Crystalens HD 4th Generation Lens

[jrws]

Just wondering if anyone out there has any new input on this new generation Crystalens. I understand they are now being used by some Ophthalmologists (having been recently released and revised).

I would love some feedback from the Dr's viewing this site as well as from any readers who have used these new lenses as to your personal experiences with them, even if your early on impressions. Thank you all in advance for your input!

[John C Hagan III, MD, FACS]

Remember "newer" is not always better. Several new IOLS (example Azar 91Z, Stableflex, Leiske IOLS) were "the newest IOL' but ended up causing many more complications than older lens when they were developed.  

Multifocal IOLs are the "newest" but--in my view--not the "bestest" for most people.

JCH MD

[2ndsight]

this model was just approved by the FDA on July 1 so it might be a little while before the reviews are in!

[jrws]

Thanks for your reply! Hope there are some people/Drs out there who have started to use this lens and have fantastic initial "sightings"/experiences to report!

We can only hope.....

[jrws]

Thank you so much for your input.

From some old posts on this forum, as I recall, you said that if you were having your own cataracts addressed, you would use a mono-focal IOL of spheric design by Tecnis (Aspheric IOL) in acrylic or silicon.

Is this still your first choice? Would this (these) be set for distance or midrange vision?

Do you prefer the acrylic or silicon? Are both of the latter impervious to whatever drops, lotions, potions (ie,products that grow the lashes longer, eye allergy medications, eye creams, etc) we may use in or around the eye?

Even though cataract surgery is touted as being such a common, quick and "easy" procedure, it is a permanent one. We all aim to make educated decisions from the information gleaned before we let anyone touch one of our most precious senses, our eyes!

Again, thanks so very much for your thoughtful and honest opinions.

[John C Hagan III, MD, FACS]

I would feel comfortable with either silicon or acrylic. Given the choice I would probably chose the latter.

I am not typical but I would rather have excellent reading vision without glasses (someting I've had all my life) So I would go with -2.25 and -1.00

Most people would go -0.25 and -1.25

Yes all IOLs are compatible with eyelid cosmetics.

JCH MD

[jrws]

Many thanks for your input!

[John C Hagan III, MD, FACS]

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[kirsty1986]

Hi i have just had my natuaral lens replaced on my right eye, my lenses where displaced in both eyes. I know have very blurry vision and a massive floater, i don't know whether or not i have done the right thing or if this is normal, as i can't read anything and i never had blurry vison before. i am wearing my old glasses and have covered up my 'new eye'.
Can anyone help me?I am only 22 and wanted to improve my quality  of life.

[John C Hagan III, MD, FACS]

You need to discuss this with your surgeon and if you don't understand or feel comfortable then get a second opinion from another eye surgeon.

JCH MD

[Rita732]

Hi...I had crystalens put in both eyes after cataract removal in April.   I also have dry eyes.  I had a yag done on my right eye two weeks ago.  Yet I still cannot read a book without at least +150 glasses.  I am seeing my dr. this week.  I'd appreciate your take regarding why I cannot read close-up without glasses.  I paid an extra $4000 for the crystalens.  The lens do not meet with my satisfaction because they do not live up to their advertisement.  Am I the only one who has this type of trouble with the lens?  Any suggestions?

Thanks...
Rita

[JodieJ]

To my knowledge, no one with the Crystalens 50 (which is undoubtedly what you have) is able to read a book comfortably without glasses.  If you have good intermediate and distance vision without glare or halos, then you have had a very good outcome.

There was a new Crystalens model introduced last month which is supposed to provide better near vision.  The jury is still out as to how much better.

[Rita732]

Thank you, Jodie.  This info does not make me happy.  I was told by my surgeon and the crystalens rep that I should be able to read close-up without glasses.  This is why I paid $4000 over Medicare,  Now that I am complaining that I didn't get what I paid for, my surgeon says it's because I have dry eyes, which I had before the surgery.  She never mentioned this condition would prevent me from being able to read without glasses.  I need glasses for my middle vision also.  

