Rezoom and ghosting problems?

[JustWant2See]

Had a ReZoom lens implanted in one eye in May. About 8 weeks later had YAG treatment for early PCO. Since then I am happy with very good (J1) near vision, but unhappy with poor far vision (20/40). Also experience ghosting, not too bad indoors, but bad outdoors in higher contrast light or at distance.  

Dr. at first thought ghosting was due to slightly off-center IOL. On last visit, lens had mostly re-centered itself (undilated exam), and he thought ghosting was now due to a) residual astigmatism, b) still slightly off-center lens, or c) just the way multi-focal lenses work. He gave me a Rx for a lens for my glasses to correct vision/astigmatism (-.75+0.75x180). Lens barely had any effect on ghosting, but helped improve far vision to 20/30.

At night I have significant glare/halo problems, and halos are not centered on light source, but off to one side. I think if they were symmetrical around the light they would be much easier to tolerate. I think my vision would be much better if there were no ghosting. Reading signs is difficult because ghosted image from one letter overlies “real” image of adjacent letter.

Questions: What else can cause ghosting? Will it go away with time? Should ReZoom be able to give me ghost free vision? Would ReZoom in other eye help fix problem? Can lens be re-centered? Is poor far vision due to incorrect prescription? Suggestions?

I still need my other eye done. If ghosting turned out this bad in 2nd eye, I don’t know if I could drive at night.

Can anyone else comment on their problems with ghosting and ReZoom? Did they resolve with time?

[Forum-OD-MP]

ghosting is one of the well known and much reported risks/side effects of multifocal implants.  no, rezoom in other eye would likely not help IMO.  many, many people here with this same problem.  not really a great solution for your problem.

[K-D]

I also have only one Rezoom multifocal. I am not an expert, but have much experience with the halos, ghosting, etc. I know that the halos can decrease greatly, but can take a long time.  My started to decrease in the 8th month.
I do know that my halo were perfectly centered around any light source.  Sounds like yours lens is not centered.  I would not have the other eye done without getting a second opinion.

[K-D]

Also, it is odd that you have such good reading vision and poor distant vision.  Rezoom's best vision is suppose to be distant, and weakest, near vision.  Something is not right. I have ghosting inside only, which I believe is from astigmatisn.  Have an appointment with another doctor next week.  Again, I would get another opinion from a doctor who has done many multifocal implants.  Best wishes.

[billeye]

Welcome to the club! I also had bi-lateral Rezoom lenses implanted (2 months apart). I had halos and the need for glasses after the first Rezoom. I was told that everything would be fine after the second Rezoom. It made matters worse. Halos are terrible and I still need glasses. I was told to wait another two months for the adjustment to take place. I did so and I still had the same halos and the need for glasses. I was told to wait another 2 months. I guess the magic number is 6 months. Now at 6 months, nothing has changed - same old halos and same old glasses. Now I have to find some doctor that will take these lenses out.

My advise, if you don't see a change in the first couple of months, more than likely you won't. I have seen way too many postings in other sites to support my beliefs. Now you are beginning to see the Rezoom veterans (6 months and up) and no real changes, just the same problems and promises. Wait until you get the second Rezoom in. You'll be back in halo city.  Any doctors in Georgia that are capable of removing these lenses?

If there is a class action suit, please count me in. This product is overrated and now we are paying with miserable vision.

[gntr]

I'm glad that I found this site. Like many of you, I wished that I had checked on multifocal lens outcomes before having the surgery. I also had Rezoom lenses implanted 7 and 8 weeks ago - the right eye first and then the left. I can't say that I'm happy with the outcome. I see halos but not as bad as some people seem to report. My problem is ghosting. Other than in bright light(plenty of sun) conditions, ghosting is very noticeable indoors and outdoors. Before choosing the Rezoom lens, I was warned that there could be some halos and glare, but nothing about ghosting. No where in the literature is ghosting mentioned.

My doctor doesn't know what to do next since he feels that the lenses were implanted correctly - very little astigmatism, if any, and well centered. I have no dry eye and no PCO. The local Rezoom representative is also at a loss. He states that halos and glare is possible, but nothing about ghosting. The rep is also puzzled by the results.

