Crystalens VS ReStor

[mkmr]

Dear All

   I am planning to do a cataract sugary for my right eye very soon, I am 35, and I have to work in front of computer all day long at work. My eye doctor recommended me to use Crystalens, but I also worried since this lens can move inside of my eye, what happened years after and one day it gets stuck and can not move again. Will that happen? Should I go for ReStore?  By the way, I also have astigmatism since my childhood. Doctor says he may reduce half  of it during the sugary, and the other half may need Lasik to get rid of it. Is that normal for cataract sugary? I am reluctant to have two sugary to fix one eye.
I am in Houston, TX, the eye doctor I went is Berkeley eye center
Thanks for any recommendations.

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

There are different answers for different people. If you do decide to have a multifocal IOL Crystalens is the best available now in the US with the ReStor second. Crystalens best for distance and intermediate and ReStor for near. I would advise you to stay away from the ReZoom IOL since we have tons of unhappy patients with that IOL here in the eye forums.

Even with accommodating IOLs you should plan on wearing glasses some of the time for some things.

The standard way of fixing the eye would be use a high quality non spheric monofocal IOL like the Tecnis and set one eye for distance -0.25 and the other for intermediate -1.25 and plan on wearing no line bifocals for reading and when you want your best vision (night driving, sporting events).

JCH III MD

[mkmr]

Hi John,

  You mentioned “Crystalens best for distance and intermediate and ReStor for near”.

I am a computer programmer, have to look at computer all day long, will Crystallengs perform well in arm distance?

Thank you for your reply

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

Can't generalize. Sometimes yes, sometimes no. Read the many posts about the pros and cons of these IOLs.

JCH III MD

[mkmr]

I went to see another doctor this morning, he suggested that I should use ReZoom. (First doc recommended Crystalens).

Now I just cannot decide which one to use.

Lots of people in this forum like ReZoom, not that many like Crystalens.

I have 2.5 astigmatisms plus 3 near sighted.

Can you tell me what your think which lens I should use?

Many thanks

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

You are NOT looking at the forums correctly. There are far more unhappy people on these two forums with ReZoom in their eyes than Crystalens.

I posted that in January 08 I went to a two day seminar on cataract surgery. In a poll of over 200 surgeons the Crystalens was the overwhelming choide of the surgeons when asked what IOL they would want put in their own eyes (IF THEY WANTED A MULTIFOCAL IOL).

There was not a single surgeon that raised her/his hand in answer to "Would you have ReZoom IOLs put in both of your eyes".

I personally would not want a ReZoom in my eye or any patient that I have to take care of. Our practice uses mostly Crystalens and using "mix and match" some Crystalens for distance and ReStor for near.

JCH III MD

[mkmr]

Hi John,

  You are right; I read some more posts these two days with my half blind eye, found out that there are only a few cases here complaining about Crystalens.

  I also found out on Crystalens website that their latest release is 5.0, should I ask my doctor if he is going to use this “version” or I can expect taht they will always use the latest release of Crystalens by default?

  Thanks again John

[JodieJ]

You have significant astigmatism, which will impair your vision at all distances with the Crystalens.  Be certain that your surgeon will be doing some type of refractive procedure to reduce/eliminate astigmatism before you pay the surcharge for Crystalens.  Another possibility for you would be toric IOLs (to correct astigmatism) set for modified monovision.

[mkmr]

Accroding to the doc, he says he can do some kind of procedure during the cataract surgery to reduce about half of the astigmatism, and few month after Crystalens installed, he will do a Lasik to get rid of the rest astigamatism. I am not sure if this is usually what they do to treat patient with high astigamatism or not. but it sounds reasonable.
The Crystalens is about $2200, it include a lasik surgery. I don't know how much it cost to do the cataract surgery and astigmatism reduce procedure yet, but will know next monday. I am sure it's going to cost me a fortune.

thanks for your response.

[JodieJ]

It sounds like your doctor has a good plan.

If you have cataracts, your insurance should cover the cost of your cataract surgery (less the surcharge for the Crystalens).

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

--------------

[eyecu]

I would go to the Heights Eye Center in Houston and get a second opinion about the ReZoom lens. If you saw the recent Masters tournament and watched Gary Player play in his 51st Masters, then you saw a bilateral ReZoom patient who was so ecstatic with his vision he became a spokesman for the lens. My sister in law is bilateral with ReZoom lenses and passed her drivers test for the 1st time in her life not needing glasses. Mixing the ReZoom in the dominant eye and the ReStor in non dominant eye is also a widley accepted practice because it gives you range of focus in all lighting conditions. I am truly surprised that since the computer is important to you the ReZoom lens  was not mentioned as it should be your first choice. Yes, there are halos associated at night with multifocal lenses but glare is a by product of the Crystalens since it only has a 5mm optic. Look on the labeling. Plus it does not have even the minimal UV protection that most standard lenses have. Get all the facts which is what you are doing.

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

Again use the search feature here an read all the bad posts on ReZoom. In a large group of active eye surgeons they would use only Crystalens and ReStor in their own eyes.

JCH II MD

[eyecu]

The meeting was a Crystalens user meeting so I would say the answers are a little biased. This board is not a scientific sampling. Any complaint does not mean it is a lens problem. It could be a surgical problem, astigmatic correction problem, target refraction could be over plus or minus, adaptation  problem etc. The ReZoom's strength is distance and intermediate vision. There are also J1 ReZoom patients so it is the only lens that gives you a chance at a full range of focus. It is a 3rd generation and does have some asphericity to it which the Crystalens does not. The ReZoom patient gets better over time as halo's diminish through neuroadaptation as they do with ReStor. Crystalens data on the 5.0 is just now approaching one year out so we will start seeing what long term outcomes with that product are and if does stop moving etc. as MKMR is worried about.

