Crystalens Problem

I had aCrystalens 5.0 implanted on 1/7/10 everything was going well now its hard to explain when under certain light it fills as if i am looking around the lens, its like you have a contact in that may be to small have been back for checkups and Dr says everything size wise is OK.  Just had the one implant also my middle vision makes it hard to focus in like in a basketball gym its hard to sometimes focus on people on the court, when outside under sunlight vision is much sharper.  Is this common or has anyone had the same issue its like its blurred on the outer edges.

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

There are scores of discussions among crystalens HD IOLs. Use the searach feature and archives to read.

JCH MD

[eyesonyou]

Hi!
It sounds like we had cataract surgery about 4 days apart.  Mine was on 1/11/10; haven't had the second eye done yet.  I had the Crystalens implanted in my left eye.

I also (very recently) began feeling like I have a contact lense in my eye.  It seems to occur early in the morning, and gets better after a little while.  Mine is noticeable when I look inward toward my nose -- that's where the "imaginary" border appears.  So, it's very interesting -- you are not alone in this.

In general, my vision in the operated eye is not a lot better for intermediate or distance, but that's probably because of my epiretinal membrane, for which I will have surgery in March.

I'll let you know if some of the other problems you described do occur with me.  I believe that this lens will require a lot of patience.  Have you had much accommodation yet for reading and close work?

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

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[caren123]

You say that after surgery in March for epiretinal membrane you expect the crystalens to provide better vision - while now it does not give you good intermediate or distance, you expect that to improve?  In other words, can it be said that a crystalens cannot work the way it is advertised to do if there are retinal problems?  Do you know what percentage see improvement?   Was this said to you by refractive, or retina specialist?.    I am in similar situation to yours.   My first impression was that it wasn't working and needed to be explanted!  Thank you.

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

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[eyesonyou]

Caren,
Hi again.  My ophthalmologist did say originally, during the cataract evaluation exam, that, because of my epiretinal membrane, he could not be real optimistic that I would get great vision with the Crystalens.  He said, "If you had no other problems, I'd say Go For the Crystalens.  But I can't be sure."  My ophthalmologist did say that your two eyes will need to work together with the Crystalens.  And since I still have not had the surgery in my right eye, it has no IOL yet.  That is what I assume is part of the problem with accommodation.  

OK, when I was evaluated back in mid-November by the retinal specialist, he said "You really have only two choices of IOL as far as I am concerned -- either get a Crystalens or a monofocal lens.  If I have to go in and peel your ERM later, I DO NOT want you to have a defractive lens (that is, a ReSTOR, ReZoom, etc.)."  He said it makes doing the surgery quite difficult.

I honestly don't think that there is a time frame that you can't exceed with the Crystalens, to get the accommodation.  I am sure that most people don't have any particular problems, and they probably do the two cataract surgeries a few weeks apart, as is recommended.  In the absence of any other problems, I would expect that these types of people get better, faster results than I have.

I also have the issue of astigmatism in both eyes.  The cataract surgeon said he's seen it take up to three months to see an improvement in vision when the LRI (limbal relaxing incisions) are done.  And it hasn't been 3 months yet.  What the cataract surgeon did to my corneas has no bearing whatsoever on the upcoming surgery to peel the ERM -- and that's straight out of the retina specialist's mouth.

So I see several things that could happen, and 2 of them are actually good:

1.  The Crystalens settles in, the results of the LRI come to fruition around April or so.
And the astigmatism improves.

2.  The ERM surgery (I said surgery in March, actually it is on April 8) improves my vision in the left eye by two lines on the eye chart.  This is what the retina specialist said we could expect if the surgery is successful.  If #1 also has a good outcome, it's all good.

3.  I have the surgery to get rid of the ERM.  Vision doesn't improve any.  And astigmatism never improves.  Nothing changes.  Eventually I get the other cataract removed and the second Crystalens implanted.  For all I know, my Crystalens will end up being a very expensive monofocal IOL!  But I will live with that.  Choosing it was simply a roll of the dice, and frankly, I figured I had nothing to lose but some hard-earned money.  The Crystalens sometimes doesn't work, even for those people with no retina problems or astigmatism.

I hope this is not too much information!  I keep wondering which of these factors mentioned above is the so-called "confounding variable."  I really hated my statistics classes, but I often think of them these days!

[caren123]

I appreciate you sharing your experiences. - it was all interesting to me. How nice that you seem to  have good doctors who care and  who communicate in plain language and  you have trust in them. Sounds very hopeful. Thanks again!

[eyesonyou]

I'm glad about my doctors too.  But the retina specialist has better communication skills than does my ophthalmologist, I think.  I will keep updating this board as things develop.

