Aa
Anyone else adapted to Lentis Mplus lens after two months?
I originally posted this as a reply to another thread but thought I'd start my own as I'd like to get some opinions. I had the Lentis M Plus lens implanted into my right eye 6 weeks ago. The left eye implant that was planned for a week later was postponed indefinitely as I had massive ghosting/double vision and glare in the right, which caused me enormous distress and concern. I have since had two other checkups, one was unscheduled as I was so worried, and my one month post-op was l2 weeks ago. I was convinced that the lens was decentred but the optometrists say it’s perfectly centred. It feels like I’m forcing my eye to see distance through the close up part of the lens.
I won’t name the clinic yet as I’m undecided whether I’m happy with them or not. I’m trying to convince myself it’s getting better (but I don't think it is) so I’m keeping an open mind for now. It’s only been 6 weeks, but they are easily the longest 6 weeks of my life! As things stand, if my left eye had been done after a week and had the same effect, I would be almost housebound, I certainty would not have been able to drive. I’m only a young 53, so I’m glad I still have a good untouched left eye (with a contact lens).
I have been assured that the eye/lens will “settle” and my brain will adapt, so I guess only time will tell. The clinic will happily explant the Mplus lens (so they say) and replace with a monovision lens, but that really defeats the whole exercise, so I do want this to work.
Has anyone had experience of these bifocal type lenses being de-centred and re-positioned? if not, I’d love to hear from anyone who had the same ghosting/blurred vision which lasted at least 5-6 weeks then cleared.
Anyone tried exercises to help with Neuroadaptation? This company in the US will happily sell me their program for $500… http://www.revitalvision.com/
I won’t name the clinic yet as I’m undecided whether I’m happy with them or not. I’m trying to convince myself it’s getting better (but I don't think it is) so I’m keeping an open mind for now. It’s only been 6 weeks, but they are easily the longest 6 weeks of my life! As things stand, if my left eye had been done after a week and had the same effect, I would be almost housebound, I certainty would not have been able to drive. I’m only a young 53, so I’m glad I still have a good untouched left eye (with a contact lens).
I have been assured that the eye/lens will “settle” and my brain will adapt, so I guess only time will tell. The clinic will happily explant the Mplus lens (so they say) and replace with a monovision lens, but that really defeats the whole exercise, so I do want this to work.
Has anyone had experience of these bifocal type lenses being de-centred and re-positioned? if not, I’d love to hear from anyone who had the same ghosting/blurred vision which lasted at least 5-6 weeks then cleared.
Anyone tried exercises to help with Neuroadaptation? This company in the US will happily sell me their program for $500… http://www.revitalvision.com/
I've read this whole thread with great interest as I had this surgery in November (about 12 weeks ago now) and am experiencing a lot of symptoms described here....although to a lesser degree than some. I had no cataracts and am in my late 40s.
I had an MF-20 in one eye (23 dioptres + 2.0) and a week later an MF-30 (22.5 dioptres + 3.0) in my other.
My distance vision is now excellent with no discernable ghosting. Intermediate and near does have this, and this is a bit disappointing for me. I work in the IT industry so spend a lot of time on the computer and would prefer if I had no ghosting. Reading and up-close work is similar.
Don't get me wrong - I can work with it mostly. Certainly for intermediate distance anyway. Also I can get rid of it by squinting (presumably thus occluding part of the lens and removing one image). When I do that, i get a crystal clear image that is stunningly in-focus and detailed.
I have no plans to do anything much about this - prepared to give it plenty of time for the elusive neural adaption...so we'll see how that goes.
Overall I'm quite happy as I've got rid of my glasses. I can drive a car and motorbike in all conditions day or night (not at the same time) and generally walking around on the street have excellent vision now. Colleagues of mine still wearing glasses are amazed at how I see now compared to before.
I also have experience of my inter and close vision being different at different times - often depending on how tired i am etc...as others have mentioned here.
As I said, I'm adopting a wait and see approach, and hope that in a year's time, I'll either be so used to it that it no longer matters, or that something will have changed otherwise. At the end of the day, I could live with it like this...but would prefer it to be slightly better.
I had an MF-20 in one eye (23 dioptres + 2.0) and a week later an MF-30 (22.5 dioptres + 3.0) in my other.
My distance vision is now excellent with no discernable ghosting. Intermediate and near does have this, and this is a bit disappointing for me. I work in the IT industry so spend a lot of time on the computer and would prefer if I had no ghosting. Reading and up-close work is similar.
