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RsStor vs Resume IOLs

Faced wtih question of Restor or resume.   How can I compare the two, to help me decide?  Is there a web site with a comparison chart?   Thanks
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Avatar universal
WOW-
     This forum was brought in to my office by a patient.  I have reviewed most of the posts since early december.  I am an eye surgeon. I HAVE NOT had cataract surgery.  I HAVE NO INVESTMENT IN ANY OF THE COMPANIES MENTIONED.   I am therefore free to choose which intra-ocular lenses I use based on their own merits.
     The posts on this forum are quite interesting.  I am impressed by the amount of information which everyone is reporting.  I must say, however, that I found "hud"s comments concerning.  His first post that I read came across as this investment banker that reportedly had all of these "facts" about the restor lens. Later posts revealed that he actually has had restor implants himself and has 'a little bit of information about the real world of ophthalmic microsurgery".  It is this type of posting that I would like to address.  Hud's posts failed to reveal initially that he actually has a bias to his "reporting" in that he has restor implant and I would bet is also invested in either Alcon, Nestle, or one of its' subsidiaries.  When I attend professional meetings the FIRST thing that is revealed by the presenter of a paper is whether or not they have such a bias which could possibly interfer with their "objective" analysis of the results.  Having said this let me share some thoughts regarding these lenses:
     1) I have used the Array lens since it was approved.  This was, and still is, a great lens.  It was probably ahead of its time because a lot of eye surgeons did not have the skill necessary to remove a cataract and leave the patient with minimal astigmatism and neither near or farsightedness. Multifocal surgery is MUCH MORE than simply putting in a multifocal intra-ocular lens.  ALL the multifocal lenses will produce some halos at night.  The Array did also.  The Rezoom lens produces substantially LESS halos than did the ARRAY.  
     2) The Restor lens concept was originally produced by 3m.  Many of their lenses were implanted world wide but the lens was never approved by the FDA. This lens was never produced on a "foldable" platform.
     3) The Crystalens was born from an analysis of cataract patients that had a "plate haptic" intra-ocular lens implanted.  These patients had better near vision than other ihtra-ocular lens patients.  Certain investigators learned that there was a minimal amount of movement of the lens in response to muscle activity within the eye.  The Crystalens near vision, then, is conditional upon the intra-ocular lens being able to MOVE within the eye.  While this may occur to a limited extent it can also be lost subsequent to cataract surgery and does not produce as good a near vision as any ot the other "multifocal" intra-ocular lenses.
    What is a cataract patient to do?  My advise is to find a good SURGEON.  Rather than spending a lot of effort on the LENS you want spend as much effort of finding a good surgeon who will answer your questions.  Explain to him/her  your desires for spectacle lens independance and arrive at a choice with them. For me, in the future, it will quite possibly be mixing different technologies between the two eyes.  This does not mean one company is admitting the short comings of their lens (note HUD) it is simply taking advantage of the two different technologies.
    Having said all of the above I will state that while I can use ANY of the lenses without bias I tend to use primarily the Rezoom lens.  The reasons have to do with the company...
     AMO (the company that distributes the Rezoom, now owns Visx, now owns the Verisys lens, recently purchased Pharmacia, etc) was "spun off" by Allergan.  The company was not "dumped".  The reasons had to do with Allergan wanting to spend research dollars on intra-ocular lenses while investors wanted more "drugs" because that was "where the money was at".  AMO has done nothing but grow since this change.
     Alcon, as HUD has suggested, is a large reputable company.  I cannot be concerned about whether Nabisco, or Ford Motor Company owns a large part of them. I have used many of their products through my career.  I might share, however, that they use different marketing strategies than some other companies.  For instance, their instrument that removes cataracts will retail for over 100,000.  Commonly they will drastically cut the price of that instrument in exchange for the surgeon using their lenses exclusively.  I run away from agreements like this because they bias my selection of intra-ocular lenses.
    Support from the company is very important to a surgeon.  Throught the years I have seen Alcon abandon the service and production of Opthalmic office support software (the IVY system), abandon the service and production of ophthalmic ultrasound instrumentation (used for determining IOL power at cataract surgery), abandon the service and production of the microlamellar keratome (the flap maker at the time of cataract surgery), and perhaps other products.  Because of these issues I tend to avoid the company.  They do make a good multifocal IOL.
     Having just posted a long letter on multifocal IOL's I would like to encourage people to share their experiences and also to reiterate that they should place their efforts on selecting their surgeon-- then allow him/her to suggest what is best for YOU--after all this is what you are paying them for.
                                   John Sonntag, MD
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Avatar universal
This is an interesting dialog as I had the Rezoom IOL installed in my left, non-dominant eye only three days ago and am scheduled to have the other eye done with a Rezoom lens in 11 days.  I see very well to drive and am typing this without reading glasses.  But I am a 64 year old high myope person in both eyes (-9 diopters left and - 10 right), and I am using a contact lens in my right eye for distance. With both I am able to read the computer screen and newspaper without reading glasses.  But if I shut my right eye, the screen blurs for a while before the eye focuses enough to read but not sharply.  This is bothersome to me and a concern.

