Rezoom both eyes or Rezoom/Restor Combo?

[Mosesandre]

I had cataract surgery in my right eye on 11/7/06 with a Rezoom lens implanted.  I have surgery for my second eye scheduled for 11/28/06.  I also have astigmatism in both eyes, and my treatment plan includes follow up Lasik surgery two months
after each cataract surgery.  My goal is, of course, to get the best possible outcome and independence from glasses.

At this time (6 days after my first cataract surgery),  I have much improved distance vision, but some fuzziness at both intermdiate (computer) and near (reading) distances.  It's
almost like I had a monofocal lens implanted.  I have had no serious issues with halos.  The Rezoom was Model NXG1 and my right eye measurements are Diopter 14.5 D, Phi T 13
mm, and Phi B 6mm.  I spoke to my eye doctor today, and he said that the correction for astigmatism should sharpen my intermediate and near vision as well as the distance vision.

My main question/concern is which lens to have implanted in my left eye (Restor or another Rezoom).  I currently have about 20/25 vision in my uncorrected left eye and want no poorer near vision than that.   My eye doctor said that picking the lens for my left eye is a bit of a shot in the dark.  Restor would likely give me the best close vision but having different lens in the eyes has drawbacks.

I welcome your input.

[Forum-OD-MP]

sorry!  i'm sure one of the other docs and or implant reps can reply.  many opinions on this.

[Mosesandre]

Thanks Hoddy44, having the combo Rezoom/Restor was my tentative plan.  I do a lot of computer reading and went for the Rezoom in my dominant eye primarily for that reason and the great purported distance vision.  I also read about the Restor being possibly too close for near vision in this forum.  I figured that I would be able to evaluate the Rezoom lens before my next surgery.  It's interesting to note the contrasting results reported for the various lens.  Most accounts I have read on this forum seem to indicate excellent intermediate vision for Rezoom, and I have not gotten this effect yet.  I'm not sure how much my astigmatism is influencing the results.  I plan to visit my doctor next week to determine how well I would see out of my Rezoom eye with glasses correction for astigmatism to approximate what the Lasik correction would give me later.  Could anyone tell me the downside to mixing the lens across eyes.  Some folks claim that it gives you the best of both worlds.  Hoddy44, I'm sure this is something you thought about.

[K-D]

It is too soon to tell about you final result.  My initial result with my Rezoom was, great reading and intermediate, and poor distance.  That changed to great distance and intermediate and reading in low lighting.  I am interested in the combo too, but have a concern because it is not FDA approved.  Best wishes.

[Mosesandre]

Hoddy44 and K-D, Thank you for your helpful comments about your experiences with the lens.  My doctor did not mention pupil size as a factor to consider when picking a lens.  It's definitely something I will ask him next week along with whether delaying my second surgery is a good idea.  

K-D, it's interesting how your vision changed so significantly over time.  Were these changes all for the better?  Also, do you have Rezoom in both eyes now?

Thanks again for youe great comments!

[K-D]

I have a Rezoom in only one eye.  Long story as to why only one eye.  Doc changed from bilaeral implants to a Rezoom and monofocal after a comparison program that I was in was finished. I had a reduced rate in the program.  Cannot agree to Rezoom and monofocal plan; so still have to decide what to do about the other eye.
My Rezoom completely changed for the better as time went bye.  At first I could read the smallest print.  Intermediate was always good.  But distance not good.  It took 3 months for the lens to settle in place, and before my PVD, had perfect vision with the Rezoom.  As others have stated, Rezoom is better for distance and intermediate and need reading glasses if the light is not dim.  I did want to tell you that Rezoom is pupil dependent. I did not know this. I understand that Restor is not pupil dependent.  When my pupil dilates, things blur in the distance.  When my pupil is small, perfect vision for distance and intermediate and reading varies.  Hope this helps you.  Know what a difficult decision it is to make. You are so fortunate not to have problems with the halos.  After 9 months, I am just beginning to see some improvement.  At first I saw halos on people's glasses, watches, anything that shinned. Was so unexpected.  That also has greatly improved, altho I still have large halos in the distance.  Can drive safely now.  At first the car in front of me had halos that covered the whole car. Dangerous driving.  Now the car in from of me has no halos, but ten cars down have large halos as well as the street lights in the distance.  Hope this helps you.  Best wishes.  Kady

[eyecu]

ReZoom has better distance and intermediate. Also has better reading in low light versus Restor. Only place ReStor has better vision is in brightlight. ReZoom better reading in low light. This just came out in a recent study. That is why mixed or blended vision with both lenses is becoming popular. Pupil size is important with all mulit-focals.