What should I do next? Is this condition permanent? Has anyone resolved this problem? I did not expect my vision to be like this. The Rezoom lens rep made it sound like I was the only person with this problem. I was very surprised to see so many postings on this forum.  Any help/advice would be very much appreciated.

[K-D]

I sure wish I could help you.  But I also have ghosting.  But it is only inside in artificial lighting.  I know my halos are greatly decreasing after 8 months.  But my inside ghosting and inside focusing problems remain. I guess we are pretty much in the same situation.  It depends upon risking explants, or the wait and see aproach. So hope your ghosting clears up.  My halos, circles, finally, finally,  improved. Best wishes.

[hud]

ghosting is a phenomenom, I believe, from not enough power difference in the add in the optic. When 3M owned the Restor lens, it had a 3.5D add, just as Rezoom does today. When Alcon acquired 3M Vision in the 90's, their R&D decided that more add (4.0D) would minimize these unwanted phenomena. The theory is that the brain needs more separation between the focused and defocused images with these bifocal implants. That is what is available today on Restor, and now AMO, the maker of Rezoom, has designed their next generation of multifocal with a 4.0D add. This is the Tecnis Multifocal that is expected in the US in 2008.

[gntr]

K-D - Thank you for your comments. Could you please give me a description of your ghosting image under artificial lights? In my case, I see the ghosted image of  the lights right below the original image. Brighter (indoor) lights make the ghosted image more noticeable and severe.

Hud - your explanation of how the optics work seem too complex for me to understand. I know from other postings in the forum that people with Restor lenses also have similar problems. Without debating which lens is better, is it possible to adapt to these unwanted images? Is the brain capable of ignoring this phenomenon? To your knowledge, has anyone (Rezoom or Restor patients) been able to see an improvement over time? Is ghosting a permanent problem?  Thanks.

[Ag-i-doc]

i disagree with the following statement posted by hud:

"ghosting is a phenomenom, I believe, from not enough power difference in the add in the optic"

i just dont thinkt ats true.  thats like saying the majority of overweight Americans are that way b/c they eat too many twinkies.  when in reality there's like 1500 factors involved with each individual weight problem, not just "twinkies".

ghosting can be caused by at least 10 different factors that i can think of off the top of my head.

[K-D]

My ghosting is inside under artificial lighting. It is a thick white shadow that outlines an object, especially one that reflects. I do not have it outside, just inside. I have had it for almost a year. My halos started to decrease starting my 8th month, and are slight now, where they were disabling at first. So, maybe the ghosting will diminish also.  I just really do not know. Alot of wait and see with a multifocal. Best wishes.

[jeepman]

I am confused. Has no one seen the same problem with Crystalens?

I have. It has been in since July 2005.
I am almost totally night blind in that eye and have been
since the time of the operation.

I had it implanted because of a cataract.
I told the doctor about it 4weeks after the surgery, and he
insisted that he had "never had this problem with crystalens before".
I was given pilocarpine to diminish the halos and minimize the
ghosts. In 30-45 days of constant usage of pilo, per his instructions, my retina
disconnected in April 2006. In July 2006, it disconnected two
more times(two weeks apart).

I am now 50% blind in that eye and am angry that I was never
told that pilo could "disconnect my retina".
This is the quote from the surgeon that has had to reattach
my retina three times, and says that I do not have a chance
for a fourth time.

I think a product action suit is now in order in my reading
of all the same problems that patients are having from these
lenses.

It is the same set of problems throughout these chat rooms, and
it seems to me that if all of the information was put together,
then the FDA might want to check up on what they have allowed
the American people to be subjected to without proper
warnings from the docs.

I still have to have a cataract removed and an implant in
the other eye, with the luck that I have been having so
far, I am not sure if I will be seeing with either eye in
6-8months!

Is there help out there?

Jeepman (angry)

[K-D]

I am`so sorry to read your post. All I can suggest is to get anoher opinion. Surely someone else can help you.

[jeepman]

Billeye
I am confused.
I am reading these rezoom lenses problems as if they
were the problems that I have had with the crystalens.
I know that this product has been defective since the
day that it was placed in my eye in July 2005.