Don't get me wrong - I can work with it mostly. Certainly for intermediate distance anyway. Also I can get rid of it by squinting (presumably thus occluding part of the lens and removing one image). When I do that, i get a crystal clear image that is stunningly in-focus and detailed.
I have no plans to do anything much about this - prepared to give it plenty of time for the elusive neural adaption...so we'll see how that goes.
Overall I'm quite happy as I've got rid of my glasses. I can drive a car and motorbike in all conditions day or night (not at the same time) and generally walking around on the street have excellent vision now. Colleagues of mine still wearing glasses are amazed at how I see now compared to before.
I also have experience of my inter and close vision being different at different times - often depending on how tired i am etc...as others have mentioned here.
As I said, I'm adopting a wait and see approach, and hope that in a year's time, I'll either be so used to it that it no longer matters, or that something will have changed otherwise. At the end of the day, I could live with it like this...but would prefer it to be slightly better.
At my November 5 follow-up with Mplus Dr. my eyes had stabilized enough for him to schedule a PRK tweak. It was originally scheduled for mid-January but they did the tweak on Nov 19 following another patient’s cancellation.
There is good news and not-so-good news.
THE GOOD NEWS IS that the universal ghosting I have had at distance was resolved. Also, my distance vision is a tad better/sharper than pre-PRK, which makes sense since my world of ghosts is now a thing of the past.
THE NOT-SO-GOOD NEWS IS that up to this point (3 and a bit weeks later) my close up vision was trashed and I still have ghosting for near-vision on computer screens, books and such. Mostly anything close up with a white/bright background. I have purchased a pair of cheap reading glasses from the drug store. A 2.25 prescription and that seems to work (though not well) for now for close up. I believe that my prior reading glass/bifocal prescription was 3.5 from you so 2.25 is an improvement but the whole point of this $5K and what looks like it will be at least a year long odyssey was to get my close-up vision back. Sadly I have had to reset my iPhone fonts back to super large. I SOOOOOO miss being able to read the fine print on the iPhone and anything else as I could pre PRK. I’m back to using a magnifying glass to read cooking instructions, labels etc.
GOING FORWARD: All is not to despair (yet). Dr. said that once my eyes have stabilized, again, he’ll see if doing another PRK tweak for the near vision loss will make sense. Also, as per the literature, sometimes it takes months for eyes to settle and ‘maybe’ my near vision will return or get better over time. Also, I’m on the last week of using the various eye drops post-PRK and I know from in the past that they can sometimes adversely affect my vision. So maybe post drops things will get a little better. And, also sometimes I do see the smaller print better. So my eyes are clearly still fluctuating some during the day.
If/as my near vision improves I’ll get cheap lower prescription reading glasses to tide me over until this is finally resolved.
Technically Dr. is pleased with the healing post PRK and the MPlus lens. Everything is healthy and going as normal. He says my eyes will keep adapting over the coming months so, as I said there is some hope there. He said the cells on the exterior are likely still healing. He said that if I see better after blinking (as I sometimes do for a few seconds) that that is a good sign. What the tear drops do for a short time is roughly the same as what perfectly healed exterior cells should do over the long term. But even for the short periods post blinking, while better, the close-up vision is near as good as it was pre-PRK.
I asked if I may need the MPlus replaced with a better prescription. He says he knows my Mplus prescription is fine because I was able to see so good pre-PRK. But I’m not sure I understand that. If my eyes are being reshaped for PRK then won’t the lens inside need changing/tweaking. He never actually answered my question as to whether it was possible at this stage to even replace that lens. Some online sources say no – but those are lay people ranting when things went wrong with their MPlus lens.
A few more details/things I wonder about:
- Doctor keeps mentioning that my eye has a slight stigmatism and seems to think this is the source of some of the problems. But if it has a stigmatism didn’t he know this in advance? Didn’t he account for this when setting the MPlus prescription?
- Night time light (eg: street lamps, restaurant signs, headlights etch) and dark room light (ie: in an apartment hallway, in darkened restaurants) sheering is MUCH worse again. But apparently that was expected and should improve over time post PRK
- Ability to see/identify people in the distance (ie: beyond 10-15 feet) when there is a bright background (eg: outside during the day, or inside when in the back of a shop facing the exterior windows with people between) is significantly improved since the generalized distance ghosting is now gone
- I get some bottom ghosting at distances now (before it was all on the left). This doesn’t bother me at all though.
My next appointment with Dr. is set for January 14. I’m guessing I’ll have to go back month after month for a few months until my eyes settle again before any next steps are determined.
