I'll be facing cataract surgery sometime soon, and need to decide what kind of lens to get (I was somewhat surprised when my ophthalmologist offered to install any kind of lens I want, though he recommends fixed-vision 20/20 lenses as most likely to be satisfactory.) Reading around here and elsewhere, it's clear that this is a very technical field, with rapid new developments and a variety of options.
It's an important decision, but I don't think I can become an expert. And I assume it's best to select a surgeon who is experienced with the particular kind of lens I choose.
One would think that somebody, a recently-retired ophthalmologist or maybe an optometrist, would set up as a consultant, tracking developments and advising individuals. (Ideally, insurance companies would pay for this to avoid complications later, but I think patients would be willing to pay for the service.)
Is anyone here able to direct me to a practice like this?
Cataract surgery and insertion of an IOL is the most common operation done on adults. In the USA in 2012 there were over 3.25 million procedures. Almost all surgical ophthalmologists are experts at this type of surgery doing it hundreds of times per year. So it is not hard to find an experienced surgeon near you. If you want more than one opinion you can go to www.geteyesmart.org and see those that practice near you.
There are a score of excellent IOLs. There is no one that is best. Think of it like automobiles. There is no best brand of automobile, many are excellent and reliable. Neither is there a 20/20 IOL. That would imply that the IOL will make you see perfect and no IOL can make that claim.
You main decisions are: 1. Do I need this surgery? 2. Which surgeon do I want to do the surgery 3. do I want a monofocal IOL or a multifocal/accommodating IOL? 4. If I want a monofocal IOL what would be my desired target refraction without glasses (for distance, for near, mini-monovision distance bias, mini-monovosopm near bias) 5. Do you understand that glasses will be necessary some or all the time after surgery? 6. Do you understand the risks of surgery (infection, bleeding, retina swelling, need for more surgery, increased risk of retinal detachment and a small chance of loss of all vision).
All of these topics are discussed at length. There is no "right" answer for everyone. Do your own research, take your time this is elective surgery. You can use the search feature and archives to read the many informative discussions from these AAO Eye Forums.
There are many brands. On MedHelp I have heard many stories of people disatisfaction in the ReStor, ReZoom and Crystalens. So what other brands of lens are better that give you good vision, halo free and no starburst affects? What I have read in so many post is those three are horrible for many people. Is the AcrySof IQ a ReStor lens? What is the difference between aspherical vs, spherical? Blue blocking better than non? Is there a color difference between the eyes if you do get the blue blocking lens?
I think these are many of the questions many of us need to know and that is why we post these questions.
Thanks for your response. Perhaps I am looking for something that doesn't exist. (You say "Think of it like automobiles" but if I want to evaluate a car I can read Consumer Reports and other publications, even test drive it.)
I did review your article on this site tallying patient complaints and concluding that monofocal lenses are most likely to be satisfactory. I wonder whether the kind of folks who insist on accommodative or multi-focal lenses might also be perfectionists and most likely to complain (also most likely to visit sites like this one).
In order to make sense of the numbers of complaints I find here, it would be helpful to have statistics on the number of lenses of various models and brands which are implanted. Is that data posted at any accessible site?
I strongly suggest you do not get the Cryatalens. I have had nothing but problems and mine was done last August. I can't read except a few words with a magnifier and I cannot see at a distance, 20/400 and 20/100. I have been to Duke Eye Center and Johns Hopkins and the doctors at both places have told me they would not get the Crystalens in their eyes. I recommend the simple monofocal lens and put up with wearing reading glasses if you need them.
Monofocals have the least problems and the highest satisfaction ratings among patients...if you have astigmatism, you'll need toric lenses like i have...the Acrysof IQ monofocal is what i have and i like it...you can get either 20/20 in both eyes (and be prepared to use readers a lot) or mini-monovision is an alternative to consider (to minimize need for readers)...
I'm in the same boat right now, and today my surgeon-to-be once again tried talking me into Crystalens. I told him that they were basically out of the question. He swears that the problems reported are due to surgeons who do not put them in properly but I refuse to believe that all problems with Crystalens are due to the surgeons. I told him that I will try modified monovision with contacts, and if that's successful, then that's the route I'd like to go. If not, then I don't know what to do, either. The doc then suggested one Crystalens set to distance in the dominant eye and one monofocal set to intermediate. I have to give him credit for trying to upsell and make more money.
I finally asked one of the techs how much the Crystalens cost the patient out of pocket. I practically swallowed my tongue when she told me $2,700 per eye!! As I told my doctor, I love the fact that the monofocal IOL's are free! :) Is it just me, or does Crystalens seem like one of the biggest legal medical money-making scams?
It is for sure about the extra money for the surgeon. Not only do you have to pay extra for the lens but also extra post-op care. The doctors at Johns Hopkins Wilmer Eye Institute told me that would get the monofocal lens when they had to have the surgery. That is good enough for me.
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