuneately, since my doc changed to wanting to give me a monofocal with my multifocal, I cannot be more specific.  Good luck Hoddy,

[hud]

I am a bilateral restor patient, and while I understand the interest in mixing optical systems, I don't see the need.
Hoddy, to answer your question about ghosting, it has more to do with the lens design than any astigmatism. Astigmatism affects visual performance (sharpness) with any system. It has been fairly well documented that halos and ghosting are more prevelant, and persistent with rezoom versus Restor, because of the refractive ring design, and the lower add power. Alcon tells me that the original restor design had a 3.5 diopter add (like Rezoom), which may give slightly better intermediate vision, but there was not enough distance between the near and far images to eliminate aberrations like ghosting and halos. They modified the add power to a full 4 diopter, which gives sharp near vision while allowing the brain to more easily "ignore" the defocused distance image. The makers of Rezoom tell me they are doing clinicals now on a 4 diopter add diffractive mulitfocal (Tecnis MF), to be more like restor.
The decision to mix is yours and your doctors', but do ask him this: what percentage of his Restor patients don't wear glasses for any activity at all? Every surgeon I have talked to states his numbers to be 90% or better. Then ask your surgeon the same glasses freedom number for Rezoom. Also, you are getting the extra retinal protection with blue radiation filtration with Restor. Rezoom filters only UV.

[K-D]

Sounds good Hoddy.  Sounds like you have a doc that is really working to give you what is most important to you.  Best wishes.

[JodieJ]

I totally agree with hud's statement that being 20/happy is what's important.  It seems that your surgeon is really working with you to meet your personal goals for your vision.  Best of luck, and keep us posted on your progress.

[K-D]

Wishing you the best Hoddy!  I wish I would have found this forum before my surgery. So informative. Because I am 20/unhappy.

[JodieJ]

I'm so sorry about all the frustration you've been experiencing recently with your vision.  But per the Forum O.D., the symptoms of your PVD are time-limited, and things do seem to be going in the right direction (although slowly).

I'm sure that you will be happier with your vision with a second multifocal IOL.  Have you considered having another discussion with your cataract surgeon about the plans for your second eye?  It's been my experience that surgeons have been willing to take my input into consideration when formulating surgical plans (given my input is rational).  What if you expressed the reasons for your reservations about putting a traditional IOL in your second eye--such as the absence of evidence in the medical literature that a traditional IOL (in an eye with uncorrected astigmatism) in combination with a ReZoom lens produces acceptable vision.  Couldn't you propose an alternative plan:  a multifocal IOL in your second eye with astigmatism correction by means of limbal relaxing incisions and/or laser vision correction.  I think that it would be worth the consultation fee (probably paid by your insurance) to hear your surgeon's response.  (I'd bring pen and paper and take notes.)

[K-D]

Jodie,

To be honest, I would have been fine with traditional implants, and to wear glasses for reading. I mostly wear glasses now to read, unless in low lighting, and then I have to cover my other eye.

I hear many of the posters talking about their doctor setting one lens back to get intermediate vision with a tradition.  That would have been fine with me.  But no mention like that was ever made. It was "get  traditional and wear bifocals or get a multifocal". And since I have never worn glasses in my life, except to read, I went with the multifocal, when I was told I qualified for the lens comparison program.  Then as I already posted, after my one Rezoom implant,  and study info in, doc changed to monofocal, which I did not feel comfortable with, and I had two days to decide what to do or drop from the program.  Now if I do go with the Rezoom, it will cost $3,400.  A traditional would have been covered by my insurance.
Asked for a script for inside vision, as my vision blurs when my pupil dilates.

R SPH +0.75  CYL -1.50  AXIS 170
L SPH PL     CYL -0.50  AXIS  44
Hope it helps with my inside vision.
Before the PVD , my outside vision was spectacular.  Really don't have much hope of getting that back. All around disappointing.

[JodieJ]

Developing cataracts is a bummer at any age; probably worse for someone as young as you are.  All of your options involve compromise.  If you had gone with traditional IOLs, you still might have gotten stuck paying an out-of-pocket fee for correcting the astigmatism in your right eye.  And post-surgery, you'd have to wear progessive glasses or multifocal contacts most/all the time to have anything close to what I'd consider acceptable vision.  "Setting one lens back" implies monovision--not a bad option but not right for everybody.  But at this point, you're committed to multifocal lenses, which aren't a bad option either, but do involve compromise.

