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Bilateral cataracts and Lentis Comfort lenses
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Bilateral cataracts and Lentis Comfort lenses

Taking a lead from the positive style of the report by “decho” on 4 January, I’ll share my recent experience with Lentis Comfort lenses.  I hope it is of interest but I make the important caveat that this not scientific data.  It is my anecdotal experience.  Whilst I hope it is encouraging, others may get different – better or worse – results than I did.  
Background: I’m 59.  I drive over 20,000 miles a year, I am a keen fell walker, and spend a lot of time in small boats.   I also spend several hours a day in front of a computer.  I have life-long myopia and astigmatism, and now ten years of presbyopia.  I have worn spectacles for over fifty years, varifocals for the last 10 years.  I am used to them but they are still a pain when in open boats and when walking in the rain.  My prescription was -3.0 and -2.75 with astigmatism of -0.75 and -1.25, most recently with an add of +3.0 for the presbyopia.  Then I developed cataracts.  

I delayed and prevaricated for nearly three years; only one eye was symptomatically affected and so it was easy enough to put off the surgery.  Finally, I had to take action.  First priority was to find an experienced surgeon whom I trusted.  Not difficult, as my husband is a doctor, so we have lots of connections.   I had done endless research on the bewildering options available to an astigmatic, presbyopic myope but you can’t make the decision without expert advice, and so I enlisted the help of Eyedoc.  

Distance vision was my absolute priority, but I did not want simple distance only lenses because of computer work. UK docs are using multifocal lenses but not enthusiastically.  Eyedoc was not enthusiastic particularly as he knows about the driving I have to do.   There is a high incidence of dysphotopsia and poor colour contrast which multifocal lenses which can make night driving difficult or even impossible.  The manufacturers of multifocal lenses understandably do not emphasise these problems.

Eyedoc recommended Lentis Comfort lenses.  They are relatively new.  They are classified as premiere lenses (so in the UK either privately or on the NHS you are looking at paying a supplement of about £180) but are not truly multifocal.  They offer distance vision and intermediate vision, but for anything closer than 60 cm, it means reading glasses.  The intermediate vision is catered for by a wedge within the lens, not by concentric circles seen in the ‘conventional’ multifocal lenses.  Eyedoc advised that it’s the circle boundaries that are responsible for the dysphotopsia and poor contrast.  Thus, the big advantage of the Comfort lenses is that they don’t seem to have all the dysphotopsia problems reported with ordinary multifocals.  Dr Google does not as yet have much information on Lentis Comfort lenses.  What there is,  is positive but most of it comes from company promotions, so it would be positive, wouldn’t it!  A UK ophthalmologist – Brendan Moriarty – has had them fitted, and is very enthusiastic.  (check him out on Google).

Despite the relative lack of information, because I trust Eyedoc, I decided to go with the Lentis Comfort, with LRIs to tackle the astigmatism.  LRIs are a compromise treatment.  It was clear that you only let a very experienced surgeon do LRIs on you, and Eyedoc met that criterion.  Yes, in a significant number of cases, when the LRI incisions heal, the astigmatism may redevelop.  But, a toric lens may slip on its axis, and it doesn’t need to slip much to give you a significant astigmatism.  But if the astigmatism recurs after LRIs, there is always LASIK if you are determined to be spectacle free.  

Finally, should I go totally for distance vision, or have mini-monocular vision?  In other words, sacrifice a little distance acuity in one eye for a little near vision. That may be a valid option for some. Having had an increasingly dense cataract in one eye for several months, I was well aware that the brain will ‘see’ through the good eye, so the disparate vision was not my reason for rejecting mini-monocular vision. Optimium mini-monocular vision may facilitate a quick glance at the iPhone, but  you will still need reading glasses in poor light or for small font reading.   And I didn’t want to sacrifice even half a dioptre of distance vision.  

So, final decision was Lentis Comfort lenses set for maximum distance vision, and LRIs to mitigate (? cure…Eyedoc said don’t hold your breath on that!) the astigmatism.  Realistically, I was pitching for pretty good glasses-free distance vision for fell walking and boating, with glasses for driving and, of course, for reading.

I had the eyes done under local anaesthetic on consecutive Wednesday mornings.  It was pain free; a little stinging from the eye-drops, but that was about it.  There was no instant visual epiphany immediately after the operation.  My eye was blurry and I got immediate and worrying dysphotopsia.  It was like a firework display.  I was driven home in the dark.  On the motorway, oncoming headlights doubled and tripled with huge starbursts, all within a glittering ground glass circle, rather like looking at life through an illuminated London Eye.  It was alarming.  I went to bed thinking I had made the wrong choice of lenses.  Next morning the dysphotopsia had almost completely resolved.  My pupil was still huge from the dilating drops and so my vision was understandable blurred, and I think I was bleached from all the bright lights.  Then, over the next 24 hours, the pupil went back to normal, and the blurring disappeared. Post-op check with Eyedoc all well.  At 48 hours post-op my right eye vision was an amazing 6/6 with NO ASTIGMATISM.  Fantastic.   The second operation on the other eye a week later followed much the same course, although the transient dysphotopsia was not as pronounced.  It took three days for the blurring to resolve. The eye continued to improve over the next week or so.

