Crystalens HD Bottom Line

[mmmmpppp]

Hello,

This one is for the doctors who use the Crystalens HD.  It is motivated by my fear of the Crystalens HD engendered by 1) all the bad stories I have read here on MedHelp, and 2) the reported 60 times greater likelihood of complaints on this forum about premium lenses compared to traditional lenses.

A couple questions:

1)  Among your patients whom you considered excellent candidates for the Crystalens HD and in whom you have implanted the Crystalens HD, what percentage have J1 or better distance and intermediate, J2 (or J3 if you think J2 is asking too much) near, are comfortable driving at night as long and as often as they wish, and would not report any major unpleasantness associated with the lens?

2)  Among your patients whom you considered excellent candidates for the Crystalens HD and in whom you have implanted the Crystalens HD, what percentage do you believe in your heart of hearts has serious doubts or actual regrets about having chosen this lens?

If Crystalens HD had been on the market longer, I would be asking these questions about the one year or greater mark.  Please do not include patients' premature doubts or regrets that pass.  Only feelings that are likely to persist.  Also, if the implant(s) was (were) recent, but you reasonably forsee that the patent will reach the threshold in question 1), please count that patient as reaching that threshold.

Please indicate if your answers to these questions coincide with what you would advise a patient you consider to be an excellent candidate for a Crystalens HD.  In other words, are you confident that you have implanted enough Crystalens HDs to expect in the future what you have seen so far?

By the way, I personally am 51 with a 20/25 left eye with either no cataract or just a beginning one and a right eye that is essentially blind from a big, dense PSC cataract.  So I personally would be especially interested in the answers to the above questions as they pertain to a cataract in just one eye.

Thanks in advance.  This is a wonderful forum.

[mmmmpppp]

Thanks once again for a great link.  You have a talent for finding them!

Bausch and Lomb finally responded to my efforts to get a copy of the FDA study.  They refused, saying that the study can't be released because it contains proprietary information.

Sounds awfully strange to me . . .

[Glad4Help]

Yeah, There was a statement near the end of the article about the Crystalens FDA study that said they didn't include the other eyes in the sample because it would have skewed the analysis toward more improvment in near vision, but I wonder if it would have also showed less far vision improvment???

Here'a a link to another article that gives statistics for Crystalens:
http://license.icopyright.net/user/viewFreeUse.act?fuid=Mzg2NTE2NQ%3D%3D

Good luck to you with the Crystalens.  My surgeon really seems very excited about his recent results.

I have decided to go with the aspheric monofocal lenses.  I went back to see my eye doctor and he says I will have much better vision than I have now but, of course, will still wear the multifocal glasses, which I have had for several years and like fine. He says I really have to do both eyes to get a proper visual balance.  And he thinks once I get the first eye done that the first question I will ask is 'how soon can I get the other one done.'  

[mmmmpppp]

Thanks for that link!  I too was struck by the appearance that they selected only those with the most successful outcomes on which to base their statistics.  If anyone else reads this post, I wonder if you know why the following statement doesn't nullify the FDA study of the Crystalens HD. When I say nullify, I mean, are the percentages of patients with various visual acuities based on a sample of only the most successful patients?  Here is the quote from the article about the study:

"For analysis of uncorrected and distance-corrected visual acuity VA, we selected patients who achieved a target refraction within 0.5 D of the intended target. We also conducted a comparison of monocular uncorrected and distance-corrected near VA with results of a randomly selected, similar sized group of patients from prior studies of the parent lens, AT-45, and the third-generation Crystalens Five-0."

It looks like not only did they select the plum HD patients, but they compared them to a random sample of patients with the previous versions of the lens.  

I too have been very attracted to the aspheric monofocal, but I guess I am just willing to gamble for the intermediate-without-glasses and maybe even something good on the near front.  But it was a close decision.  I hope I don't regret it.

[Glad4Help]

I really appreciate your input.  And, to tell you the truth, the thought of replacing the good lens in the left eye has given me pause for thought a few times.  I am far from blind in the cataract right eye but do favor that eye for reading, which I do all day at my job as a tech writer.  Actually, it is more annoying than sight critical and I think my reading ability with the left eye is improving, so surgery could wait a while.  I am going to consult with docters some more before taking the plunge.  

[ace399]

I think it has to do with the image size.  An IOL makes the largest image and contacts make a slightly smaller image.  Glasses make the smallest image.  So, an IOL in one eye and glasses in the other eye at a refraction of -6.25D was a mismatch in image size, which was difficult for the eyes to resolve into a single image.

[Glad4Help]

Thanks for the advice.  Do you know why glasses would not work but a contact would?  I haven't worn contacts in years.