[JodieJ]

I agree that surgeons' opinions at a Crystalens user meeting might be biased sample.  However, when surgeons attending the ASCRS 2007 Symposium were polled as to which of four multifocal/accommodating lenses they would want in their own eye, the ReZoom lens also placed last.  In this forced-choice situation, the results of the polling were as follows:  43% of the surgeons chose Crystalens, 33% chose Synchrony (not available in the US, possibly a protest choice), 16% chose ReStor, and 8% chose ReZoom.  Since these surgeons are privy to  "inside information" about how well these lenses actually perform, these results are hardly a vote of confidence for ReZoom.  

[mkmr]

I just had Crystalens installed in my left eye two days ago on April 16th.
Now I noticed that I have some glare when I am indoors, especially form the ceiling lights; I don’t see any glare when I was driving at daytime in the sunlight. And the distance vision at daytime is excellent.  When I drive at night, the street lights give me circling glares from small to large and fly away from my eye when I pass it. This is kind of annoying.

Will this glare go away after a few days or weeks?

My arm distance vision is very blurry, I can not read from a computer monitor unless I set the resolution to 800x600, but when I put a 1.25 reading glass on, it becomes very clear.  I don’t know what’s going on. Will I be able to gain the close vision in the future? Should I keep using the reading glass I just bot? I wife suggested me to train my eye to read in arm distance by staring at the monitor very hard, she thinks using a reading glass at the age of 35 does not make much sense.

Any suggestions appreciated.
Many thanks!!!

[mkmr]

I just found a picture that can best descript what I have in my eye when I am approaching a light, it is not that intensive like the picture, but it more spread out. Not that strong like the picture. When I look directly at the light source, I don’t have any glare or flare.

http://upload.wikimedia.org/wikipedia/en/a/a6/Rainbow_flare.jpg

[lsnstr]

From a former Rezoom implant (had them explanted) I can tell you in no uncertain terms that the Rezoom lenses are a piece of junk. It is not only the halos you need to worry about, it is poor intermediate vision, ghosting, etc. I can't believe there are doctors still implanting those useless lenses!
Eyecu, are you a Rezoom salesman?

[JodieJ]

Based on her responses to previous posts, I believe that eyecu does work for AMO, the manufacturer of ReZoom.  She is very knowledgeable about many aspects of cataract surgery involving multifocal lenses.

Lsntr, based on what I've read about ReZoom, I share your sentiments.  However, I've seen a number of posts from people who are pleased with their vision with a combo of ReZoom/ReStor.  It's an open question as to whether these same people would have been even happier if they had gotten monofocal aspheric lenses set for (modified) monovision.

Mkmr, your eye is still healing.  What does your doctor tell you?  In your place, I'd wear the +1.25 readers if I needed them to read my monitor.  
  

[lsnstr]

I have modified monofocal vision and I'm very happy with the results. I was inspired to have the Rezoom implants removed based on the successful procedures and positive results shared by others in this forum.

[mkmr]

I did an eye exam the day after surgery, but my eye was still dilated at the time, so I don't see any glare/flare,
I will have a another follow up exam early next week.
Hope this glare/flare will be gone when my eye is healed.but until now this morning, I can still see them.

[eyecu]

My sister in law is a very happy ReZoom patient. Every patient out there has experienced trouble and has had lenses explanted whether it is ReZoom, Crystalens or Restor. That is the whole point. There is not perfect lens. And if you had poor intermediate vision than your surgeon missed their refractive target or did not know what they were doing. I am just looking for balance. If the Restor or ReZoom was perfect they would have never been mixed in the first place. There are Crystalens patients who have had low diopter Array lenses implanted or piggybacked so they could have near vision. ReStor patients also experience poor distance vision like looking through wax paper. Surgeons can be polled and say they would have or prefer a particular lens and they have never even implanted any of the three. The cream will rise to the top and the good news is that technology is being driven to find a better mousetrap.

[mkmr]

update
I had my second post surgery exam this afernoon. doctor says the glare is normal, the lens is perfectly aligned with pupil. it will either go away or my brain will filter it. I told the doctor the vision I have for crystalens is fine, even I can not read from the computer monitor.
The only problem right now is all these glares that bothers me most. and these ray like glares sometimes can occupy most of my eyesight if the light source is at certain angles. and doctor says he did not get that complains very often, most people only complain that they have glares occasionally. he asked me to come back to check again two weeks later, I asked what's my options if this problem continues. he answered "lens exchange", they do that a lot few years back when they had wrong power of lens installed. I asked what's the risk for exchange, he says the risk is just like to put the first lens in.
I hope these glares will go away, because even for a lens exchange, I have no idea what lens I can use. people in this forum get glares/flares from all three lens, crystalens,restor,rezoom. Maybe a monofocal one does not have glare.

[2ndsight]

I had a Crystalens implant 1 day after yours, 4/17. Right now I am using 1.25 readers for the computer, I have very little glare just a few reflections here and there. In my reading about how the Crystalens works I understand it should take a little time for the lens to be accomodating to intermediate and near vision. I have the impression that I can see well at all those distances (everything except fine print)  but there is actually still some blur. The Bausch & Lomb website I think says somewhere to allow 4-6 weeks for adjustment.

[2ndsight]

p.s. have you tried polarized sunglasses for the glare