Three weeks later my vision is bilaterally superb.  I’m delighted and so is Eyedoc.  I have spectacle free vision in both eyes slightly better than 6/5 and no astigmatism.  Both distance and intermediate vision and, in particular, colour contrast, is outstanding. Better than anything I have know throughout my life.  Of course, even if you don’t have cataracts, as you age, your lenses do not transmit light as efficiently as they did when you were a teenager.  Oh! To be a teenager again.  Well, in terms of eyesight, at the moment, apart from reading glasses, I am.  I can drive, I can work at the computer with ease.  In bright light, I can read all normal fonts as close as 18 inches.  But yes, closer than that, or in poor light (restaurant menus), I need the reading glasses.  Night driving is not a problem.  Oncoming headlights have very slight starbursts (but then, they always have had) and I suspect I am only noticing them because at the moment I am being anally analytical about vision.  I went for a walk in the rain today.  It was wonderful.  No raindrops on my spectacles.  No misting up.  

I have achieved a better result than I dreamed of.  Of course, Eyedoc knows what he is doing; under-predict and over-perform.  That’s his business.  In the meantime, my eye-wateringly expensive varifocals (two pairs – one normal, one sunglasses) are in the used toy box.  

Will it stay like this?  Who knows?  I may well get some posterior capsule opacification but that can be lasered in out patients.  The LRIs may fail and, if they do, that may be sooner rather than later.  In the past, I have always said I would never consider LASIK surgery, and would persevere with spectacles.  But now, for the first time, I have experienced life without spectacles, so LASIK might be an option. It would be hard to go back.

In conclusion, a great outcome.  Lentis Comfort lenses (I have no connection with the manufacturers and nor does Eyedoc) were right for me.
Tags: bilateral cataracts, lentis comfort, LRIs, dysphotopsia, night driving, intermediate vision
11 Comments Post a Comment
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233488_tn?1310696703
We don't get many stories with happy endings. Thanks for sharing your experience.

JCH MD
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Avatar_m_tn
Londonfreda, how are things now, after 3 months?  I had an Mplus lens in my right eye (-2.25) which I'm not getting on with at all, and after a second opinion last week, I may explant and replace with a Lentis Comfort.  If that works, I will get one in my left eye (-2.00) also.  I'd be very interested in your feedback, especially with night time and low light vision.
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233488_tn?1310696703
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Avatar_f_tn
Hello can you keep me updated re your experiences and how you are?

I have had the Lentis MPlus lenses in both eyes and not getting on with them at first i thought it ok i can see after the operation, and then i will get used to them.  but it has got worse in that i am finding it hard to accept that distance is not sharp, although i can see to walk and drive, i feel i am always straining into the distance and it makes my eyes and me so tired. tv is a problem or can be as i feel that my lounge tv is too far away now and its a strain on my eyes

halos, glare at night really bad, some put smilie face on headlights seems cute at first but it gets annoying

i just thought its ok it takes time my distance will become sharp dont be silly you wont be one of those that end up not happy with this

but i am finding it hard, with glasses the distance was sharp, its not sharp now and i feel i a looking into the distance and not enjoying it and its straining my eyes

there seem to be other lenses but whether its good to take lenses out as there could be complications?
or is it dificult to take out?
what if you end up worse off?

there the Lentis Comfort lenses? but that does not give you reading does it
but maybe one will have to settle for good intermediate good distance and wear reading glasses?
maybe i shall have to compromise
but then whether the company i went to, one of the big well known ones, will allow me to have my lenses out, or allow me FOC to have a different one?
what pressure can you put on them?

Lentis MPLUS TORIC?  what is this and its benefits
Lentis Tplus?

there are so many out there

and i thought i had got it right with the Lentis MPlus mulifocal lens as it says distance, intermediate and near, all one could want?

please do keep in contact i am getting fed up of my eyes, but i am kind of stuck as cant afford to pay it all again and why should i? but there again dont want to even if they offered have the ops again and find out i have worse vision that would be terrible

any suggestions
feedback
your own stores
findings

thank

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Avatar_m_tn
Sunsinett,

The MPlus is multifocal with a +3.0 near zone, so while It may allow some intermediate it's strength is 30-40cm. I don't think it is a true tri-focal.

The Comfort is multifocal with a +1.5 near zone, which suits 60-80cm.

The MPlus Toric is an MPlus multifocal for those with things like astigmatism.