My husband, who had the regular lens put in, seems to see better than I do, or at least as well as I do.  Something is not right and I intend to fight this.  My argument is that I should have been given all the facts before surgery so that I could have made an informed decision whether I wanted to pay the extra money.

[JodieJ]

I can understand your anger, and I have trouble accepting your surgeon's explanation.  Dr. Kutryb (one of the forum ophthalmologists) recently stated on another thread that his own research suggests that the Crystalens 50 provides only about .5 diopter of near vision.  This really isn't enough to make a significant difference in near/intermediate vision; you'd probably still need glasses for using the computer and reading.  Sometimes surgeons set the Crystalens for modified monovision (leaving one eye a little nearsighted) in order to improve intermediate vision.  Of course, regular IOLs can be set for modified monovision, too, with no surcharge for the patient to pay.  Check out the archives of both eye care forums for more information about other people's experience with the Crystalens.    

[Rita732]

Thanks again, Jodie.  I cannot find the archives you spoke of.  Also what is the name/numbers of the new Crystalens that came out in July?  I need all the info I can get to take to my surgeon on Thursday.  

You said : I have trouble accepting your surgeon's explanation.  Could you explain what explanation you are having a problem accepting?  

[JodieJ]

Type in "Crystalens" in the box where you see "Search Med Help"  (upper right corner of screen.)  You will pull up links to other posts about Crystalens.  The new Crystalens that came out in July is the Crystalens HD.  (See the first post on this thread.)

Your surgeon told you that you're unable to read with Crystalens because you have dry eyes.  However, I'm not aware of anyone who has good distance vision with the Crystalens 50 who doesn't need glasses for near vision (including all the people who don't have dry eyes.)  

[Rita732]

Of course you are right!  It just entered my mind that if dry eyes hindered my ability to read close-up, it would also hinder me from seeing distance clearly.  This is ammo I will take to my surgeon.  I really do have excellent distance and middle vision.  No complaints there.  I just have a problem with computer reading and certainly with newspaper and books.  However, Crystalens advertise that I will be able to read a newspaper and a telephone book without reading glasses.  My surgeon did not tell me differently.  I must say in her defense that I was only the second person she had implanted with the Crystalens.  She would not do the procedure before because of the bad rep the older generation of Crystalens had.  But she is wrong to say that it's my fault (dry eyes) that the procedure isn't working.  We will see what happens when I see her this Thursday.  Obviously she needs to stop listening to the Crystalens tech.

You have been of great help to me.  Thank you so much.  

[JodieJ]

I have good news and bad news for you.  First, the good news.  If you read through other posts about Crystalens, you'll discover that some people have terrible problems with glare and halos.  They are not able to see well at any distance, especially at night and in certain lighting situations.  By contrast, your outcome with the Crystalens is very good.

Now the bad news.  If you need glasses when using the computer, you do NOT have good intermediate vision.  Rather, you have about the same intermediate (computer) vision you would have gotten with no-additional-fee monofocal lenses.

It's possible that your vision with Crystalens is somewhat impaired by astigmatism, nearsightedness, or farsightedness.  Ask your surgeon if this is the case.

[Rita732]

First good news...I do not have problems with glare or halos. I do not have astigmatism.  Middle distance is good but not when it comes to reading small print.  Not sure about nearsightedness or farsightedness but will find out.  Bad news...you just confirmed what I've believed all along, which is, that I could have had the same result with the no-additional-fee monofocal lenses.  Now I have to see what can be done regarding the $4000 fee I paid.  My only defense is that I did not get what I paid for or promised by Crystalens company - the ability to read a newspaper or telephone book without glasses.  

I can almost bet that if I make enough "noise" I will be offered the new generation of Crystalens HD that came out in July.  You can be sure that I will let my surgeon know about them.  I will give them a try if offered, but not before I get something in writing regarding what will happen if they are not successful.  