The doc gave me drops a few months later to get rid of the
ghosts and the halos, because he had never seen any problem
like mine with crystalens.
The drops made my retina detach, per the second surgeon that
has put my retina back together for three times(once in April, and twice in July 2006).
My vision is only 50% and blurred in the daytime.
It is 10% to gone at night.

I am trying to initiate a med mal practice suit against the
doc that gave me the drops, because I was never told that
they can cause retinal detachment or I would have stayed status
quo.

I am also looking into a product liability suit against the
crystalens company and the drops mfg.

Not trying to hide the fact about these actions. especially
when I am now reading about the tremendous amount of people
that are affected by the same vision problems everywhere.

Hope all heals well for you.

Jeepman

[Susan12345]

At the very least, everyone with multifocal problems should report them to the FDA.  It is simple to do on line at FDA.gov.    Susan12345

[Ag-i-doc]

jeep:

the pilo/RD problem you had is not realy related to the crystalens implant and its symptoms.  i mean i know the doc gave you pilo to reduce your halos/blur, but other than that your halos/blur with the crystalens is unrelated to your retinal detachment.

the halo/blur is a commonly reported side effect of ALL multifocals, crystalens included.  more people here talk about restor b/c its more common, but the same or similar complaints are widely reported with every multifocal implant.

[ddtla]

I also have the ghosting problem. I had bilateral rezoom done 5 and 6 weeks ago. The halo isn't bad but it is not centered around the actual image, it is more inferior to the actual image.

My worst problem is the ghosting. I see ghosting if the object is beyond 2 feet from my left eye and if it is beyond 10 inches from my right eye. The ghosting for both eyes appears inferior to the actual image and gets larger with increasing distance. I see ghosting both indoor and outdoor. Again similar to Justwant2see, my reading vision would be much better if the ghosting does not overlap the actual image.

The ghosting in my right eye is larger when compared to my left eye. My gut feeling tells me that the lens are not centered.
My doctor looked at my eyes 3 weeks post-op and he said that the lens looked centered and that the ghosting is probably due to the multifocal nature of the lens projecting different images onto the retina and that is something that I may have to live with.
I was aware that halos and glare were possible complication for rezoom but I was never made aware about the ghosting.

I don't know what to do. I was hoping that the ghosting will lessen with time but now I am reading that people who are 8 months out still have the same problem.
I am planning to get a second opinion next month.

Justwant2see and gntr, is your ghosting image similar to mine as far as the location and the distance from the eye when the ghosting start to appear? Does your ghosting image get larger with increasing distance from the eyes? How is your vision now for far and near?
Mine is currently 20/20 distant for both eyes and for near it is J3 for my left eye and J5-7 for my right eye.
Also is your near vision better in a darker environment compared to a brighter environment?

[mlm343]

I've also had rezoom iol done Nov 3 dominant right eye and restor left non dominant eye Nov 7. I've got severe debilitating ghosting in the rezoom eye. The halos are severe as well but I expected them and they don't interfere with my driving. I've gotten used to them. However, the ghosting is another matter altogether, resulting in blurred vision 24/7. Worse indoors, worse in dim/low light, worse with high contrast, e.g. white letters on a dark green background or a black coat on a light background. Everything out beyond about 18 inches to two feet is ghosted. Even in bright sunlight the lines on the tennis court are ghosted, seem to diverge with distance. My left Restor eye vision is clear and sharp. Totally different. At least the Rezoom has given me excellent near and intermediate vision whereas the Restor is fine for distance but not near/intermediate. When last checked Dec 13 my vision was 20/25. Unfortunately I'm out of the country till April 1 and can't visit my opthamolgist till after I return. This forum has been incredibly helpful in knowing that I'm not alone and helping me research the probable causes. It will be interesting how my doc approaches this but as I understand it a wavefront analysis and/or slit lamp examination is the only way to accurately determine if the lens is decentered. Im hoping it is simply some additional astigmatism resulting from healing that can be corrected. I also have some posterior capsule opacity but the ghosting began BEFORE there was any problem with the capsule and it has not compromised my vision yet. I'm only 10 weeks post surgery so still have some hope that it will improve but am not holding my breath. I have read a number of articles and ghosting is mentioned but only in passing and as a potential result of healing, which is pretty wishy washy. At this point as I understand it the ghosting could be caused by:
1) edema/swelling after surgery
2) astigmatism developing as a result of healing after surgery
3) decentered lens

A Dr Michael C. Knorz in an article on Lens Exchange does address the issue of ghosting and at least recognizes it as a potential problem but offers no solutions.
www.crstoday.com/0605/CRST065_F10_Knorz.pdf

If anyone finds anything out there that addresses this problem directly I would like to hear about it.