So I am still open as to how well my left eye Rezoom is working near and intermediate because of this.  The doctor in my post-op exam 2 days ago said to give it a few days to adjust and I am.  The idea of having a Restor lens in my right eye to improve near vision is intriguing, but it seems distance suffers.  I play a lot of tennis and do a lot of hiking where I want good distance vision, and as a monovision contact lens user, I know that does not work for tennis.  So unless I hear differently, I sense that another Rezoom lens in my dominant eye, as recommended by my doctor for high myopes like me, is right.  Agree or disagree?  Stay with Rezoom on Feb. 24 or not?
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Avatar universal
Dr. John:  Excellent points.  I am down to 2 surgeons with excellent reputations.  The dilemma in lens choice is this:  one surgeon recommends REZoom , the other Restor lens.So, as the patient, I am taking  the initiative to learn as much as I can and then make a decision. Since I am under 45 y. old,I have to guess what kinds of activities I will be doing in the future to decide which lens would be most appropriate.One surgeon implants BOTH lenses, the other surgeon only implants RESTOR lens. There is an entry CATARACT 49 who has just had the Rezoom implanted and has been giving some valuable information re: his recovery process and what it "looks" like through his eyes. Unfortunately, the thread we were having a conversation on ,is now "full". I hope he continues to let us know about his progress.
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Avatar universal
I agree with your doctor and you should carefully consider his advise and recommendations. I am having my second ReZoom done tomorrow in my R/E after considering all the options in consultation with my surgeon.  Also, remember that you just had mircosurgery in you eye several days ago where they cut the side of the cornea, stuck a surgical instrument in the side of your eye, blasted the cataract away with ultrasound, irrigated the sac, sucked out all the remains of the cataract, inserted a folded lens, centered it and patched you up.  In addition, I'm sure you surgeon has you on various meds such as for pain, swelling and other things associated with cataract surgery. All of these meds also affect your close and intermediate vision. Your eye(s) will take a period of time to heal, recover and adjust.  Following is an excerpt from the ReZoom brochure."

" Q: Does the ReZoom Multifocal lens require and adjustment period?
  A:  Yes. For most people there is a period of weeks when you brain is learning to "see" up close and at a distance with the new lens. The adjustment period is usually complete within 6 to 12 weeks,  Also, like all multifocal lenses, some people report halos or glare around lights.  Again, for most people this diminishes over time.  For some, it becomes less troublesome but never completely go away.  Most people report that the ability to see near and far outweighs any and visual side effects associated with the lens."

Give it some time philz and I'm sure things will work out. I'm also your age and play golf, tennis and want the best vision possible at my station in life.  Will let all know how the next surgery goes by the end of the week.

