Best IOL for Me?

[Glad4Help]

I am 62 with cataract in right eye, very farsighted with minimal astigmatism.  
OD: +6.00  -25  x 180    VA: 20/30
OS:  +5.71  -75  x 3    VA: 20/30
IOP: OD: 12   OS: 14

I am an alternator but use my eyes together for peripheral vision.  Also, when I focus in with one eye, the other eye turns.

My cataract surgeon is strongly encouraging me to get Crystalens.  He said he has very good results and I would have better vision with it but I will probably still have to wear glasses for reading at least.

My optometrist thinks I should just get the standard lens because they are tried and true and I could expect very good vision with the standard lens and glasses.

I would be willing to pay extra for the best vision I can get but I don’t want halos and any other problems.  And, if I will have to wear glasses anyway, I think the Crystalens might not be worth it unless I would get significantly better vision with it.

Can anyone give me some insights that might help me decide which lens to get?

I didn’t think to ask why I am not an “ideal candidate” for Crystalens.  Would it be because of being farsighted or because of strabismus and/or alternating?  

Would I get more clarity of vision with Crystalens or only better range of vision?  

Are there any statistics available that tell what amount of improvement very farsighted people have actually gotten with Crystalens or what percentage of people with Crystalens have halo issues or other problems?

[Sandy Feldman, MD, MS]

Dear glad4help,

There are risks to cataract surgery, no matter what implant you obtain.  Different risks exist.  Each surgeon prefers a different style implant which is usually based upon your eyes and what you describe as your most important vision.  While the crystalens is not perfect, it does give some functional range of vision which is helpful in daily activities.  Since the cataract will be removed, you should experience better quantity and quality of vision. There are no guarantees as to the ability to see without glasses.  I would ask your eyeMD why you are not an “ideal” candidate. It is possible that according to the measurements, you might still have a refractive error.  This will be important in evaluating the probability of having good uncorrected acuity.  

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[betheplunk]

I'm also 62 and struggling with the same decision right now.  Crystalens sounds like the miracle cure until you read patient stories, so, like you, I started to back away from my first attraction.  I see it as a decision between quality of image versus freedom from glasses.  Because I want the best quality of image I can get and don't want to discover that I have glare and halos, and because I'm already using glasses for computer work and reading, I'm strongly drawn to some combination of traditional lenses.  Heavy thinking aside, whenever I read a post on this site that advocates for traditional lenses, it "feels" right to me, so I have to notice that this solution seems to match my basic personality.  I'm not much of a risk-taker or wishful thinker where the big decisions are concerned.

Anyway, as you can see, this topic is widely discussed on this site.  Read, read, read and take your time reaching your choice.  In the end, we have to make a peace between the positives we want the negatives we can live with.

I don't understand all of the optometric abbreviations and numbers, so maybe your case has particular considerations.

Good luck,
David in Massachusetts

[Glad4Help]

Dear Dr. Feldman,

Thank you so much for your comments, which really helped me put things into perspective.

My surgeon's assistant checked and told me the reason the doc said I was not an 'ideal' Crystalens candidate was more because I am an alternator and my eyes don't work together than that I am severely farsighted.  

She said he has had "very, very good results" since my initial visit in Jan.  Also, I have decided to have two eyes done instead of one.  So I guess he is now more confident that I would have a good outcome with the Crystalens (but would also still need glasses).

Can you tell me... is the Rx for a Crystalens considered harder to calculate than a standard lens?

Thanks again for your help.

GH

[betheplunk]

Dear Glad4Help --

I'm afraid that I do not have answers to your questions.  Maybe the docs will chime in on that.

Another thought I'm having is that, while explantation is not desirable, there may come a day not so far off when technological advances make explanting a traditional lens in favor of an extremely good accommodating lens quite acceptable.  Who knows?

David in Massachusetts

[Glad4Help]

David,

Thanks for the good wishes.  I'll keep you posted.

I did get a call back from my surgeon's assistant.  She says the standard lens should give as much clarity of vision as the Crystalens but just not as much range of vision.  Also, the doc's statement that I am not an 'ideal' Crystalens candidate was more because I am an alternator and my eyes don't work together than that I am severely farsighted.  (I wish the other docs here would comment on this.... Maybe I will re-post with better questions.)

She also said my surgeon had not had a lot of experience with people having only one eye done, so wasn't sure of outcome for that; but since my initial visit some months ago, he's had very good results with that, too.  BTW, after seeing my optometrist, I am now planning to have both eyes done.  I don't knw why the surgeon didn't just tell me I should have both eyes done in the first place.  

Do you know if the Crystalens lens strength is considered harder to calculate than a standard lens?

I am also still concerned that the Crystalens may be more likely to cause secondary cataract.  Have you read anything about this?

[betheplunk]

Dear Glad4Help --

Good luck on July 8.

I hope you will post your impressions of your experience once you have recovered

I just got scheduled for July 30 to do the first eye.

Best wishes,
David in Massachusetts

[Glad4Help]

Yes, sounds like we are having similar experiences.  

I think all my Rx means is that I am extremely farsighted.  I thought it would be helpful if one of the docs comments.  

I read that IOL prescriptions are harder to calculate for farsighted people and I think the Crystalens Rx might be harder to calculate than standard lens, but not sure.  I figure if the IOL Rx is not going to be that accurate, then I will have to wear glasses more, so why spend the money on something not totally proven.

I am really interested to know if the standard lens gives as much crispness of vision as the Crystalens, regardless of range of vision far and near.

My surgery is scheduled for July 8 but I will have to postpone if I can’t make a decision.

Good luck to you, too.