Crystalens Nightmare

[Eye-Kant-C]

I am 47 years old, female and in "excellent" health, no smoking, drinking, etc. I had a clear lens extraction (for refraction -- no cataracts) because my eye doctor and his associates were so excited about the new alternatives to Lasik. I was losing my near vision, but intermediate was still good. They told me that I would be free from reading glasses, except for really small type. I have pretty bad eyes (-10 myopia soft contacts for 33 years). I wore +1.5 readers for extended reading, but not needed for computer work. He put in -12.5 Crystalens for right eye and I had great distance vision, and was planning to do the left eye 4 weeks later. I called to tell him that my closeup vision was much worse than before the surgery and his technician said he may want to do more measurements before doing the 2nd eye. He never called me to come in, but when I went for surgery on the left eye, he said they had decided to do my other eye so that I would be slightly nearsighted and that would carry me through till the right eye gained near vision. He put in -14 in the left eye. The near was immediately amazing in the left, but terrible distance. I NEVER WANTED MONO-VISION AND I HATE IT!!!!

Now -- right eye (2-1/2 months post-op) and left (1-1/2 months post-op) are exactly the same as after surgery -- distance in right 20/20 but can't see to even use the computer, let alone read. Left eye -- good for closeup, 20/70 for distance. MONO-VISION. Which is pretty irritating during the day, and I can NOT see well enough to drive at night. And I drive at night a lot.

But in addition to that: I have cloudiness in both eyes which he says I need to have laser to fix (YAG?) and I am at high risk for detached retinas being very myopic and my mom  & sister both had D.R. previously for no apparent reason. I heard that YAG really increased the risk of D.R. And Crystalens really increases the risk of PCO because it is made of silicone. And you can't get a Scleral Buckle if you need it for Detached Retina because of the silicone in the Crystalens. Why didn't anyone tell me this?????

Believe it or not: the worst part is this -- I have constant edge glare where I can see reflections around the lens (doctor says this is not possible, I'm not really seeing the edge of the lens). It's like floaters -- no big deal if you just ignore it and I have halos at night -- also not such a big deal -- BUT, I have EXTREME edge glare/flare that looks like sunrays only usually rainbow-coloured, that flash across the front of the lens when any light source hits the edge of the lens, day or night. In doctor's offices and side-view, rear-view mirrors, street lights being the worst. I also see major glare from windows even during the day. He gave me the Alphagan P (Allergan) but that did nothing to stop the light show.

I know that removing the lenses is probably not possible -- I've read all the horror stories, and YAG would weaken the capsule, quite possibly causing Detached Retinas. He said I may not have a choice and I will have to do the laser procedure. Why would a reputable surgeon do this to a perfectly healthy person, knowing how risky these lenses are? Are they using us as guinea pigs??? Is there anything I can do to see better/not go blind?

I thought about sports contacts to cut down on the glare/reflections -- not sure how dark they are for night driving (I sometimes use sunglasses at night now, but it's scary) And I considered Multifocal contacts to get back some near vision -- I miss it badly. That's the only reason I did the surgery. I'm now wearing one contact for distance, since I was so miserable with mono-vision. So I'll be back to contacts and reading glasses and I went through excruciating pain for the 1st eye surgery and still have eye pain in that eye, a lot of money ($6,000 total) and I am higher than ever risk for detached retina and have major light show/fireworks when encountering light sources in my peripheral vision.

Sorry this post is so long ... I am driving my mom nuts with this -- I'm so miserable. It's good I went through this first because several relatives/friends were considering Crystalens implants. I have spared them and I hope to warn others. I know everyone says have patience, but I highly doubt this will get better since it hasn't changed at all in 2-1/2 months. Not even a little.

[peakhope]

The ablation procedure might be PRK? Doesn't sound as scary, somehow.

[ace399]

How is the ablation technique done?  

[JodieJ]

Get another opinion before proceeding.

[scmite]

I just had a cataract removed and my doc sugested the crystalens . said my vision would be better. needless to say the 20/20 vision I had before the crystalens is now 20/60...Now 2500.00$ later he wants to do an ablaction technique to try to make my vision better...This procedure takes longer to heal and is painful... Has anyone had this done?  I am afraid it will make things worse or blind me....

[JodieJ]

In your place, I'd schedule an exam with a retinal specialist before doing the YAG.  I think it would give you peace of mind to know that your retinas were in sufficiently good shape to have the procedure.  Given your long eyes and family history of R.D., it might be a good idea to have periodic followups with the retinal specialist, if these were recommended.