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Avatar universal
I definitely recommend ReZoom over ReSTOR for your second eye based upon your activities. Intermediate (computer) is important to you and certainly for tennis ReZoom will give you much better distance vision than ReSTOR. Let us know!
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Wow, this is such an interesting thread.  I have Crystalens in both eyes since end of last year.  Although I have developed floaters in one eye which blur my vision alot, my distance and intermediate vision is very good.  Reading is coming along ok when the floater floats out of view.  

I can really identify with the person who mentioned the intense colors.  I also am amazed at the bright white!  I thought the entire world was sepia colored! I really had no idea that the cataract had "yellowed" my vision so much.
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Thanks for in-depth explanation posted on 2/10/06 of the various options now available.  I asked my surgeon about a ReZoom/Restor combo in my case after doing other research and and reading recent threads.  He recommended based on my lifestyle and station in life that I stay with a ReZoom/ReZoom.  He offers all three of the IOLs as options to his patients but likes the results of the ReZooms for us mature folk that are 60+. Overall, I got the impression he favors the ReZoom over ReStor. My first ReZoom in L/E was done on 1/25/2006 and my vision continues to improve at intermediate and close.  Distance vision is spectacular with clarity and color I haven't experienced in years.  The IOL was a ReZoom Model NXG1, Diopter 19.5D, SN 4109700512.  I am scheduled for surgery on the R/E (My Dominate) on 2/15/2006 where a ReZoom Diopter 19.0 will take the place of an old cloudy cataract.  Will let all know how things are going by the end of the week.
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Update:  My distance vision still has not shown much improvement, (but only three days).  However, my eyes are really working well together with the left Rezoom and the right Restor.  The only way I can tell that the right eye does not see distance is when I shut the left eye, otherwise, I can see distance just fine as if I were using both eyes to see.  I can see well at all distances.  I only require glasses if I want to do close intense work like sewing.  BB