Yes, $3400 is a significant expense.  (Could you put it on a credit card?  One of my friends keeps transferring her debt from one low interest card to another as she gradually pays it off.)  Still, it's probably a bargain if it provides you with many years of visual freedom.  I don't know whether a ReZoom/ReStor combo would give you better vision in a range of lighting situations.  (Ask your surgeon.)  But having multifocals in both eyes should reduce your night vision problems.  And once you've had your second eye done, you can start putting the whole business behind you.

[K-D]

Jodie, I totally agree that I am now committed to a multifocal .  I will go that route when I have no choice. Since I had my wits scared out of me before my second Rezoom surgery, and advised to go with a monofocal , I am going to wait until that eye gets very bad.  Right now the right eye is just smokey.  The left eye was a dense cataract, and I could only see white in the middle of my vision; so I had no choice.
Jodie, what is confusing me is that posters and relatives that I talk with that do not have monovision, which I would not want due to a depth perception problem, tell me that they do not have monovision.  Their lenses are set so that all they need is glasses to read because one lens is set back just a little.  No monovision.  This is what I would have wanted if I had be informed that it could be done so that you could see using glasses to read only, and yet no monovision.  I would have been 20/happy with this.  My vision has always been 20/40 and 20/200.  And I functioned very well without glasses.  Just wish I had been given this option or found this board before my surgery.

[JodieJ]

Setting lenses so that you only need glasses to read is  modified monovision.  One eye (usually the dominant one) is set for distance and the other eye for intermediate vision.  You could probably get by without reading glasses for everything but small print or lengthy reading with this set-up.  (I read someplace that people with small pupils tend to have greater depth of focus, so they might rarely need readers.)   But if you can't tolerate monovision, you wouldn't be happy this arrangement.

What makes someone 20/happy probably depends on what they're used to.  I'm a former high myope who wore contacts or glasses all the time since grade school, but my vision was always correctable to 20/20 (even with a developing cataract.)  When I did monovision I didn't need glasses for reading or the computer.  So my standards are pretty high.  You're currently dealing with PVD, having only one multifocal IOL, and a developing cataract, and you're accustomed to having less than 20/20 vision for distance.  I predict that two multifocals will give you the best vision of your life (once your brain has adapted.) So you have lots to look forward to.

[K-D]

Thank you so much Jodie.  You certainly know how to make a person feel better.
Kady

[sandy243]

Hoddy, sounds like you have really talked with your doctor and have made the right decision for you. Thank goodness for this forum and a good friend who gave me some information that I sorely needed.

K-D, I think that when you get the second eye done, you will be happier. I was being driven crazy with needing to cover my undone eye to be able to read! But definitely talk it over with your physician, and before making this expensive a commitment (mine cost $3444 but that was for both eyes), you might want to consult with someone else, too. Ask around, friends and coworkers, for names of people who have a high success rate. (My doc is an older practioner but one who does tons of cataract surgeries and smart lens implants, and had the surgery himself--so he knows what it's like to go through it.)

I just had my check-up, and was doing so well that he released me until my regular visit in one year. I've got 20-20 up close (still ghosting some in the ReZoom eye, but mostly on the TV, and my husband says there is some ghosting on that picture anyway) and distance vision is 20-25 and 20-30, ReZoom and ReStor respectively. The tech said I will continue to get better as the weeks go by, and even though she could improve my vision for distance with glasses, it was such a minute improvment that it would be stupid to do it. Patience is a virtue, and frankly, I'm seeing so much better than I did that I'm pretty happy right now.

Oh, and the halos are getting smaller--I used to see them even up close on cars and such, but now they disappear at greater distances from me, so that's getting better. It's not that annoying after being unable to drive at night AT ALL.

My advice to anyone considering this surgery is ask questions, seek opinions from those who've had it done, and find the right solution for YOU. We are all different and what works well for one might not be the best solution for another (I hear some people actually like those no-line bifocals--ugh!) Good luck to all!

[K-D]

Thanks Sandy.  Will take your advice. Glad you are doing so well!  Best wishes.

[k0k0]

Hi Sandy,  I have recently (4 days) had a Rezoom implanted in my non-dominant eye.  Vision except for reading is more than excellent! Wow.  However, I am considering a Restor in my dominant eye at a later time because of reading.  I really want to be spectacle free.  My doctor, while very experienced with Restor, has done very few Rezoom and is open for any decision.  You now have both... what more can you tell me?  This to me would be the perfect solution, but I wonder if you have any distortion in your distance vision; is the reading comfortable, does light variation bother you.  I have no concerns about the ghosting, etc.  It will pass.  I would appreciate a dialogue.. Its such a BIG decision.  Thanks