[gntr]

ddtla - My ghosting is very similar to yours. Mine starts at 2 feet and expands with distance. The ghosting in my right eye is larger than the left eye. In general, your symptoms are the same as mine. I had my eyes checked yesterday - wavefront and slit light analysis. Everything looks fine (lenses are well centered). Any residual astigmatism is negligible. I have no edema or inflammation.  The doctor has given me three choices - live with ghosting (not likely to improve), replace the lenses with Restor or monofocal lenses. The doctor has done some research on his own and is finding out that ghosting is in fact a potential side effect with Rezoom lenses. I wish he checked earlier. I don't know where to go from here. I swish there was some positive feedback but I haven't been able to find any.

[K-D]

If you have any thought of an explant, it must be done before 3 months for safty.  I have only one Rezoom.  After getting ready for the second Rezoom, after the trial compairson program I was in  was completed, I was told that I have too much astigmatism for the second implant. Yet, it was the same pair of eyes that I walked into the office with. So,in a second consultation yesterday, I was told that at almost a year out, explant is very risky and could result in worst vision.  And he also recommended a monofocal for the right eye, although he admitted, it would be a different vision having a multifocal and monofocal.  So, I am left with risky surgery, or living with imbalanced vision.  Also, I am now developing the cloudy capsular bag which requires a YAG.  However, if I have the YAG, will make explant and new implant very risky and very, very, difficult to measure the proper lens replacement. Horrible delema.  So, with my now nearly blurred vision requiring YAG, which will lock me into no hope of an explant, horrible floaters from a PVD, and two different systems recommended in my eye, I am 20/ miserable.  Hope others have a better outcome.  The doctors needs to stop the sales pitch of seeing, near, far, and inbetween with a multifocal and concentrate on the risks. I was never told of the pupil dependence of the Rezoom that could make a person's vision fuluctuate constantly depending upon the lighting. Near, far, and inbetween without glasses. Bull. I would be happy to have one, which I believe the traditioal offers without all these miserable complications. Best wishes to all in their search of options to see the very best possible. I know there are many people that are very happy with their multifocal and accomodating lens. Unfortunately, many are not. And if not, it is very difficult to remedy.

[Dr. Crysta]

YAG capsulotomy is common in all lens explants irregardless of lens replacement type.  It is a very safe procedure and if done properly by an experienced surgeon you should be fine.  

Multifocal lenses by definition are abberated optics.  They split the light as it enters the eye.  Some patients tolerate the ghosting, many do not.  An accommodating monofocal lens would have been the better choice. (no light splitting). Work with you Doctor he wants the best outcome for you.

[K-D]

I was told by two surgeons that after YAG, it is very hard to get the right measurements in a replacement lens.  I was also told that after 3 months a lens exchange is very risky. Do you agree with this?  Shouldnn't a refractive surgeon know if you have too much astigmatism for a Rezoom before putting it in??  Also, if my vision is imbalanced with one Rezoom, would it not be more imbalanced with a Rezoom and monofocal?  At lease now I have more than one focus point with the cataract eye. With a monofocal, I was told I would have one focal point of vision.

