Ashperic Restor vs. Monofocal for 33 year old eye?

[javadesigner]

Hi:

I am male, 33 years old, with bilateral (and growing) PSC cataracts. Also a huge (and growing number) of floaters as well. Have had many dilated eye exams from very good doctors and there are no retinal complications (although, there may be faint signs of PVD, but no retinal tears or detachment).

I've consulted with some doctors who have performed upwards of 25,000 cataract operations and several thousand Restor implants. (Dr. Christerbury in North Carolina, Dr. Mckool in NYC, some others in teaching hospitals)  

No one can really recommend a lens to me. They've all gone over pros/cons of monofocal (Alcon IQ aspheric, for example) and multifocal (Restor). They've all said that Restor has "good" performance but does leave halos around bright lights which will never go away.
No one is sure whether mono or multi is good for me, everyone has said that although most people are happy with restors, some people are never able to adjust.

Also restor is similar to Monofocal for distance but not great for intermediate vision.

I'm a computer programmer, heavy web surfing, cell phone, video game use. Reading finely printed computer manuals and switching back and forth from the manual to the screen is important to me. I've worn glasses since 14 and have -5.50D in both eyes.

So my questions are:

1) Does the Aspheric restor improve intermediate vision over the previous version ? Does this newer version make going with restor now, a no-brainer ?

2) I've read that with monofocals, vision is quite blurry less than 5 feet inwards. With monofocals, could I switch easily from keyboard, monitor, open manual etc with bifocals or would i have to keep switching glasses to read a monitor 22 inches away vs. a book 12 inches away ? IF this is possible with MONOfocals, then maybe they are a safer option ?

3) Having the ability to read my wristwatch when I get up in the morning or a book to fall asleep to would also be great :-)

4) What other advise would forum members give me ? I really need to get surgery in the next year or so (I have too much glare, halos, smudged vision as of now with PSC). I'm
generally quite fussy (a smudge on my glasses really bothers me) but as I grow older, I think I can learn to compromise/adjust better with whatever type of IOL I choose.

Thanks so much for all your advice and replies.

Best regards,
--j
***@****

[JodieJ]

If your doctor had given you more information about all your options initially, then you would not need to be going back to see him.  The option suggested by Dr. Hagan is excellent for many people.  My friend who has this type of correction only needs glasses for prolonged reading or seeing small print, and he had excellent vision from day 1 post-op (and no out-of-pocket surcharge to pay.)

This thread is about a year old, and there have been a few improvements in IOL technology.  There is now a new aspheric ReStor model offering some improvement in intermediate vision.  (If driving at night is important to you, the ReStor would probably not be a good choice.)  And many people posting here have been happy with their results with the new Crystalens HD.

I'd suggest that you do a little more research on this forum, focusing on the 2009 threads.  Make a list of your questions and concerns.  Then call your doctor's office to set up an appointment to discuss them with him and/or his staff.  It's your vision, after all.

[val42]

PS:  My surgeon said he was going to use ReStor & on the box it would say D-1
I can't find any listing like that to research.  I did find a study which said+ 3.0 D was better than +4.0 D, but this means nothing to me.  I emailed the surgeon's tech to ask which he was going to use, and she has not answered.  What does all this mean?

[val42]

I just signed up to get ReStor multifocal lenses in both eyes post cataract surgery for a total of $4500.  I am having 2nd thoughts, especially after reading the postings.  I like Dr. Hagan's idea of the -0.25 for far & -1.25 for intermediate, but I have been back to the doctor twice and don't have the nerve to go again.  He probably thinks I'm a nut for being so indecisive.  (The first time I just said OK to surgery, did not ask what kind of lenses, etc, so I assume they would both have been far vision with reading glasses, then I saw other choices on the internet & went back).  I don't mind wearing reading glasses, I just don't want to have to go around with a pair of glasses hanging from a rope around my neck!  If this forum is still going on, can you give me some advice?  Luckily, my surgery is not scheduled til April.

[72vo]

My cosultation with 2nd doc produced the following recommedation: Toric IOLs for both eyes eventhough I have astigmatism in right eye only.  He also recommends -0.75 difference between the two IOLs instead of the -0.25 and -1.25 you recommended for far/intermediate.  I have four questions: (1) Is Toric IOL better choice than limbal relaxing incisions for correcting aproximately 1D astigmatism? (2) Is there a better IOL alternative to Toric IOL for the non-astigmatic eye (doc claims it's best to use same IOL for both eyes)? (3) Why do you recommend -0.25 for far vision (I am assuming 0.00 produces optimal far vision)? (4) do you recommend UV filtering in the IOLs, and is this an option?
Thank you.
72vo

[JodieJ]

If you had strabismus, you would not need to check on this--you'd already know it.  So I don't think you need to worry.  Your doctor can see if you have a phoria (aka "latent strabismus") by covering one of your eyes and seeing if the other eye turns in/out, although this might not even be an issue with blended vision.  Dr. Burton Kushner at the University of Wisconsin is probably the worldwide authority in this area.

Best wishes for an excellent outcome.


  

[telya]

You are too fantastic to answer that question for me.  Thank you soooooo much more than I can tell you.
That gives me an idea ( I do realize it can be different for each person)
of how much difference I might expect between blended eye's night and distance vision and both set for distance.  Valuable info for me.
Now, can anyone tell me if I check with my doc and see whether I have ever had strabismus, let's say she says I have not, will I get it from blended implants?  It is a risk and if so, how big a % of a risk?
I think I read that it occurs more in strict monovision where one is set for distance and one for reading because there is such a wide setting between eyes but am not sure if that also applies to blended, one set for distance, one for intermediate since there is not as wide a difference?
So much to learn.
Thank you so much.