The TPlus is a monofocal Toric lens

The Lentis Mplus and Comfort are asymmetrical - they have their near zone at the bottom like a pair of bifocal lenses. This means you don't get the 360degree circular halos that like other multifocal lenses, but as you noticed some can get a large blurred image through the near zone while looking at headlights and traffic lights than can look like a smile or dish, and if your brain can't adapt and suppress that image then it can be hard to drive at night.

See my reply to your other post for my experience so far with one MPlus eye and one Comfort eye.
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Avatar_m_tn
I don't know who did your IOL implants (and don't need to), but if you are not happy, then tell them.  That's what I did with mine, I was polite but made it very clear that I was not happy and was getting extremely stressed by the whole saga.  It was obvious from day one that I had problems, and the second eye was not done (and still isn’t).

After more than two months of no improvement, and without me even asking, they referred me to an independent specialist for a second opinion, who recommend that the Mplus lens was changed for either a monofocal or Comfort.  You don’t say how long ago your lenses were implanted, but if it’s less than a year then you certainly shouldn’t have to pay any extra.  I specifically asked, and they made it clear to me that if I was unlucky (as I seem to have been) and didn’t get on with the Mplus lens, it would not cost extra to have it replaced.  I hope they keep to their word…
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Avatar_n_tn
I am having cataract surgery  next week in Australia. Right eye first. Dr recommended Lentis comfort for me, though I wanted to be completely  glasses free. So how are yours now...still good?. How close can you read comfortably without glasses. I use computer alot so need good intermediate, so this is why Dr selected Lentis Comfort, not LentisMPlus.
From reading on here, distance is not as food with MPlus either. Who knows!
Problem is, there's not much feedback here on Comfort lens, other than yours. Are they quite new?  
But I would still like to be able to read 10 or 12 font,(12 inches away) plus my keyboard, without glasses.... Plus great distance.Thanks for any advice.
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Avatar_n_tn
Has anyone else had Lentis Comfort iols recently after cataract surgery?

What was your experience with near, intermediate & distance vision. Thank youl
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Avatar_m_tn
Hi Mum8,

I noticed you posted to me in another thread too so I'll answer both here.

I had a MPlus in one eye and a Comfort in the other (dominant) eye. Done by Dr Stephen Leppard at http://www.visionaryeyespecialists.com.au in Sydney a few months ago.

I do read a lot and also work long hours at a computer. The MPlus gives me the best vision for 30-40cm reading and the Comfort gives me the best vision for 50-80cm intermediate. With both eyes open I don't really notice which one is which, they just work nicely as a team. Both work for distance vision.

I am completely glasses free, unless I want to do something intricate at say 15cm, then I could whack a pair of +1.5 or +2 readers on. The only time I have done that this year was when repairing a laptop with tiny screws in it.

If i cover the MPlus and try to read at 30cm with the Comfort it is doable for a short stint but a bit out of focus and probably not something you would want to do for a long stretch - I would find it straining. Probably OK for casual reading like shopping aisle prices and things.

I think if you get two Comfort IOLs you would have a good change of very nice vision for most distances, but I wouldn't count on being able to read comfortably at 30cm without glasses. The near lens in the Comfort is only a +1.5D, while the Mplus is a +3.0D

For distance vision I think the Comfort is a little sharper, so it is probably the better all-rounder. But I'm happy to have an MPlus for reading.

When I first got the Mplus in one eye I was finding it hard, so we decided to do a Comfort in the other eye with the option of also swapping the Mplus for another Comfort. However my eyesight was much better after both eyes were done and I opted to keep the MPlus so that I can continue to read books and eBooks without glasses.

So it has all worked out well for me. I had rapidly deteriorating cataracts so even with the compromises of multifocal lenses I am very happy at the great improvement over the hazy mess I was seeing before. It is nice to be able to recognise faces of people outside again.

All the best for your surgery.

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Avatar_m_tn
mum8 wrote:

> I would like to be able to read 12 font print without glasses also.
> Will lentis comfort allow this? I use PC alot.

My computer screen is 60cm away and with the Comfort I can read >much< smaller than 12 point on screen. Probably even 6 point or less.

But not as good at 30cm. MPlus works better there (or +1 glasses on the Comfort)
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Avatar_n_tn
I am booked to have a Lentis Comfort lens put into my left eye (which has a cataract) at the end of August. However I am concerned that many specialists (including my regular NHS Consutant who diagnosed the catact) seem reluctant to get involved in anything other than monofocal lenses.
I am trying to gather as many views and experiences as I can to help me tp confirm the decision to go ahead with Comfort lenses. However, as you and other contributors have commented, there is relativerly little independent information on these lenses
Would you be willing  to give me details of your surgeon so I could seek a second opinion from him? I would really appreciate it  
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