Which lenes? ,Crystalens, ReZoom or ReStor or nothing?

[Needinfoplease]

I am a 39 year old male who has worn glasses or contacts since I was 2.  Let’s just say that if there was only one thing I could change in my life it would be my eyesight. My contacts are +7.00 with my right eye corrected to 20/20 and my left to 20/50. My left eye is also a lazy eye but it can only be noticed when I am tired.  I work in law enforcement and so my eyesight means a lot.  My question is which one the 3 lenses has the best "record" of working with the least amount of complications?  I want to be able to at least do 95% of things without glasses.  If I had to use reading glasses to read a driver's license at night or something fine but other than that I would like to be free of them.  Any other suggestions other than these three?  Or the last option...continue wearing my contacts.  Thanks, Mark

[Forum-OD-MP]

answer below

[Ag-i-doc]

you need to do research & make a descision on your own.  this is like asking which type of car is better...dodge, ford, toyota or chevy?  you will get different opinions depending on who you ask.

most of the multifocals like restor and rezoom recommend that the procedure be performed on both eyes and that both eyes be correctable to 20/20 before you start...which YOU ARE NOT.  you have reduced acuity in one eye, so you according to the manufacturors of restor and rezoom, you are not the greatest of candidates for those IOL's.  that being said, it may still work well for you...one never knows.

bottom line is you need to delve heavily into researching and make the descision that is best for you.  good luck

[Needinfoplease]

Thanks for replying and for the info.  I guess I want opinions and I am trying to get as much info on all three lenses that I can.  I have read articles that say each of them have good and bad points.  I haven't found a lot of information about Crystalens except their homepage and medical articles.  I had heard so much about these lenses and how good they are but it seems most of the personal type experiences have all been negative.  I hoping it's true that complaining/sharing a negative is easier than spending the time to share the positive.  The way it seems now is there are a lot more problems with these lenses than successes.  I'm looking for information/opinions personal/professional about these lenses and thoughts/experiences with them.  My doctor says that there is a "good chance" I will get the results I want but I want more information.  I always thought if there was any way that I could go without contacts/glasses that I would do it even if it was risky but that was when no one had a solution to the problem.  Now there is a solution and I don't want to make the wrong choice.  I know the decision is mine and that's why I'm looking for the most info/experiences I can find...to make the correct choice for me.

[Eagle eyes]

Hi. Dr is right, it does work best in patients with 2 good eyes. Having said that, you have amblopia (laxy eye), and we have had patients do well with ReZoom with your condition. Of course, you should go to someone who does ReZoom. I would not recommend Crystalens for you. ReSTOR will give you up close (too close near vision. Of the 3, I think ReZoom would be best for you (of the 3) What town do you live in?

[Jesse Optics]

Dear Need Info,

You are quite young to be considering lens replacement for a refractive purposes.  30 day soft contact lens have continued to get better and better, have you considered them?

If you do go with surgery (please think long and hard about that) the high amount of astigmatism you have combined with the lazy eye makes you a interesting challenge for the surgeon.  I don't agree with eagle eyes that you shouldn't consider the crystalens, it may be your best choice considering your amblyopia.  You should consider everything that is available to you.  I have heard of excellent experiences with all three lens currently available.  If you want to see the marketing hype put out by all the companies here are the links:

www.acrysofrestor.com
www.crystalens.com
http://visioninfocus.com/423.asp - ReZoom

If you want unbiased FDA data I suggest you review the following summaries of effectivness as vetted by the FDA

http://www.fda.gov/cdrh/pdf4/p040020.html - ReStor
http://www.fda.gov/cdrh/pdf3/p030002.html - crystalens
http://www.fda.gov/cdrh/pmasep97.html - array/ Rezoom

Good Luck, Jesse Optics

[Needinfoplease]