[Eye-Kant-C]

Here's an update:

Called surgeon's office and filled his assistant in on all problems I'm having (she didn't know) and told her that my surgeon's associate (my regular opthalmologist) suggested opaque green contacts without power (plano?) just to test to try to cut down on edge reflections with Crystalens IOL's. She was surprised by all the problems. (All doctors/technicians at this office are very professional and trying to do whatever they can to remedy my problems -- very nice people, also.) IMO, the manufacturers are not being really straightforward with physicians about the actual performance and problems of their lenses, with Crystalens probably being the most deceptive in their advertising.

If the opaque lenses help, I am going to try to change from -1.5 contact over Crystalens in left eye to -1.25 and maybe +.25 contact lens in right, if that works, to become slightly nearsighted again in hope that I get back a little of my intermediate vision. I'm willing to try almost anything at this point, but very leary of any more surgery, including Lasik.

I asked her about increased risk of Retinal Detachment with YAG, as I am already high risk and she seems to think I shouldn't really be concerned at all, she says R.D. is very unlikely, but I have read in several forums and websites where doctors are strongly recommending against YAG for high myopes like myself, let alone with a family history of R.D.

Any thoughts?

[Eye-Kant-C]

Thanks for your input. I have read and read and read many of these forums!!! Very helpful. And I surely wish I had researched the whole IOL thing before getting it done. I searched for "Crystalens" and only came up with numerous physicians' websites, which all say how fantastic these new accomodating lenses are. Never thought to type in "Crystalens problems." I am not in a hurry to do any more surgeries at all. And I definitely don't want to attempt an Exchange, since I've read that they're extremely risky with Crystalens. I may try the opaque contact lenses to reduce the edge glare -- one of my surgeon's associates suggested it may help. (I guess you can't wear the sports contacts long-term.) He also thought the glare may be reduced over time. It's actually unbelievable how bad the glare is, not just halos. I could live with halos, if that's all it was (which I mentioned I also have). I saw an article that describes it as follows:

"The specific visual symptoms reported by these patients may include temporal darkness, shimmering or pulsing light, arc, flare, and/or a central flash (usually an edge reflection caused by a peripheral light)."

REF: http://www.revophth.com/index.asp?page=1_643.htm

I have the arc, flare, shimmering and worst of all "central flash." Definitely worse at night, but the shimmering is all the time. The central flash is really dangerous for driving.

Does anyone have experience with bifocal/multifocal contact lenses? In addition to trying the opaque lenses, I may see about trying my luck with the multifocal contacts. I'm going to wait a while to see if the near vision gets any better, but I wonder if the blurriness could be helped at all by the YAG? My distance in the right eye is extremely good, though. And near in left eye also very good. I notice all vision is much worse in low light (much worse than before the surgeries). Could cloudiness be blocking out some light that would help with focus?

Thanks again for your comments.....

[JodieJ]

I agree that your Crystalens experience has been a nightmare, so I'll try to focus on the positive.
While the silicone Crystalens with its small diameter wouldn't be the first choice IOL of most retinal specialists, I don't think it would preclude surgery for retinal detachment.  When I researched this issue last year prior to my own cataract surgery, I discovered that many retinal specialists don't object to a silicone implant in patients at risk for retinal problems.  (There's actually a post somewhere in the archives from a woman with a history of two retinal detachments.  Her retinal specialist reportedly referred her to a cataract surgeon who did a hard sell for getting the Crystalens.)

The forum M.D. has given you some excellent suggestions.  You should definitely get a second opinion about your options (preferably from a surgeon who is very experienced with the Crystalens.)  If you do opt for an implant exchange, please thoroughly research the lens you will be receiving.  (You might not be any happier with ReStor or ReZoom than with Crystalens.)

You might try posting about your edge glare problems on the eye & vision forum at HealthBoards (www.healthboards.com).  I believe that there have been reports of this problem diminishing over time.  Also check the archives of this site about this issue.

Best of luck!
  

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

Use the search feature on this website to look up previous discussion of problems with Crystalens, ReZoom, ReStore, multifocal implants, accommodating implants and monovision.

I suggest you see a experienced cataract-refractive surgeon for an independent second opinion about your options. You need to know just how cloudy the posterior capsule is. You also need to discuss implant exchange. If this is something you want to consider it is safer if done before Yag laser capsulotomy.

Another possible option if the capsule is not cloudy is LASIK on the left eye. If you do this you will gain vision at distance but lose the same upclose and glasses will likely be necessary more of the time, perhaps much the time.

JCH III MD Eye Physician & Surgeon