[jbigdan1]

I think that none of the lenses work like there suppose to. But you know if you can see half as good with one of the lens it's better then going blind. Now having said that I have the Crystalens HD 500 in my left eye and I was told by my Surgon that the next day I would see better then I ever have before,That eye has ben blurry ever sence FEB,2nd the day after surgery. I was told by my surgon that I have astigmatisem and I need LRI, To correct that. I also have the dark shadow and the flickering on the out side of that eye. I have desided you can't turn silver into gold so im going to take what ever happens and just be thankfull I can see at all. I believe that there is no surgon any where in the USA that knows how to implant the Crystalens or the multfocal lens. I think that there is some good surgons out there that can get close to what is advertised but it will be years before it is perfected. Any way you look at it you will go blind if you don't choose one of the lenses, So I say get a dart board put them all on there and where ever the dart hits thats your lens. I know I sound bitter but you see my surgon who I trusted lied through his teeth just to sale me the Crystalens and then lied again about what it was made of. I ask him if they were made silicone or acrilic because im diabetic and that I have read on these threads where silicone lenses was not a good choice for diabetic. I ask him again the day before the surgery and he told me that they have both silicone are acrilict and he said the one im getting is acrilic. So I said ok and then I found out later that week it was silicone. Even if the silicone lens wont do me any harm it's just that he said it was acrilic. Any way the right eye will be implanted with a monofocal lens set for distance and I will just ware glasses. I should have lisened to DR. John Hagan. On the monofocal lens. Good luck to all.

Jbigdan1

[eyesonyou]

Jbigdan,
I am sorry that you had this experience with your ophthalmologist.  I can't blame you for being upset when the doctor talked up the Crystalens and then it failed to deliver.  (Not to mention the lie about the materials it's made of).

In some ways, my experience was not totally on the up-and-up.  I will tell you straight, and thank goodness I can be anonymous here.

In my case, the cataract surgeon did not appear to be pushing the Crystalens.  We discussed the pros and cons, in the light of the macular pucker in my left eye.

However, the doctor does have a fairly large office staff.

His office has a "refractive coordinator" and she was the one pushing the Crystalens, perhaps because she gets a small commission for each one sold.  Hey, after all, the Crystalens is the most profitable one of all!  Google ads are bid out very high for this lense, compared to the ReZoom or the Tecnis  (Few ads bring in more money than Lasik ads, but that is another story!).

Anyway, his refractive coordinator said:  "If you can afford it at all, I hope you'll get the Crystalens.  Many people get a monofocal IOL with their cataract surgery, because that is all that Medicare will cover.  But with a monofocal lens, you will lose some depth perception.  As we get older, we need all the help we can get, especially with decreased mobility."

Whoah!  This statement about monofocal lenses didn't sound right to me.  But that day, I was not ready to choose a lens.  I had to be referred to the retina specialist, who was to check out my macula.

Well, I go to the retina specialist a few weeks later.  When talking about IOL choices, I blurted out what the refractive coordinator in the other office had remarked about the monofocal IOL.  The retina doctor got a dark look on his face, and looked over his half-specs at me, and said, "That is NOT true about the monofocal IOL.  And I'm going to tell Doctor X about the way his office staff misrepresented the lense to you."

The retina specialist and the cataract surgeon are very closely associated.  They actually practice at both offices interchangeably.  Whether he actually followed up and pointed out the lie to the cataract surgeon, I don't know.  But the retina specialist did not hesitate to call B.S. on this, and one other thing, so I came away impressed with his honesty.  I am very glad that he acted as a "check" on the whole chain of procedures.

Good luck with your other lens.  I do hope that you'll post more about your progress as time goes on.

[jbigdan1]

Thank you for sharing that withme. I will post on every thing I have done. I still need LRI. but I have made appointments with other doctors but I just don't know who to trust. Doctor O. Is always saying find a center of excllence but there is only two in Tulsa one don't except my insurance and the other only has one Doctor and he is an O.D. and I dont know him at all. But I will go with someone and have it done. Again thank you for you input.  

Jbigdan1.

[caren123]

Regarding finding doctors you can trust (my situation is that I had crystalens implant and retina comlications and am facing retina surgery),  I recently saw a general ophthalmologist my friend has gone to for years, and loves . He is  very experienced (over 25 years)  and was a medical doctor before becoming an eye doctor.  My friend long ago had pinholes in her retina which he lasered, so I thought he must know about retina issues. Obviously, he has also dealt with an aging population and  cataract problems.  I liked him very much as he patiently read my reports from four doctors...He agreed that I should undergo retina surgery.   When I asked,  he recommended a surgeon who turned out to have over 8 years experience in vitrectomies and whose education was at one of the best schools on Dr. Hagan's list. He accepted my proposal to oversee my case from here on in .  I couldn't have done better at this point - what a relief to find someone knowledgeable to help make decisions. (as well as having this website and all the support it gives).  And,  he is not trying to sell anything.
I did not have a general ophthlmologist before this all began with the cataract surgery and retina complications. Maybe it would have helped.

[eyesonyou]

Caren, I am delighted to hear that you found someone you trust to oversee your case, and also a surgeon with good credentials.  Let us know how your surgery turns out.

Jbigdan,  I remember being impressed with the medical community in general in Oklahoma.  Oklahoma City is certainly the center for medical care in that state.  I wonder if you might find someone there to do the surgery.  Regardless, I wish you the best.