Thank you both for your replies. To answer your questions, First, I live in Spokane WA.  The doctor I am going to is one of the best in town from what I have heard and he has given me the option of ReZoom or Crystalenses.  I have gone to him in the past few years to try to get my eyes corrected but he has turned me down (lasik).  I have checked with others and they suggested putting in standard IOLs in my eyes and have me wear glasses to read.  I guess where I'm at is that I "want" to stop wearing contacts.  I hate glasses and with my job I feel they are a problem.  Contacts work well but I have always "wanted" to wake up and be able to see or to swim without the worry of having a contact float away.  This is the problem, I "want" to be free of contacts but not at the expense of my sight.  I have wanted this long for a solution and I'm torn between taking the risk and staying the way I am now.  Once I heard about Crystalens, I thought I would have them put in and problem solved!  Now that I can I've started to think about what could happen.  I have an appointment on the 31st to get a more in-depth consultation.  I've only had the preliminary exam so far.  The doctor said he thought the Crystalens would do the job but I'm talking about my career and my family’s future.  Thanks for the web addresses, I have read most of that "stuff" and it sounds good.  Then I started trying to found out from people who had the procedure do and that's where the problem began.  The only experiences I found on the net where, shall we say were less than positive.  For the cost ($4500 an eye) I feel it is a small price to pay if it works.  If it doesn't, there is no going back and it could cause me my career.  Which one of these has a better track record in my case?  My doctor says 1/1000 chance of having a problem if I understood him correctly.  That seems low to me but if I have them put in and I still need glasses/contacts them I took and chance and spent a lot of money for nothing.  Any information and or opinions would be welcomed and again thanks for the replies.  I would give you the doctor’s name but I'm not sure if I would be correct/fair to put it on the web.

[Jesse Optics]

Dear Need Info,

I would only use the web and forums like this one as a single data point in a complex decision formula.  One only needs to read the headlines of this or any other forum to understand that this is where the patients with problems are seeking help.


Have you considered extended wear contact lens.  I know you've expressed a dislike for them, but you can go 2 weeks now without having to take them out.  

JO

[Needinfoplease]

Dear JO,

I have thought about it but I'm not sure if I can wear them.  Way back when you took your contacts out, cleaned then and then put them in a heated sterilizer, I scratched the corneas of my eyes.  The doctors made a big deal out of it and took pictures of my eyes and said that my eyes "appeared" to not get enough water or air (I don't remember which) through the contact which made the cornea swell.  When I removed my contact, I scratch my cornea.  I know I'm not a doctor but I know how I took care of my contacts.  I think I didn't clean them as well, the sterilizer hardened the protein deposits over time and then when I removed then they scratched my eyes.(Has anyone heard of this?)  They told me I may never be able to wear contacts again.  I now wear monthly contacts that I take out every night.  Is there something new out there that work better where I could wear them 24/7?  Could you recommend a contact is I know what I'm asking for?  When I wear my contacts now and sleep in them, I wake up and they are dry.  

As far as using forums for information, I guess I just didn't want to listen to the only the doctor and the companies that market the lenses.  I'm not trying to say the doctor isn't looking out of me or the companies are lying.  Maybe it's because of my work but I just believe they also have their interests to think about.  I know when marketing the lenses both are trying to sell and make money for their families.  I'm just trying to get as much info as possible.  I just don't want to make the wrong decision and I want to try and get as much info as possible and as many points of view.

In all of your experience how have these lenses worked?  I spoke to one of the doctor's patients who is in her 60s and she had the Crystalens put in and see loves them.  She doesn't wear any glasses at all.  She made the statement that if her eyes at her age did so well, then mine at my age may do better.  Is this a valid thought?  I don't see any reason to have a lens replacement unless it gets me what I have now without having to wear contacts or gets me better that I have now.  

Thank you very much again for all of your answers and information.  Any other thoughts or information would be greatly appreciated.  I am considering any option including staying in contacts and waiting for awhile.  I just want to do the right thing for the right reasons.

[farm_marm]

Have you trialed a lot of different contacts?  I think I would do that before as you say, spending a lot of time and money possibly to still have problems.  As you say it's your life, job, and family on the line.