[Mosesandre]

Thanks everyone, your comments are very helpful.  Could anyone enumerate or comment further on the problsms or downside associated with mixing Rezoom and Restor?  I still am getting no further improvement in intermediate and close distances, but my astigmatism may be responsible at least in part.  I should know more after next Monday when I will look through lens intended to correct for astigmatism.  Any feedback about the drawsback with mixing would be appreciated?  Has anyone out there had a Rezoom in one eye and Restor in the other?  If so, how is it working for you?

[MDAZ]

About a year ago  I was given advice to have ReZoom/Restor combo.Not much was known about it then. Now it seems it might be good idea to mix,(for some patients).
    I was impressed with Sandy's 243 results,and would like to know who did the surgery and where.  Also would like to hear about recommendations in Phoenix,AZ area.
      I am considering having it done now, although I wonder if it is worth waiting for ReZoom/Tecnis ZM900 combo, when it becomes approved.

[K-D]

What is the Tennis that you are referring to?  Is it a multifocal?

[MDAZ]

Yes, Tecnis ZM 900 is multifocal.

[JodieJ]

The Tecnis multifocal (manufactured by AMO) is still awaiting FDA approval, although it is currently being used outside the USA.  It reportedly provides near and distance vision which is similar to ReStor.   One report states that a ReZoom/Tecnis combo produces better computer vision than ReZoom/ReStor.

[K-D]

Thanks much Jodie.  Maybe my waiting to do the second eye, will in the end work out better for me, as new products become available..

[Tony12]

I had the Tetraflex Accommodative lens put in both eyes, the right was done nearly 3 weeks ago and the left just 5 days ago. I have excellent vision now for reading, computer work and distance, but what is more amazing is I experience no halos at all at night. I believe it is still undergoing trials in the USA (i'm from the UK). My surgeon told me he will only use these lenses now, mainly because they are halo-free, and I have been reading similar stories on the web. They work similar to the older Crystalens i.e. they use the eye muscles to change the shape of the lens and move it forwards during accommodation, but the Tetraflex works better as it doesn't use a hinge like the Crystalens, so it is more like the natural lens. Also the Crystalens has problems which the Tetraflex hasn't got, the main one being that instead of moving forwards for near vision it sometimes moves backwards. So it is well worth considering this lens for the future.

[K-D]

No Halos?  More than a little envious.

[JodieJ]

Your results are marvelous!  Apparently your lenses don't require the 9-month adaptation time of the multifocal IOLs.  Unfortunately, even though the Tetraflex was invented here in the USA, it's not expected to be available here until 2008.  I guess if money was irrelevant (ha!), we Americans could take a little trip to the UK or Australia and pay for the surgery and IOLs out of pocket.

[Mosesandre]

Hi Everyone,

Just wanted to update you concerning my trip today to the eye doctor.  Recall that I had Rezoom implanted in my right/dominant eye two weeks ago and needed to decide about what to do with the left eye.

I read the previous comments about the Tetraflex lenses with great interest.  Unfortunately, as was just pointed out, these lenses will not be available in the U.S. for at least a few years.  They sound like something close to the Holy Grail for those of us with cataract problems.  Hopefully, they will hold up well after clinical trials.  I had rejected Crystalens as an option due to limited purported accommodation and safety concerns I had about possible extraction.  The Tetraflex lenses appear to have remedied some of these issues.

Fortunately, for me, I have not had serious problems with halos in my Rezoom eye.  The main issue with me is the limited improvement in intermediate and close distance vision in that eye.  I also have a 1.5 issue with astigmatism in each eye.  

During my eye evaluation today, I learned that I currently have 20/20 distance vision in my Rezoom eye.  Simulated glasses correction designed to fix the astigmatism improved my vision at various distances, but not enough at close range for me not to benefit from the Restor lens.  My doctor felt that the Rezoom/Restor would be the best way to keep me free of glasses under different lighting conditions.  I should have excellent continuity across lenses for distance vision, and my brain should adjust to accommodate for the differences in vision at other distances.  Both lenses are uv protected.  He did not think that the Tecnis ZM900 lens was a better choice than the Restor for me.

