crystalens..restor..rezoom..question?

[kanga-roo]

I am scheduled next week for crystalens surgery.

I just found out that my doctor does not do restor or rezoom and yet many of the doctors in my area have dropped doing crystalens and are opting to do the other two.

I have been searching on the web for answers as to why all three would not be offered to patients by an experienced eye doctor.

So, my question would be, are they finding out that one is a more difficult surgery or results are better for one over another?

I may just be a little nervous about next week..

[Forum-OD-MP]

no.  just different opinions and experiences.  crystalens is a good product.

[eyecu]

Each product has their strengths. I would definitely talk to someone who has done all three. Many surgeons are also mixing technologies. If your doc is only doing one and has not tried the others than how does he know what does best? All depends on your lifestyle, occupation and hobbies along with pupil size etc.

[K-D]

Eyecu, you mentioned pupil size.  I have one Rezoom in my dominate eye.  The outside vision is crystal clear, in that eye,  well before my PVD.  But when my pupil dilates, like inside, the vision changes and blurs, depending upon the lightening.. I really don't like the constant changing of vision, depending upon my pupil size  Does this happen with all Rezoom implants? Also, does a person have a greater chance of having a PVD with a multifocal lens? It's 8 months since my surgery,  and I still have the large halos.  Is this due to my astigmatism?  During my last visit to the doctor, he wanted to implant a traditional lens in the other eye, due to my astigmatism, which is greater in the remaining eye.  But I am not  at all comfortable with that decision. He said I could end up with distorted vision with a second Rezoom implant. Wish I would have been told this before the first implant. I was told repeatly before my last visit, that Rezoom was made for bilateral implants and my vision would improve with the second Rezoom. Then he changed to a traditional lens due to astigmatism, which I had all along.

[kanga-roo]

I want to thank everyone for their replies. I have actually canceled my surgery because I think I need to do more homework on the subject.

I have heard good and bad about all the implants, but I will eventually have to choose one.

I am not as concerned about the cost as the product itself, but I am comparing that also. My doctor was charging $5200 per eye for the Crystalens. I have heard that the others are a little cheaper.

Thanks again.

[K-D]

You did the right thing.  You have to live the rest of your life with this lens, or risk having an explant.
Be absolutely sure of what you want to do.  And even then, nothing is for sure. Read everything you can about all the lenses, and then hope for the best.  Also, your surgeon is very expensive, compared to others.  But don't look for discounts where the eyes are concerned.  I would find a surgeon that is very skilled with ALL the lenses, not just the crystalens. Best wishes.

[eyecu]

K-D, monofocal lenses  focus the light in one point so you have better acuity and contrast. Wave front lenses such as the Tecnis account for spherical abberation of the cornea as well and as the pupil expands still focus all the light in one point to give you better contrast than a tradional monofocal which do not account for sperhical abberation. Traditional monofocal lenses are stronger at the periphery of the optic so all light rays do not focus totally at one point. Simplistic description. Multifocal lens do depend on pupil size. Crystallens does not as it is a monofocal with hinges on the haptic arms which are supposed to allow the lens to move forward and give you a pseudo accomadation. Unfortunately with the capsular bag constricting after surgery and fibrosis occuring it might not move as much over time.

The Restor shifts to distance as the pupil expands in low light to cut down on unwanted visual sensations. In bright light it is great for reading, the ReZoom is not. It is great for distance in bright light. As the pupil expands you get to the second ring which brings in near and the transitions between the rings give you intermediate. With the Restor you cannot read as well in dim light as you can with the ReZoom. One patient mentioned this on another thread saying he could read better in low light and did not know why.

Astigmatism wreaks havoc on all multifocal lenses and vision in particular but it can be corrected with LRI and laser. This could be a big problem for you. There are surgeons who implant a multifocal and monofocal with good results and there are surgeons who mix. This is not an exact sciecne and there is no one answer. Obviously the more refractive surgeon does and the more experience he or she has with these technologies, the more attuned they will be to fix a problem and hit it right the first time.

There have been patients who say they don't like multifocal lenses and then have them taken out, have monofocal lenses put in and then want the multifocal back because they did not realize what they were losing. By putting glasses on a patient that have a +2.50 add on which takes on the near point of the multifocal and showing them what they will see with a monofocal, they can determine if the visual disturbances are or side effects are worth the trade off.

Opinions change as well. The original studies that were done were done with a multifocal in one eye and monofocal in the other eye for the control group. There were happy patients in those studies that had both. The original thinking was that the same system was better in both eyes. At that time there was only one approved multifocal design. As more designs came approved, surgeons could obviously try both and now that has come into vogue with good results for many. Surgeons like Kevin Walsh who the one patient went to have been working with all these technologies for year and more and more are getting educated.

The only that is certain is change and everything will continue to get better for all. You just have to define your problem and either live with it or do the research, talk to a few surgeons who are experts in the field and make a decision to pursue an alternative.

Your PVD happened due to surgery and the anatomy of your eye would be my guess no matter what lens you would have had. That is a risk you did not have much choice since the anatomy of your eye and age just creates that risk. My unlce had a RD due to being a high myope after surgery but he could have had that walking down the street one day due to the anatomy of his eye. Luck fo the draw.

[K-D]

Thanks for all your info.  Much appreciated.

[Gary F]

I had a monofocal IOL put in one eye several years ago. I now need cataract surgeray in my other eye, does anyone know if you can have a Crystalens put in this eye?  I understand that they don't recommend doing this with a Restore or Rezoom lens, but in researching this,  have not been able to get an opinion on Crystalens.

[JodieJ]

Why don't you try consulting surgeons who implant Crystalens?  They would be able to tell you whether one Crystalens might work for you.