Choosing an IOL

[suzu]

Hello--
I am in desperate need of help deciding between the Rezoom and traditional monofocal intraocular lens implant.  Several surgeons have diagonosed fast-growing cataracts (probably as a side effect of tamoxifen for breast cancer).  
I am only 59 years old, with a people-and-reading intensive career, and am vain about my appearance!  
I have always had very poor near, far, and intermediate vision, and have been happily wearing multifocal contact lenses for many years (and have accepted halo and glare at night with them).  I have never been happy with progressive glasses because of the "fun house mirror" effects on peripheral vision.
Should I risk Rezoom lens implants?  I want to have fun now and lack the imagination to choose IOLs for retirement activities!  
In great appreciation . . .
Is there anyone who can help?

[John C Hagan III, MD, FACS, FAAO]

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[colavecd]

My optician told me the same in regard to using my dominant eye for distance, so I can live with that. When the time comes to have a transplant in my other eye I will consider making that my distance eye.  It's been ten days post op and I am thinking I am done........my vision hasn't changed in the last week. At last measurement I had 20/20 reading which includes the newspaper, menus, price tags, novels, etc. with adequate lighting and 20/30+ distance.  In between is best of all. The only negative if I want to look for one is from dusk to dawn my vision is poor. The speed limit signs are legible one car length away. If both eyes had the same night vision I would not be able to drive without correction. Worse case scenario will be glasses for night time. THe optician menytionedLasik to get further correction for night vision. I will be seeing the surgeon in two weeks and will discuss the situation then with him.  Thanks!

[John C Hagan III, MD, FACS, FAAO]

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[bstaggs]

With my Crystalens, I was able to see distance and intermediate very well from the beginning and that has not changed either way.  Close up was not good at first and still not good enough that I could read with that eye (without glasses), but it has improved over time.  It actually is accommodating to some degree as I can focus on large print now. Even with the improvement in the Crystalens, the Restor is carrying the load for up close.

bstaggs

[John C Hagan III, MD, FACS, FAAO]

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[JodieJ]

You should discuss the issue of reversing what you're used to with your surgeon.  Most people doing monovision use their dominant eye for distance, and I predict that you will do fine this way with the Crystalens.  When I did monovision with contacts I could use either eye for distance and have comfortable vision, and I suspect that you can, too.

[colavecd]

My Crystalens is only 4 days old. Right now I am able to read small print from the newspaper and see quite clearly the monitor, however distance has been measured at 20/40, which appears to be far worse than what I could see with my contacts. From what I've read on these posts, there are a few comments that lead me to assume my vision will improve over time. Has this been your case, improving vision right along?   Since I will have the other eye done in the near future, like others I am searching for information to help in my decision as to what lens to have transplanted in that eye. I am enjoying the reading capability but wondering if I am doing myself a disservice by sacrificing the distance. Unfortunately, I've got good reading in my non-dominate eye so the decision as to what way to go with my dominate eye is critical. I've always read with my dominate eye using a mono-vision option with contacts, leaving my non dominate eye for distance. RIght now, if the Crystalens remains this way, my eyes will be reversed. Thanks for reading!

[John C Hagan III, MD, FACS, FAAO]

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[bstaggs]

I would think that your previous expensive with multifocal contacts, and the fact that you are willing to accept the side affects makes you a good candidate for a multifocal IOL.  Why are you limiting your options to the Rezoom only?  From what I have seen on this forum and other sources I would have the Rezoom last on my list.  Search this forum for “Rezoom”.

I have a Crystalens in one eye (dominate) and a Restor in the other, a combination that is working very well for me so far. It has only been a little over 2 weeks since I had my last surgery, so my praise may be premature.  The halos I am get from the Restor are exactly like the first figure in the article below:

http://www.eyeworld.org/article.php?sid=4036

I do have glare from the Crystalens under certain lighting conditions, but it seem to be getting better all the time.

If I had only the Restor I would need glasses for intermediate task such as using the computer, but not for reading or distance activities.  If I had only the Crystalens I would need glasses for reading but not for anything else.   But if you search this forum for either Restor or Crystalens you will also see some people are less than happy also.  ??

Good Luck!

[John C Hagan III, MD, FACS, FAAO]

I think the above advise by JodieJ is right on.  If it were me I would chose a high quality aspheric IOL monofocal and after surgery either wear glasses or resume the contacts.

I would never consider a ReZoom IOL for a patient or myself. An increasing number of surgeons are coming to the same conclusion.

JCH III MD

[JodieJ]

Who says that you have to stop wearing multifocal contact lenses?  You can certainly wear them after cataract surgery.  I have aspheric monofocal IOLs and sometimes wear bifocal contacts.  So that's another option for you.

[suzu]

Thank you very much for your speedy and supportive reply.  Actually, the surgeons I've spoken to have been very conservative.  I have been a bit overwhelmed by the various options out there so I greatly appreciate your helpful response.

Actually, I'm meeting one additional ophthamologist (who used to perform cataract surgery and now has his own implanted lenses).

You have helped me understand that I am having anxiety about separating from my current multifocal contact lenses and had hoped to internalize them.

Best wishes to you too!

[JodieJ]

You will find many threads about ReZoom.  (Check the archives and recent posts.)  They are reputed to be the worst of the available multifocal IOLs.  Reportedly, few (no?) cataract surgeons would want them implanted in their own eyes, and they have "inside information" about how the IOLs actually perform.

There is nothing "youthful" about glare, ghosting, halos, or the inability to drive at night.  If full monovision doesn't work for you, I'd suggest aspheric monofocal lenses set for modified monovision (distance vision in dominant eye, intermediate in non-dominant).  You might also consider the Crystalens, utilizing a slight monovision effect.  But whatever you choose, do your homework first.  There are a lot of very unhappy people posting here who simply followed their surgeon's suggestions (or perhaps the recommendations of the IOL Counselor.)

By the way, I don't know what you mean by the "fun house mirror" effects on peripheral vision.  Apparently, there are a number of designs/lens types for progressive glasses.  My progressive lenses are aspheric, and they give me better vision (without peripheral distortion) than my bifocal contacts.  (I do hate the anti-reflective coating, though, which seems to magnify smudges.)

Best wishes for an excellent surgical outcome.