BOTTOM LINE: At worst my distance vision will be slightly better than it was pre MPLus because of the PRK and my close-up vision will be slightly better but not at all useful as I’ll still need reading glasses if things do not get better and cannot be corrected further. But there is still hope for better vision going forward. Just need to wait and ‘see’.
So, there we are. I’ll update you again after my Jan 14 appointment or subsequent appointments if/when there is anything significant to report.
…Dale
Hi there, I would like to think that the reluctance to implant a certain lens has to do with their (poor) prior experiences with it, but there could be other factors involved as well such as commercial considerations. Unfortunately it may be one of the unknowables.
But the general view of accommodating lenses in the ophthalmic community is that they don't really accommodate. It's difficult for the lens to flex if the capsule fibroses and stiffens. The effect of accommodating lenses is unpredictable, and accounts for the usual practice of aiming for 'mini-monovision' with these lenses. The near vision effect of multifocals is much more predictable, and that is why they dominate the market despite the side effects often encountered.
The other unpredictable aspect of accommodating lenses is that they vault, and occasionally if a capsular bag is small or contracts significantly there could be a refractive surprise or a refractive shift.
Monovision is predictable, and importantly, is easily 'reversible'. For example, you cannot easily reverse the halos of multifocals-you'd have to explant and exchange them. Monovision could be reversed with glasses/contacts/LASIK. Many patients have also tried monovision with contact lenses before, so it is something they are familiar with.
There is a reason for everything, and it behooves the doctor to explain everything properly to their patients.
But the general view of accommodating lenses in the ophthalmic community is that they don't really accommodate. It's difficult for the lens to flex if the capsule fibroses and stiffens. The effect of accommodating lenses is unpredictable, and accounts for the usual practice of aiming for 'mini-monovision' with these lenses. The near vision effect of multifocals is much more predictable, and that is why they dominate the market despite the side effects often encountered.
The other unpredictable aspect of accommodating lenses is that they vault, and occasionally if a capsular bag is small or contracts significantly there could be a refractive surprise or a refractive shift.
Monovision is predictable, and importantly, is easily 'reversible'. For example, you cannot easily reverse the halos of multifocals-you'd have to explant and exchange them. Monovision could be reversed with glasses/contacts/LASIK. Many patients have also tried monovision with contact lenses before, so it is something they are familiar with.
There is a reason for everything, and it behooves the doctor to explain everything properly to their patients.
This may seem initially off-topic but please bear with me.
I had cataract surgery with OE over four years ago now. The multifocal lenses from that era were taking and absolute hammering on the forums so I insisted on having the Tetraflex accommodating lens in both eyes. OE were oddly resistant but I was determined (and paying with £4k of borrowed money) so they eventually (very begrudgingly) gave me what I wanted (though I was given a slight monovision prescription I didn't ask for and which I don't recall being discussed or even mentioned pre-op).
No halos, no glare, no neuroadaptation issues. UV protection as standard. I can read the tiny writing on food packets at arms length under a strong light in our kitchen, kindle Paperwhite at 8-10" no problem, kindle at 4" in bed needs a +1 reader, distance vision is absolutely superb in all conditions. 3D movies, no issues at all. The only problem with night driving is that my eyes let in so much light now that modern Xenon headlights are very dazzling but there are no noticeable artefacts from the implants. I am absolutely delighted.
My wife is about to have cataract surgery and is keen to follow my tried and tested path if her eyes are suitable for the same IOL. We have only been for the first consultation, scans and measurements etc. but we are already getting some push-back about dictating what we want rather than accepting the MPlus lens OE seem to prefer.
I need to be clear: if there is an *objective* reason Tetraflex is unsuitable for my wife then fine, we'll consider alternatives. I also realise that, perhaps, I was exceptionally lucky. Just as there are a small percentage of failures like the one's described here there is another tiny group who have an exceptionally good result. I'd like to be treated like a grown up and told that they switched lenses because they had problems with the one I have or found distinct advantages with the one they are offering now. Or told they have a range of lenses and a set of rules which dictate the most suitable.
But we didn't get that information, just that, as a company, they have a preferred lens they have few problems with. Private health is supposed to be about the magic word "choice" so we'd like to choose. It's not as if we've Googled a lens they have no prior experience with, I can understand the implantation procedures will differ... but it's the same company, same lens and even the same surgeon.
We're having what they call "second consent" when I gather we'll be talking to someone with more detailed knowledge of the available products so I hope we can resolve the situation then.
My questions are these:
Why were OE so reluctant to implant Tetraflex and so keen on MPlus?
Why are informed customers who have done their homework seen as problematic? It's called "informed consent" after all...