I know it probably seems strange trying to get money back for an operation, but I'm hoping in this case things turn out to my benefit.  I'll keep you informed.

Thank you so much for helping me understand what is going on.  You've given me a lot of info that I can take with me Thursday when I make my case.  Keep your fingers crossed.  I can only hope my comments and your replies have helped someone else not make the same mistake as I did.  I should have done much more research beforehand.

[JodieJ]

No cataract surgeon can ever guarantee results.  You have had a good outcome with the Crystalens 50--crisp distance vision and good near/computer vision with glasses.  In your place, I would absolutely not assume the risks involved in explanting the Crystalens 50's and replacing them with the HDs.  (You might end up much worse off than where you are now.)  Please let me know the outcome of your appointment Thursday.  Best wishes.

[scams]

Jodie, you mentioned the "risk involved in explanting  the Crystalens 50s and replacing them with the HDs."  Is this type of replacement a greater risk than the initial cataract surgery for the Crystalens 50 (or for any initial cataract surgery) , and if so why??   The reason for my question is I am considering cataract surgery and using the Crystalens.  Sure glad I found this forum.  Thanks for any information about this subject, Sam.

[JodieJ]

I think the risks are about the same.  I've read that the accommodating features of the Crystalens might make explanting this lens a little more complicated.  If you're considering the Crystalens, you should discuss your concerns with your surgeon.  You might also use the "search" feature of this website to learn more about other people's experience with the Crystalens.  There's a wealth of information on this forum.    

[scams]

Many thanks for your reply, Sam.

[dand1]

I just had the crystalens hd put in today. Right now I see halos around the tv screen and the lamp shade. The doctor said my vision would be blurry at first that is to be expected. I opted not back off the my distance vision .5 to .75 diopter for reading like was discussed with my surgeon if I had gone with the crystalens-50. The hd is supposed to give more reading ability without comprimising distance. I will post later as to my progress. I just hope I made the right decision going with the crystalens.  

[Fran313]

Did you wear glasses for nearsightedness before you had the cataract surgery?
Are you able to see far yet?
I am debating on getting the Restor lenses but I am afraid of the halo effect.

[dand1]

I had monovision. I could read in my right eye and could see far in my left eye although neither was 20/20. The halos lasted only the first day. My doctor said it was because of the surgery. I do see glare from lights at night when outside or driving. It happens when the light comes from the side or overhead. I'm hoping this will subside as my eye heals from the surgery. I do have one stitch that will be removed next week. The doctor said my vision would get better and then worse the first week before getting better. I do see far and mid range and have since the next day. It's the close up that should improve over time. I can not see my computer screen sharply yet witch he told me I would be able to do without glasses. I wish I had opted to back off the distance to give me closer reading ability and left the left eye for distance. That would eliminate the need for glasses. The doctor did say if I wasn't happy with the outcome he could tweak it. What that means and by how much I don't know. I'll find out next week.

[2ndsight]

so far the outcome sounds similar to the earlier Crystalens models, like the AT-52 which I have. The glare you describe is (I think) a kind of reflection on the lens and some people say it comes from the Crystalens being slightly smaller (5mm) than some other IOLs. I have gotten used to this (4 months post-op) and hardly notice it now. Your night vision should improve over the next couple of weeks. Let us know if your close-up vision improves - that is what the HD is supposed to be all about.

[dand1]

I'm using readers +2.50  and my reading vison in my left which I can not read at all with  is fine but not in the right eye although it is better it is still not sharp. How close up can you read a newspaper without glasses?

[2ndsight]

I cannot read the small print very well at all but I can read the larger headlines, ads, etc. I only need 1.25 readers though. I had 1.00 diopter of astigmatism before surgery, and afterwards, with the Crystalens, the astigmatism seemed a lot more noticeable. So some of my reading vision is affected by that, the small typeface looks like it has a jagged edge. I can actually see and read the computer screen without glasses but it is more comfortable with them. Like you I only had one eye done (so far.) My left eye has a contact lens, and I see 20/20 with that. My reading vision is actually better with that eye.