I asked him about whether my pupil size was limiting the effect of the Rezoom lens in my right eye.  He said that my pupils were a bit on the small size but not enough to negate the benefits of the Rezoom lens.  He also said that potential halo issues should be of even less concern when both lenses are implanted.  

My doctor also pointed out that astigmatism correction would still be needed to get the best possible results and recommended that this be done at least two to three months after lens replacement.  He saw no compelling reason to delay the cataract surgery for my left eye.  Fortunately, for me, Lasik surgery for astigmatism was included as part of the extra money I paid for having the multifocal lenses.  My doctor said that postoperative Lasik surgery is much more accurate in eliminating astigmatism than are muscle relaxing incisions during or after cataract surgery.  I checked out various clinics before having my surgery done.  Most included the muscle relaxing incisions as part of the deal but not the Lasik surgery.  That was a big factor in me choosing my clinic along with the good reputation of the doctor.

So, at this point, I'm putting my fate in the good doctor's hands and hoping all goes well.

    

[JodieJ]

Laser vision correction is supposed to be the most predictable way to correct astigmatism.  And despite some advantages of the Tetraflex lens (e.g., lack of halos), results of the clinical trials suggest that ReStor gives better reading vision.  Best of luck with your second eye, and let us know how you're doing.

[Mosesandre]

Thanks Hoddy44 and JodieJ,

Your comments give me increased piece of mind.  I'll keep everyone posted following surgery next week.

[heyEm]

Emily, new kid on this block, here.  Late January is set for a ReStor implant in my worse eye, with ReZoom or ReStor following
2-4 weeks later in the dominant eye.  Goal:  independence from
glasses (which I've always hated) and contacts (which are no longer strong enough for use without magnifying glasses added).  BUT I don't have cataracts, so this is purely elective surgery.
I am very excited about it and have only good feelings even with the understanding of having to go through the whole process.

I'm in my early 50's, no medical conditions, no astigmatism, went into glasses for reading about 10 years ago...then 4 years ago into monovision contacts in anticipation of an under-and-over correction Lasik procedure which I never bothered with since the contacts were acceptable.  I'm thinking that I should get the implants taken care of now - before I develop medical contraindications, and when I have the time.  Any input?  Anybody out there who has had this procedure without cataracts?

In north NJ and have selected a surgeon after seeing three... Hoddy,did you see anyone in my neck?

Thanks!

[Mosesandre]

Hi again everyone,

Just wanted to report on my experience with the Restor implant in my non-dominant, left eye, following implantation of Rezoom in my dominant, right eye three weeks earlier.  It has now been 29 days since the first implant and 8 days since the second.  My distance vision is great with my right eye and better but still a little fuzzy with my left eye.  I have not gotten the anticipated intermediate or near distance vision with either lens.  This was a little surprising as Restor is supposed to provide the best near vision of all the multifocal lenses currently available.  Fortunately, I still am not experiencing any really significant problems with halo effects.  I am hoping for independence from glasses, but at this time have to use drug store reading glasses to read books or computer screens

My doctor believes that the source of my problems with intermediate and near vision is the astigmatism I have in both eyes.  The astigmatism is a little worse in my left eye, which is consistent with the somewhat poorer distance vision with that eye.  I had had nearly perfect close vision in my left eye before cataract surgery.

I will be having Lasik surgery to correct the astigmatism in each eye within the next few months.  I'm hopeful that this surgery and healing period will remedy any remaining issues with my vision.

I am 55 years old and had pretty bad cactaracts, especially in my right eye.  I really needed the surgery but have lost some near-vision acuity in my left eye, at least temporarily.  I'm not sure whether I would have this kind of surgery if I didn't have cataracts.  Results do vary person by person.  New and potentially better multifocal lenses are also being developed and tested.  I read everything I could find about multifocal lenses and consulted several doctors before making my choice of the Rezoom/Restor combination.  I think that I made a reasonable choice, but will not know for sure until I have had the follow-up Lasik surgery.