There are hundreds of kinds of contacts.  They come up with new and better ones virtually everyday.  Mine are so comfortable I actually can't tell sometimes if they are still in.  And all my life I have had problems tolerating contacts and hated them until now.  I use one for near and one for far.  

Your eye doctor should be willing to order many different kinds for you to trial.  I went thru 10 different types before I settled on the kind I now wear.  Took a lot of time but was so worth it.  The trial pairs are free so what do you have to lose?

[Eagle eyes]

As a +7.00 Diopter Far-sighted person, the risks for lens exchange is much, much lower than if you were near-sighted. Crystalens works, but takes alot of exercise and pushing afterwards to get ideal vision. ReZoom is more predictable. Does work well with lazy eye, as long as you don't have the need for prisms. Ask you doctor about that. Prisms are used to help keep your eyes straight, the muscles working properly.

good luck.

[Jesse Optics]

Dear EE,

Are you really recommending multifocal vision for a 39 y.o. hyperope who is amblyopic and +7?  There are many intermediate steps that a patient of this age must consider before surgery.  I would be careful in so enthusiastically recommending surg for patients who may not be candidates for refractive lens exchange.  

Jesse Optics

[Eagle eyes]

It always depends on an individual basis and whether or not that person is a candidate after a full discussion of all benefits and risks. If someone is so motivated to have something done, we all know that if they look hard enough they will find a surgeon to take their money and do the work whether or not it is in the best interest. In addtion, every ophthalmologist has an opinion and therefore can be confusing when those opinions differ. Hyperopic LASIK is done by many, but that doesn't mean every pt receiving hyperopic LASIK is happy. As it relates to this particular scenario, if he does not want to wear glasses or contacts and is determined to have a corrective procedure, I believe a lensectomy is better than LASIK. Amblyopia, as a stand alone, is not an absolute contraindication for lensectomy with ReZoom. Obviously, it needs careful evaluation to determine if there is any strabismus that needs prism correction. If so, post op there will need to be glasses to correct this. However, think about how impaired a +7.00 D hyperope is? Look at the data for lensectomy in hyperopes, and how safe it is. Phakic IOL is not an option for this person. With that said, I do suggest putting it off until he is presbyopic, but at 39 and a +7.00, doen't you think there is already comprimise in the near world for this person?

I strongly believe the best option would be for a person in this scenario who is considering corrective surgery to find someone who has experience with the procedures. (LASIK, lensectomy, and mulifocal IOLs. To go to someone who doesn't do all of these, defeats the purpose of getting an educated, informed, unbiased recommendation.

I am not overzealous, just have been in the business of taking care of eye patients a long time, since 1977, and know that when someone is determined to have something done, they may as well go to someone who will assist them in the decision that is best for them. It may well be sticking in contacts or glasses for a longer time, but that is not for you or I to decide.

I also do not recommend anyone reading advise on this website to let that solely affect the major decision for eye surgery. My goal is to offer suggestions and information for them to take to the practitioner of their choice and be better prepared to discuss all options after their individual situations are discussed.

[Mintha]

I am looking for input of people who have had Crystalens IOL's put in  and their experience with them.  Has anyone had to have them removed? Has anyone also had them put in that has had a prior partially detached retina ( some doctors appear to be concerned about the possibility of the silicon material in the lens reacting with a silicon oil used in extreme cases of retinal detachment but cannot find any cases of this actually happening).

   I am quite astimatic (-7.75) and have some astigmatism in one eye and 3 to 4 D astimatism in the other. Have worn contacts for over 40 years but am starting to experience dry eye so think my
years with them are coming to an end.  Have had a partially detached retina years ago successfully fixed by laser.  Due to cataracts in both eyes I need surgery and am getting varying opinions about the Multi-focal lenses.  Have been told
that I am not a candidate for Restor or ReZoom but that Crystalens would work for the distance. One wants to do Lasik and Limbal Relaxing to correct astigmaism . Other docs have said
I am not candidate for Lasik either and that I should wait for the new Toric lens coming out in April (a lens that will is a monofocal but that will correct some astigmatism). Am concerned with a monofocal lens that I will end up needing glasses full time.