[dand1]

I had my astigmatism corrected when I had my cataract surgery done. The doctor told me with the Crystalens-100 I would need a +1.00 for fine print. Now that I have the Crystalens HD I am expecting something better. I just don't know how long that takes after sugery. I still had some glare tonight driving. Not as bad as last night but still a distraction and quite annoying.  The surgeon told me it is better to have both eyes done because they work together. I'm having the left eye done in 2 weeks. After that they will give me execises to do to improve my vision and get both eyes working together.  

[2ndsight]

as I mentioned my night vision took a few weeks to improve, I actually didn't drive at night for 3 weeks after surgery. I am sure yours will get better.

[Rita732]

I had Crystalens implanted late April at the recommendation of my doctor/surgeon.   I specifically asked for lens that would provide good near vision so I didn't need to wear glasses for close-up reading, etc.  Not only do I NOT have good near vision, halo's with long streaks suddenly (last week) began appearing around car lights, street lights, etc.

I was told my near vision might get better as time goes on.  Has anyone experienced this who had Crystalens implanted?  What about halo's?  I need any info you would be willing to share so I can take it to my doctor.  

In comparison, anyone who would like to share their experiences with long-term monovision IOL's would also be very appreciated.

Thank you!

[dand1]

Chack out this article espesicially the last paragraph. It sounds like it works better when you are youger and your eye muscles are stronger. Remeber if you have had presbyopia for a while your eye muscles have probably weakend from not being used.  

[JodieJ]

Dand1, where can we access the article you are referring to?  Are you saying that the Crystalens doesn't work well for older people with presbyopia?  They are the primary potential patient group for the Crystalens, and all of the advertising seems to be targeted to them (e.g., "See young, be young" ads with attractive, in-shape seniors.)   Not too many people under 40 need cataract surgery.

Rita, one of my mother's friends (age 80) has full monovision with monofocal IOLs.  She previously used monovision contacts for many years.  She never wears glasses; she's able to drive at night, use her computer, and read the newspaper and books without correction.  But not everyone can adjust to full monovision.  Most people who have never tried it are probably better off with modified monovision (and using weak readers for small print.)

[2ndsight]

when I had my surgery in April with the Crystalens AT-52, there was a full page in the consent form dealing with the issue of presbyopia and the fact that NO multi-focal IOL was guaranteed to correct this. I actually had to sign and initial this page stating that I was prepared to need glasses or some other vision correction for reading.

My surgeon also stated to me that ReStor had better possibilities for reading vision than Crystalens. I would assume from this that reputable surgeons out there are able to separate truth from marketing hype. It is really unfortunate that so many patients are being sold the Cystalens on false premises, and then have an unhappy outcome. It really is a good lens overall and this issue of "never needing reading glasses" is giving it a bad name. I hope the manufacturers take note of this and hopefully modify their sales pitch to doctors.

[dand1]

  Sorry I forgot to link the web page. It was a CNN article if I find later I will let you know. The C-HD is marketed to people 45+. I am 53. Dr.Hagan told me the following "It may take several months for things to settle down with your Crystalens. Remember Crystalens is generally best for distance and intermediate and less so for reading."  
  My doctor and staff told I should be able to read a menu but might need a +1.00 for fine print. That was was with the third generation Crystalens. So now I'm expecting something better with the C-HD. I was told it could take several months before the final results will be known. I have heard of some peolpe's vision being better a year later. At my 1 week apointmenbt last week the assisant physician told me the Crystalens takes a while before it works up to it's potential. The nurse had told me because I was younger that I might do better than someone older because my eye muscles are younger. So far I am reading most things. I can read my computer screen but it is a challenge at this point.  As an example reading vision is more blurred when I have been using readers. It adjust after I take them for awhile which tells me I will be able to strengthen my reading ability by not using them and making my brain and eye muscles  adjust. The doctor told me it is best to have both eyes done since they work together. He will give me exercises to do to stenghthen my eyes and to get them to work together. So only time will tell the final outcome.