[mlm343]

I also had rezoom in dominant right eye Nov 3 and restor in non dominant left eye Nov 7 and am 33 days post surgery but my results have been different. However, I don't have any astigmatism which might be part of reason for different outcomes. Hopefully once that is dealt with your near and intermediate vision experience with the rezoom in dominant eye will be similar to mine. I've had great results with near and intermediate vision with rezoom lens in dominant right eye and was reading the paper and working on my pc within hours of rezoom implant, even with only one "good" eye.  Only downside of rezoom at this point is really severe ghosting. Anything beyond two feet is a problem. I expected the halos at night and can live with that but the ghosting was a total surprise. Worse indoors and worse in low light. Restor has not been satisfactory for near vision which surprised me as I thought it was supposed to be superior for both near and distance. It has been great for distance, clear and crisp. No halos and no ghosting with the restor. If I can get rid of the ghosting in the rezoom eye I'll have best of both and be really happy but it could take months according to the research I've done. However have already achieved my goal of being free of glasses. The combo has definitely given me good near, intermediate (rezoom) and distance (restor) vision although results totally subjective at this point. Will see the doc on the 13th and get some accurate numbers.

[Mosesandre]

mim343, Thanks so much for relaying your experience with the Rezoom/Restor combo.  I'm soory that you are having problems with halos and ghosting.  I occasionally see a gold ring with my Rezoom lens that is not linked to a particular light and disappears if I tilt my head a certain way.  I mentioned that to my doctor and he said that he had not heard that one before.  I don't get that effect with the Restor.  Lights in general are brighter than before the surgery, but not that much different from what I was seeing before cateract surgery.  All and all, I think I'm pretty lucky with having minimal effects with halos.  I hope that don't change after my Lasik surgery.  My doctor feels that I should wait at least three months before having that surgery.

Your good results with the Rezoom lens are encouraging to me.  It seems that the pattern of vision I have now is consistent with astigmatism effects and the nature of the lenses.  I am not getting great close vision with either lens yet, but it is better with the Restor, especially in good light.  I have been using drug store reading glasses for computer work and reading very fine print.  I also have noticed gradual improvements in intermediate and close vision since the initial surgery, but not as dramatic as the distance vision results.  I am still using drops in my left eye and will continue to do so for two more weeks in reducing quantities.  I suspect that might blur my vision some.

I hope that your halo/ghosting issues disappear over time and that your near vision improves with the Restor lens.  I understand that it may take some time for the brain to adjust to all of these changes.  Please keep us posted regarding your progress.  I will do the same.

[JQB]

I had a Rezoom implanted in right eye non dominate on 12/11.  Diopter 19.5D, T:13mm,B: 6mm. No cataract in the left eye yet but need 1.5 readers for it. Not sure if my gold ring is the same as yours... it's a wispy thing with faint spokes that seems to hang a few feet out from my head - goes in and out when I turn my head.  Real weird hits more at night particularly when a light shines from above or from side.  Maybe some people are calling this ghosting? Does anyone else have this issue - is it expected to go away?  Could it be a lens surface defect?

Other than that I can see 20/20 far and near in the new eye - computer vision two feet out good, but near vision clear only if I hold the fine print exactly 12" out from face - moving it in or out blurs vision.  I also have the bright headlight halo on left side of lights - could this be due to astigmatism?

[Mosesandre]

Hi JQB, the ring you describe is exactly what I'm experiencing, and I'm also uncertain whether this is what people mean by ghosting. I have been noticing the ring somwhat less as time goes by, but saw the nasty thing again tonight while walking my dogs.  The quality of vision you are getting from the Rezoom lens seems better than mine and in line with its purported advantages of those lenses (good distance and intermediate vision).  I had the Restor implanted in my other eye to deal with close vision.  I had much better close vision in that eye before surgury but wekaer distance vision.  Astigmatism is supposed to wreak havoc with multifocal lenses and my experience is consistent with that.  My doctor thinks that all my problems will go away after Lasik usrgery to correct astigmatism.  He wants to wait at least three months though.  My close and intermediate vision have not improved much yet since initial surgery (11/7 and 11/28).  I would ask your doctor about whether astigmatism is an issue fir you.  Hopefully the other stuff will abte over time.  Thanks for commenting!

[K-D]

Speaking for myself, I would never, ever, have multifocal implants without cataracts.  If you read more on this board, you will see that this procedure varies greatly from person to person.  Those of us that could not see due to cataracts, had to have a lens implant.  But you need to think long and hard about your decision, when not having cataracts. Once your accomodating lenses are removed, there is no getting them back. And there is no guarantee with the surgery.  And reading this board, there are many miserable multifocal posters.