[aimee37]

I'm new here and have found this site to be most informative.  I had the Rezoom done on my right less-dominante eye Nov. 7th and my dominant eye November 16th.  I was farsighted originally but developed presbyopia in my 40's. (I'm 50 now).  My dr. used to do the Crystalen but has since changed to Rezoom lenses.  I didn't even know Restor existed until I saw this site!  My distance and intermediate are superb (20/15 right eye) and (20/12 left eye).  You'd think I'd be thrilled, but I'm not happy at all with my near vision.  I work 12-16 hours a day at times on a laptop computer. My dr. was aware of this.  It was very important to me to be able to see easily at about 18"-24" away.  I can see the computer alright but my eyes tire easily.  My left eye doesn't see black type as dark as my right and I have ghosting and bleeding of text which makes it difficult to read for long.  I have mild astigmatism (I believe they said .5 in left eye & .3 in my right).  COULD THIS BE CAUSING MY DIFFICULTY TO FOCUS CLEARLY AT THIS DISTANCE ON THE TEXT ON MY LAPTOP?  From everything I've read, maybe he gave me the wrong lenses if Restor lets you see better up close.  I don't think he does that type though as he never mentioned it.  I didn't even know what type of lense he was using until after the surgery!  He is well known and has been using these implants for over 7 years...he even does all the eys for the NFL team in our state and speaks at many eye conferences nationwide...so it's not his credentials...but I am so frustrated.  I was never told about ghosting either NOR that this is more likely to happen with the Rezoom lense.  I told him I was having a hard time reading on my computer and he said to try to just go for two more months without using anything to cheat.  If, after two more months I still have problems, he will give me very low .75 cheater glasses to wear while I work on my computer.  This is NOT why I spent almost $10.000.00!!  If I wanted to wear glasses to work on my computer then I would have saved my money and just continued to wear my glasses.  It IS wonderful to have this great distance vision, but I needed the near/intermediate vision more than distance.  I told them that before surgery and after all the extensive testing they did, I trusted him to choose the right lens.  Did he give my the wrong lens for my needs or am I being too hard on him?  I do have a couple side effects that I need to ask you all about.  One of them is NEVER mentioned on here and I was told by my Dr. that this is "inherent" with ALL lens implants...here's what's happening.....

1.  At night, mostly indoors when an overhead or any other light source hits my eyes AT AN ANGLE (left eye mostly) from either above me, below me or from either side, I can actually see the rings in the rezoom lens.  Depending on how the light is hitting, bright white, curved lines with little starburst lines though them appear.  When I move my eyes around they move, too.  Dr. said it was the lines in the different lens zones and that it was normal and that I should just try to "ignore" them.  Has anyone else had this???  If so, do they go away?  Please, if anyone out there can help me, it would be greatly appreciated.  

2.  Would correcting my astigmatism via lasik allegretto help with my focusing on the computer, the ghosting or the curved lens lights reflecting back into my eye?

Thanks so much and hope someone can give me some insight.

[aimee37]

There have been a lot of recent posts relating to multifocal problems.  It would be worth your time to  read these threads.  I have monofocal IOLs, but I'll try to address your concerns based on what I've know.  ReZoom is supposed to be better for intermediate (computer) and distance vision; ReStor is supposed to be better for near vision.  There seem to be a lot of unhappy recipients of both lenses.  Many people posting on this forum need to wear glasses over their multifocal for near/intermediate vision.

You have very little astigmatism.  Does your doctor think that laser vision correction would improve your vision?  Maybe you should get a second opinion from a doctor who is very experienced with multifocals.

This is an old thread, and I'm afraid that many people won't see your question.  You might want to re-post it as a new question.

[aimee37]

Thanks, Jody.  I will try reposting as a new question.  I appreciate you input!

[aimee37]

It is almost three months since I've had Rezoom implants.  I am so upset at the fact that I spent almost $5,000 to have ghosting when I watch t.v., in my classroom where I teach, in gymnasiums when I watch my students play sports and many other places.  I also am having a very difficult time with large rings around lights.  This is almost a nightmare at night.  I see huge rings around car lights, streetlights and signs.  I have to be very careful when I drive at night and do not take other people with me.   I've been told to be patient, it will get better.  My reading has improved a little, but I still need to wear glasses in my classroom and at the computer.  I  was told I may experience halos, but these rings are more than halos.  I was never told about ghosting  at all.  I really believe I have been misled about how wonderful the Rezoom lenses really are.  I feel like this has been the biggest and mostly costly mistake of my life.

[Hijack4242]

A related discussion, Crystalens was started.