Since I am getting greatly divergent opinions and would not like
to have to wear glasses full time after surgery would greatly appreciate hearing from any of you who had conditions similar to
mine who have had this surgery. I am afraid of making a bad decision.

Mintha

[eyecu]

t-man: Did you have cataracts? Have you had both eyes done? What exactlydo you have going on?

[Tman1865]

Hello,

I'd like to say to needinfoplease to think twice about doing this controversial procedure, and when I say think twice I mean don't do it.  

I know that sounds direct from someone who is not a doctor or a rep or knows anything special about IOL's.  I get my experience solely from being a fellow patient on this forum with my own sight threatening decisions to make.  

But as an objective 3rd party, I'll give you my take on the situation as I have appreciated when others have done the same for me.

1 You are not an ideal candidate as stated by the OD, both eyes are not 20/20.
2 You are not an ideal candidate as stated by yourself: 'You can't wear extended contact lenses" and "no one will perform LASIK" on you.  
3 You do not NEED this surgery, there are other options to you.  
4 If things do not go well, you could be left careerless, with worse vision, and left bearing the remorse that you chose to bring this on yourself.  

It sounds like lots of people have subtly advised you against this and you keep searching for a different answer though you really know what the answer is: you have more to lose than gain from this (IMO), and there are things working against you before you even start.  

This is advise that has served me well:  fully prepare yourself to live with the potential negatives of your decisions, before you start preparing yourself to live with the potential positives ....    

As the REP above said; you will find a way if you want to, and whatever your decision, I sincerely hope for the best outcome.  

Once again, I'm just a guy trying to help, these are my opinions and not medical advice; do what you like, consult a professional and don't sue the messenger.  

Sincerely,
T

PS - I would like to sincerely thank Eagle Eyes and Jesse Optics for being a part of this community.  Your expertise adds a vital dimension to this forum; helping people find vital information and inner peace.

[eyecu]

Being a high myope you already experienced a retinal detachment so you are naturally a higher risk. My uncle is about the same as you and had Array lenses implanted which was the first multifocal lens. He was doing great but had a retinal detachment in one eye so he does not get the full benefit. I will see him in about a month and will speak with him about his vision etc. as I am curious if he is still happy with the other eye and his decision. I am not sure how much astigmatism he had. If you are facing cataract surgery, though, you do not have much choice and it will not get better. I would probably choose a monofocal lens such as the Tecnis and then have LRI's or laser to correct your astigmatism. Some surgeons would still target a minus probably around -2.50 so you would still read without glasses since that is what your are acustomed too. You would then need glasses for distance or they might try to give you monovision. But with a retinal problem you probably need as much of the light as you can to get to the retina. You definitley want to go to someone one who is a refractive cataract surgeon and can control your astigmatism as well and one that is experienced in cataract surgery and knows what to expect when working in myopic eyes.

[Tman1865]

I hope I didn't come across negative in my post.  I thought about it afterwards and I regret some of the ways I worded things.  

For me this situation would already be a decided one, and I would take the sure thing with the contact lens until nature forced the issue more decidedly.  

You need to make the right decision for you; and when I say don't do it, I just mean I wouldn't do it.  Goodluck with whatever you do, and I hope you find the peace of mind you're looking for.  

T

PS - I can tell you that in my case I had very minor consequences [(Moderately increased floaters and POSSIBLY a slight reduction in vision from 20/20 to 20/25 (could be age related)], and that has turned my world upside down.  Difficulty focusing, increased eye strain, headaches, difficulty using eyes, nausea, stress, and depression.  So that's where I'm coming from.  Again, I wish you well in finding your peace of mind.

[mom206]

A related discussion, monolense vs. multifocal was started.