[dand1]

Here is the article.

http://www.****.***

[dand1]

check your email

[JodieJ]

If your distance vision is plano, you can use my vision as a benchmark for your gain in near/intermediate vision with the Crystalens.  I'm plano in both eyes with monofocal IOLs.  Without correction I can read most restaurant menus (especially in good lighting) and my computer monitor, but I'd have to strain and squint.  I can't read small print in any lighting without correction; my progressive glasses are +2.25 D.  Based on the articles I've read, the older Crystalens model provides about .5 D to 1.0 D of near vision.  The newer model is supposed to do better.

I couldn't find the article you sent.  You could try re-posting here but replacing the dots with spaces (e.g., www castleconnolly com).

[kitkathy]

Hi, I am 57, had cataract surgery Aug. 11 with the crystalens hd.  I used to need reading glasses only.  After the surgery my distance is blurry, but can use the computer and read without any problem.  My doctor lasered my eye twice and now he gave me drops to keep it dilated til Sept. 8, hoping the lense will set back further.  I really don't think that will work!  I paid $1450 for the lense that ins. wouldn't cover.  On Aug. 27 he said there are other options with one being lasik along with $1000.   I'm told that is a low price and maybe cutting me a deal???  I am hoping in time the hd will work well for me??? I would like to know if you can see the curves of the lense?  It seems the lense is out further than my eye and I can see it!  I have enjoyed keeping up with everyones problems and at least don't feel alone in the process.  Good Luck to you and keep me posted.   Kathy

[2ndsight]

a couple of other people have now also posted that they could read with the new Crystalens HD but that their distance vision was blurry. Keep us posted on whether your distance vision improves!

[JodieJ]

If you can read with the new Crystalens but distance is blurry, it means that the power calculations were off and you are nearsighted.  I would not expect much improvement in distance vision.  However, this does not mean that the final outcome won't be great.  Getting excellent distance vision in your second eye could give you a very nice range of focus.  With a little luck, you wouldn't need glasses for any activity.  I read one report from a surgeon who stated that his few premium IOL patients who experienced a "myopic surprise" in one eye were eventually "thrilled" with their outcome.

[kitkathy]

Thank you JodyJ and 2ndsight for the info.  I guess because I paid the extra I feel jipped with the outcome.  The distance,  unless I get used to it, makes my eye feel like it is not opened all the way and teary.  Yet it seems like I am looking through a camera lens. The doctor also gave me some drops for dry eye because I was seeing film once in awhile.  Hope that is not forever.  How can the company say 90% have no problem when the lens just came out?  Have you experienced seeing the lens glare in your eye?  I think if I cannot see distance I will follow whatever the doctor suggests.  Maybe a contact would work.  I've never worn them but could get used to it!  My husband had cataract surgery 2 weeks before me with and could see distance after a couple days. He still needs reading glasses.  He did not get the crystalens HD.  Will keep you posted and thank you for getting back so fast and on a holiday weekend!

[2ndsight]

regarding what you call lens glare, yes, I would describe it as reflection, when a light source (usually from the side or overhead) hits the lens. Other Crystalens patients have described this. It was very noticeable for me at night, when driving beneath street lamps, or when light was coming in a window from the side. It is 4 1/2 months since my surgery and I hardly notice this anymore.

[JodieJ]

A contact lens (like 1-day Acuvue moist) or LASIK should give you good distance vision once your eye has healed.  

[kitkathy]

Thank you both for the info, concern and assurance that it probably will be alright in the future.  There are so many choices these days, sometimes I forget how much progress has been made and all the alternatives there are in alot of situations.  All a person can do is go forward and hope for the best.  Thanks again!