I just wonder how this compares to monovision.  Anyone know?
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the chart that the doctors use for reading has those numbers...J1 is the standard for normal reading.  I will keep you updated..bb
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paulb-it looks like bjbnfl is going to give you a first hand experience on the combo.There are two theories. Put the same lens in both eyes for a stereo effect. The other theory is that if you put a lens in an eye and the patient complains of halos than if you put another one in it compounds that effect. If you put two different systems in than it offsets and you don't have the problems.One well respected surgeon says to implant the Rezoom in the first eye, if the patient likes it implant it in the second eye, if he has halos than implant a Tecnis monofocal in the second eye, if he wants better near implant a Restor. There are just so many opinions. I know a few surgeons that have Arrays themselves and they implanted alot of Array lens because they could explain and relate to the patient. But most surgeons have to go by results and listening to what patients tell them and describe to them as this board does to form opinions. It is exciting yet confusing. This is what I will say, the ReZoom is great for distance and intermediate. It can also provide good near vision. Not as good as the ReStor maybe because it has a 3.5 diopter add and the Restor a 4 diopter add. You have trade offs in life. If you want to read better, than you give up some distance acuity. The Crystalens had great distance but you give up near. Technology is advancing to try to mimic the crystalline lens and will get better. But the technology today is excellent and has brought youth back to many people. With a monofocal lens, the outcome is presbyopia. YOu will love the colors and be happier and have great distance and even some intermediate and will notice a great improvement over your vision with a cataract as you have had a gradual deterioration of vision over time until it gets to a point that it bothers you. When you have surgery, the vision is so much better you wonder why you waited so long. The retrospective quality of life studies report that patients are happier with multifocal lenses because they mimic normal vision. They are willing to deal with a few visual disturbances such as halo that diminish over time as you adjust. These are really only at night as the pupil enlarges and have to do with ligthing conditions.But they say, hey I can deal with that for what I get during the day. There are some patients who cannot seem to deal with it but it is a low percentage. They end up with lens exchange. But there are even patients who once they have had the exchange want to go back to the multifocal. It is up to the surgeon to explain and deal with that and that is why it costs more becaase they have to spend more time with you both  pre-op and post-op. It comes down to patient education prior to surgery which puts you ahead of the game because you are trying to get the answers now instead of jumping into it. I personally would opt for a multifocal lens becuase I want to have pseudo accomodating vision like when I was in my 30's and have a chance not to have to wear readers if I forgot to bring them to the restaurant. I want the freedom. But, if I was used to wearing glasses all my life, then that would not be the case. SO you can see all of the factors involved in the decision. The surgeons that have used the Array and do lasik and are refractive surgeons have more experience than the ones that just came on board. They are ahead of the game. They also might be hesitant to jump on ReZoom because they think it is about the same as Array so they try something else for a while and then realize that it is not perfect as well and then try ReZoom and find out that it is better than they thought. They then try mixing technologies and find out that works pretty good as well. The bottom line is what are you looking for, what is your occcupation and hobbies and what are you trying to obtain. If you both go in with a postive outlook and try to achieve that outcome to meet your needs, and he or she hits the refractive goals and accuracy, you will be very happy. Sorry for being so verbose. I feel you are just lucky to have more options today to find what you want.
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BB
Glad to hear your operation was a success and you're pleased with the R/R combo!!  Sounds like you are having NO problem with the "brain control" of complimentary focusing from near to intermediate (left to right eye or right to left eye).   I'm thinking of Rezoom in the Dom eye and Restore in the NonDom eye, and my ability to accomodate the "switching" at near and intermediate is the big fear.  Your results are giving me more faith / courage!!  Let us know how you're progressing!  PB
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It has been less than 24 hours since my surgery.  I had a check at the Doctor's office this morning.  With the Rezoom in the left eye I have 20/15 (brightly colored vision) and with the newly implanted Restor in my right eye, I can read J2 with the right eye alone and J1 with both eyes working together.  If I shut my left eye and look off in the distance, my vision is not that great with the right eye Restor but with both eyes open, I have no problem. I am using the computer with my flat screen monitor about two feet away and I can see the small writing with both eyes working togehter or seperately.  My Doctor feels that the Restor distance vision will improve over time but will never be as good as the eye with the Rezoom.  I am amazed that I can see close so well so fast because of the Restor.  I am curious and I ask the Doctors on this thread, how is the intermediate (1-2) feet vision with a regular lens implant?  

I would never want to give up the crisp wonderful distance vision I have with the Rezoom.  So far, I believe that I have made the right choice.  BB
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PS... sorry to be slow on the vocabulary, but what exactly is J1 and J2 ???
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Thanks for the thoughts.... so if I understand, to get the Rezoom done first, I would have to do that in the Dominent eye. Then If I'm ok with the reading, I could do the NonDom with Rezoom, and if I wanted a better Reader, I could try the Restore?  After reading several boards, I'm "put off" a little by the Restore anecdotal stories... the mid range blurring and an occasional report of "wax film" at distance worry me, and the nightime halos are a major fear for me, since at 50 I still do quite a bit of nite driving.