Why are surgeons so obsessed with monovision? Relying on neuroadaptation is clearly a problem for some patients, it is poorly understood and inconsistent from one person to another. Both monovision and multifocal lenses rely upon this phenomenon which creates a problem if you make it a core part of your standard operating procedure.
Why is an apparently inferior technology (multifocal) dominating the market when an apparently superior alternative (accommodating) exists?
I had cataract surgery with OE over four years ago now. The multifocal lenses from that era were taking and absolute hammering on the forums so I insisted on having the Tetraflex accommodating lens in both eyes. OE were oddly resistant but I was determined (and paying with £4k of borrowed money) so they eventually (very begrudgingly) gave me what I wanted (though I was given a slight monovision prescription I didn't ask for and which I don't recall being discussed or even mentioned pre-op).
No halos, no glare, no neuroadaptation issues. UV protection as standard. I can read the tiny writing on food packets at arms length under a strong light in our kitchen, kindle Paperwhite at 8-10" no problem, kindle at 4" in bed needs a +1 reader, distance vision is absolutely superb in all conditions. 3D movies, no issues at all. The only problem with night driving is that my eyes let in so much light now that modern Xenon headlights are very dazzling but there are no noticeable artefacts from the implants. I am absolutely delighted.
My wife is about to have cataract surgery and is keen to follow my tried and tested path if her eyes are suitable for the same IOL. We have only been for the first consultation, scans and measurements etc. but we are already getting some push-back about dictating what we want rather than accepting the MPlus lens OE seem to prefer.
I need to be clear: if there is an *objective* reason Tetraflex is unsuitable for my wife then fine, we'll consider alternatives. I also realise that, perhaps, I was exceptionally lucky. Just as there are a small percentage of failures like the one's described here there is another tiny group who have an exceptionally good result. I'd like to be treated like a grown up and told that they switched lenses because they had problems with the one I have or found distinct advantages with the one they are offering now. Or told they have a range of lenses and a set of rules which dictate the most suitable.
But we didn't get that information, just that, as a company, they have a preferred lens they have few problems with. Private health is supposed to be about the magic word "choice" so we'd like to choose. It's not as if we've Googled a lens they have no prior experience with, I can understand the implantation procedures will differ... but it's the same company, same lens and even the same surgeon.
We're having what they call "second consent" when I gather we'll be talking to someone with more detailed knowledge of the available products so I hope we can resolve the situation then.
My questions are these:
Why were OE so reluctant to implant Tetraflex and so keen on MPlus?
Why are informed customers who have done their homework seen as problematic? It's called "informed consent" after all...
Why are surgeons so obsessed with monovision? Relying on neuroadaptation is clearly a problem for some patients, it is poorly understood and inconsistent from one person to another. Both monovision and multifocal lenses rely upon this phenomenon which creates a problem if you make it a core part of your standard operating procedure.
Why is an apparently inferior technology (multifocal) dominating the market when an apparently superior alternative (accommodating) exists?
I posted earlier in this thread that I was planing to have RLE surgery using Lentis MF-20 multifocal IOL. This lens has a +2.0D near (MF-30 has +3.0D near add).
I had the survey on my second eye 2 days ago and I am already free from glasses. Vision is crisp and sharp at all distances. So far (touch wood) I am delighted with the outcome. The only slight observation is that while watching TV if there is bright white text on black background I see a small ghost/shadow of each letter underneath it, giving it a 3D effect. This by no means bothers me and I had prepared myself to expect it. I have already learnt to ignore it.
The adaption period for this lens is immediate. I could not have put up with months of waiting while my eyes adjust to the lens.
I had the survey on my second eye 2 days ago and I am already free from glasses. Vision is crisp and sharp at all distances. So far (touch wood) I am delighted with the outcome. The only slight observation is that while watching TV if there is bright white text on black background I see a small ghost/shadow of each letter underneath it, giving it a 3D effect. This by no means bothers me and I had prepared myself to expect it. I have already learnt to ignore it.
The adaption period for this lens is immediate. I could not have put up with months of waiting while my eyes adjust to the lens.
Have an Answer?
You are reading content posted in the Eye Care Community
Top General Health Answerers
Kansas City, MO
Grand Prairie, TX
San Diego, CA
Discharge often isn't normal, and could mean an infection or an STD.
In this unique and fascinating report from Missouri Medicine, world-renowned expert Dr. Raymond Moody examines what really happens when we almost die.
Think a loved one may be experiencing hearing loss? Here are five warning signs to watch for.
When it comes to your health, timing is everything
We’ve got a crash course on metabolism basics.
Learn what you can do to avoid ski injury and other common winter sports injury.