[dand1]

/www usaeyes  org/lasik/faq/crystalens  htm

[dand1]

Mine was set for distance and middle vision and was told I would be able to read a menu and my computer screen with the previous Crystalens. This C-500 is supposed to give more reading ability but will take time. The doctor told me the Crystalens takes longer to see the final results than a standard monofocal lens. After hearing about you seeing the edges of the lens is making me think twice about getting my second eye set for reading. I'd rather wear glasses for reading than see the  edge of the lens. That would be annoying to say the least. My lens power is 18. The nurse gave a card to carry for any medical attention I might need in the future. It tells medical personal what lens and whta power it is on the back. As I stated before the doctor told me it is best to have both eyes done with this lens becauase they work together. I will have certain execises to do to strengthen my vision and get both eyes to work together. So my reading ability and overall vision should improve.

[JodieJ]

I think that the problem of seeing the edges of the lens is related to your pupil size rather than the power of the Crystalens implanted (i.e., whether it's set for distance or near/intermediate vision).  If you have good distance vision in your first eye, it probably wouldn't be a bad idea to give your near vision a boost in your second eye.

Thanks for posting the link.  Now other forum users can find the article.

[dand1]

You're right about the pupil size and seeing the edges of the lens. I asked the nurse about this before deciding which way to go on my dominant left eye. I wasn't going to back off the distance but after talking to the doctor in the operating room he convinced me it would be better for me. I'm glad I did. My vision is better than expected. Not only am I reading without glasses but my intermediate vision as well as distance is great. Let me clarify distance. I can see across the room and everything is sharp and then it starts to fall off. It's only been two days since my surgery and I'm seeing better than expected. My right eye has backed off has far as sharpness for distance and intermediate but I was told at first my vision would be better and then get worse before getting better again. Still though with both eyes together everyhting is in focus. It is so nice to be able to see everything as it really is once again and without glasses.  I can't wait until both eyes heal and settle down so I can see even better.

[dand1]

P.S.  I still have some glare at night while driving. Not as much in the left eye set for reading but the nurse today said this will also get better as the eye haels and settles down. It takes 3 to 6 months to see the final outcome.

[JodieJ]

It sounds like you already have good results, which will probably get even better with time.  Congratulations!  I hope you enjoy your new vision for many years.

[dand1]

Thanks. I hope others who are thinking of getting this lens read this blog. it is a big decision. I'm not telling anyone to do what I did because their results may not be the same. As an example KitKathy. It pays to research doctors and get a really good one and one that uses the latest technology.

[dand1]

I noticed in your last email you said your emails had disapeared. I have sent you two but when I check my sent file it doesn't show them as being sent. Just wondering if you got them.

[kitkathy]

It has been 1 month since my cataract surgery with the new crystalens hd.  I no longer see the lens glare, but still have blurry distance.  Dr. says he thinks this is what I can expect and suggests something called piggyback but kind of reluctant to do, contacts or lasik surgery. Right now I have mono-vision (I think) one has distance, one reading.  Before surgery, only needed reading glasses for both.  For now I think I am going to try contacts for the distance.  I guess some people just can't wear them for one reason or another.  Hope I have no problem.  Considering the 30 day ones?  Wish I had posted questions before surgery and read results.  Could be Drs. fault or just one of the 10% that have a problem with the lens. I am anxious to get this taken care whatever  I need to do.                  

[JodieJ]

I've found the 1-day disposable contacts more comfortable than the 30-day disposables, although they end up being more expensive.  (There's no time for deposits to collect on the lens.)  You could test drive more than one type of contact.  If contact lenses work for you, then great--problem solved.  (BTW, it can be much cheaper to buy contacts online once you've found a brand that works.)  LASIK would be another alternative--probably safer than getting a piggyback IOL.  

[TW101]

A related discussion, Crystalens Hd was started.

[sossells]

A related discussion, cruystalens problems? was started.

[skibug5]

A related discussion, Crystalens not what they said was started.