But I haven't read anything pro or con about the binocular adjustment problems of using Rezoom and Restore... seriously, would that be an easy adjustment??  With Restore being Strong at 12" and not so good at 24, and vice versa for Rezoom, am I setting myself up for Frustration or should this be easy as blinking?
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PS... I'm definately going to call the surgeon tomorrow for a list of people who have done the R/R combo!  Thanks
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Not Dr. S in Jax...I had surgery today.  My eyes are still dialated, so I cannot report anything right now.  Surgery went well though...more later.  bb
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I will definitely let all know how the two lenses work together.  If this board is full, I will post under a new topic that will be something like: restor in one eye and rezoom in the other. BTW eyecu....thanks for the post.  I already had the rezoom implant in my left eye and was supposed to have another rezoom in my right eye.  Since I did not like my close vision with the rezoom I suggested to my doctor that he do the combo.  My brain seems to adjust to either eye for distance and/or reading.  He is an excellent surgeon....with excellent credentials and about 15000 cataract surgeries performed...(we get a lot of those here in Florida).  I will be his first patient to do a combo, he told me that immediately.  I know he would not do this if he did not feel he could or should do it.  He knows me and he implants both rezoom and restor lenses...just never on the same patient.  I have total confidence in him and he has worked with me on this whole thing all the way since day 1.  More Friday or Saturday...bb
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paulb-There are quite a few surgeons using the combo approach of all three lenses. They are saying that they are getting very good results.  The Rezoom in the dominant eye is the what most recommend for good distance and intermediate and the restor for reading in the non dominant. The ReZoom allows for better distance acuity, reading in low light and intermediate. The Restor for reading in bright light so you have pupil size coming into play depending on lighting to give you the benefits of both lenses. You will find happy patients with all scenarios. I would quiz the surgeon who is recommending the combo and find out how many he has done and see if you can speak with some of his patients that have had this done. The ReZoom does have 20/20, J1 plus for reading in some patients. Some think you should go ahead and have the ReZoom implanted and if you are happy for all distances and not bothered much by halo than have the other nondominant eye implanted with it and you will be fine. If you are not happy with the reading, then get the ReStor in the other eye. What is nice, is the options are available and it sounds like the one surgeon is trying to listen to you and meet your needs. That is what is most important. Trying to meet your needs.
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Hope your procedure goes well!  Keep us posted.  Anyone else have thoughts / experience about the "2-brand" Plan?
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I am very interested in your experience w/ 2 different lenses in each eye.  Thanks for posting.
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To bjbinfl - Just curious to know if your surgeon is Dr S in JAX. Just learned today when I had my final meaurements for a ReZoom that he was preforming his first ReZoom/Restor combo tomorrow.
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Paul, I do not have trouble seeing at night with my rezoom lens.  The hallow effect is very mild in my case.  I do have trouble with my intermediate vision and it has been three weeks, but my distance vision is so very good as well as the wonderful color that I do not mind.  I will be getting the Restor lens in my right eye on Th.  I will let you (and others) know how it goes.  I am really hoping that the Restor will provide the good close vision that my right eye currently gives me.  What the right eye is missing (due to the cataract) is good distance vision and colors look like they are tinted yellow.  BB
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Hi All.  Had the same dilemma recently in trying to decide between the Rezoom and Restor.  I am 63 and was diagnosed several years ago with cataracts in both eyes and surgery was only a matter of time.  Well the time came in January of 2006.  I had two highly qualified surgeons here in JAX to consider, a DR. S and Dr. C. Dr. C only offered the Crystalens and Restor and Dr. S offered all three, the Crystalens, Restor and Rezoom.  I elected to go with Dr. S who had a great deal of experience and about 30K procedures behind him.  After a through evaluation he recommended the Rezoom based upon my eye condition and lifestyle.  After cataract removal on 1/25/2006, a ReZoom IOL was implanted in left eye.  After surgery, I had some problems with a cornea abrasion and some swelling.  Dr. S took care of the problem promptly with a contact lens cover for a couple of days and appropriate amounts of Cosopt, Nevanac, Pred Forte and Muro 128.  A couple days later, Walla, a miracle, a sight to behold like an eagle to infinity.  Everything out of left eye is clear and the color is so vivid I still hardly believe it.  Intermed vision is excellent and I'm still adjusting to near vision.   Estimated are 6 to 12 weeks for the adjustment period of the IOLs. I now estimate that my vision had deteriorated about 30 percent with the cataracts.  It was like looking at the world through yellow wax paper.  My next surgery is scheduled for 2/15/2006.  I am looking forward to a bright future with my new Rezooms.
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Eyecu:  Thank you for your response.  Is there any way a non-physician can find out what the studies at your annual meeting are purporting?  I scheduled surg for the end of March but maybe I can postpone it a few weeks into April until I have more information from that meeting.
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