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Clear Lens exchange questions

I will be 43 in a couple of months and and have been very nearsighted since I was a child.
I have used glasses and contacts for a long time.
my contacts are  -9.50 left eye and -9.00 in the right eye
I still have my reading vision so far.

I have had a lasik evaluation last year and the DR. said I was a borderline case because of thin corneas.
He said he could do implantable lenses so I explored that further at a second appointment just 2 weeks ago.
He is a very experienced cataract surgeon and after my exam he recommended going with a clear lens exchange
using Crystalens.

I was thinking he might suggest Verisyse or Visian ICL instead, he doesn't do the Visian though.
I am getting a second opinion at another experienced surgeon who does both next week.

Being nearsighted I understand I have an increased risk of a detached retina, how much does a CLE procedure inrease that risk if any at all ?

Does a Visian or Verisyse increase the chance of a detached retina also ?

I realize that if I go with a Visian I will someday need reading glasses also so is the CLE the best way to go?


I am a mailman so I drive and read the addresses on letters every day.
on my off time I am a motorcycle rider and my contacts really bug me even with a full face helmet after a long ride.
I don't feel my vision is nearly as good when I wear my glasses.

Anybody here have a CLE with Crystalens ? would you recommend it ?


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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
One thing to consider with any of the options is that you are very nearsighted.  That means you are used to seeing near objects without glasses.  The Crystalens accommodative IOL is known to, when done properly, give good distant vision and mid-vision.  Near vision is limited.  You would likely need to wear reading glasses for near tasks from now on.  (There is the new Crystalens HD that was released on the American market in July 2008.  It is supposed to have improved near vision, but there hasn't been much feedback on MedHelp.)

Possible complications with accommodative IOLs (Crystalens) or multifocal IOLs (ReSTOR, ReZoom) are glare, halos, starbursts, loss of contrast, ghosting and poor low-light/night vision among the many.  See this site for examples of these anomalies:  http://www.thevisioncommunity.com/

Monofocal aspheric IOLs pose the least risk.  As the name implies each IOL has only one focus.  You could set both eyes for distance and need reading glasses for some mid-vision tasks and definitely for all near tasks.  Monovision sets the dominant eye for distance and the non-dominant eye for reading.  (Modified monovision sets the non-dominant eye for mid-vision.)  This way you would have some independence from glasses.  Also note that many people adapt will to monovision, but some don't.

I've had CLE with multifocals (Tecnis ... not available in US market) and am very happy with the results.  It gives me excellent near vision and good vision for distance.  Having CLE is a very personal choice.  If you are fully corrected with contact lenses you are probably getting the best vision you can now.  I didn't do the CLE until I was 51.  I recommend you wait a while.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
Dr. Hagan thanks for the info, I may in fact get a third opinion from Dr. Doane.


KG17 thanks for your insight on the Visian ICL.
I have read stories on the internet of people having problems with almost all brand of lenses at some point.
it makes you pause and consider your options very carefully.
I hope your eyes are able to be repaired by the cataract surgery.
best of luck to you.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
While I may be few in number, I suffered from several complications due to Visian ICL to correct -17 diopters.  I had a very competent, highly respected surgeon.  I ended up with cataracts, high intraocular pressures, painful dry eye, and debilitating visual aberrations.  I so regret the decision to do this surgery and wished that I had just stayed with contact lenses.  The tradeoff for supposedly better vision (which I did not get) and the convenience is so not worth it.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
The risk of RD is raised but the biggest risks are cataracts, then corneal damage, then glaucoma.

Yes both surgeons are skilled and respected.

John Doane MD of Discover Vision Centers,   Phi Beta Kappa, Alpha Omega Alpha, world lecturer, book authors, medical journal editor, nice guy and brilliant surgeon would be worth a third opinion. If I or a member of my family where to have eye surgeon that is who I would pick.

JCH MD
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Avatar universal
Dr. Hagan, does the IOL procedure increase my risk for retinal detachment?

I have read many different varying opinions on this, what are your experiences ?

I do live in the KC area and am consulting two highly skilled surgeons I am sure you know of Hettinger and Cavanaugh.
I will be seeing Cavanaugh next week for a consultation.


Thanks for your help in this matter.
Helpful - 0
233488 tn?1310693103
MEDICAL PROFESSIONAL
I would avoid multifocal IOLs and just have monofocal.  I do not advise my patients to have intraocular contact lens. Risks include infection, bleeding, glaucoma, corneal damage, and need to remove.

JCH MD
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203589 tn?1267475170
Neither type of correction is perfect and more than likely you will need to wear glasses or contacts afterwards.

ICLs, as you age you will loose your ability to accomodate and thus your reading vision will suffer.

IOLs, will more than likely leave you needing correction for either near or far, and depending on your case maybe both.

Hope this helps.
Helpful - 0
203589 tn?1267475170
You mention two different procedures:
1.) CLE, which is similiar to typical cataract surgery, except that the lens is not yet cataractous. So IOL's like Crystalens, ReStor, etc are available. However, they are not perfect and many patients are unhappy w/the results. Success here has been best w/ monofocal not multifocal IOLs.

2.) ICL, the implantable contact lens leaves your natural lens in place. These are placed either in front of or behind the iris and work w/your natural lens to provide better vision. This is where your choice between Veriseye and Visian come in.

You need to get more information from your doctors as it seems like he/she has bombarded you w/options which you need clarification about. You can also google the above choices and read through these forums since the two topics have been discussed before. Good Luck
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