Crystalens "stuck"

[jefields]

I'm pretty sure I know now what happened with my Crystalens and why I don't have any distance vision at all. The first day, when I came home from surgery, I spent most of that day at my computer and doing some reading. It was exciting to be able to do that without glasses. That would have forced the C lens forward and I really believe that it got stuck in the forward position. As far as I have been able to glean from various (not all necessarily authenticated) sources, once the lens gets stuck in the forward position, it will not go back. If all this is true, then I could have unknowlingly caused this myself. However, no one said not to use the eye for reading/computer work.

I am scheduled next Thursday to have the lens explanted and a new implant. This morning I will be getting a ReSTOR in the right eye. I think I would like to get another Crystalens in my left eye (if this is what happened with it) because the two types of lenses seem to complement each other. My left eye is the dominant one.

I appreciate any comments and/or feedback.

Thanks
jefields

[JodieJ]

What does your doctor say about your Crystalens problems?  It is quite possible that the power of your Crystalens missed the target, leaving your eye on the nearsighted side (i.e., with good intermediate and near vision but myopic for distance).  Did you have clear distance vision immediately after surgery, and then suddenly lose it?  (BTW, the biggest problem with the Crystalens reported in the literature is that the accommodation feature simply doesn't work.  If this were true in your case, it would also support the theory that the power of your Crystalens is incorrect if good distance vision were your target.)

The ReStor lens is hardly problem-free.  Please do some research about it before proceeding with your scheduled surgery.  And you would certainly want your doctor to double check his power calculations.  If the power of your Crystalens is the source of your problems, you don't want that same incorrect power with ReStor.

Two of the forum M.D.'s have recently described "blended vision" with aspheric monofocal lenses.  (This seems to be the "surgeon's choice" correction for their own eyes.)  It would give you crisp, clear distance and intermediate vision, plus near vision that was good enough to see menus and price tags.  This is probably better vision than you would get with ReStor in the best case scenario, and you wouldn't have to spend upward to 12 months waiting to "neuroadapt" to your multifocals.  My best advice:  Evaluate all your options before explanting the Crystalens and implanting ReStor.

Best wishes, and keep us posted.


I can totally relate to your anxiety and your wish to correct the problem ASAP.  I'm just

[John C Hagan III, MD, FACS]

I agree that going from a Crystalens to a ReStor IOL may be going from the frying pan into the fire.  If you can see clearly at mid range and near with your present lens why not just leave it and see what happens. If after a number of months you're unhappy then you could consider LASIK on the overly myopic eye. You could also later have another Crystalens put in the other eye tweaked for distance.

I would not blame yourself for your problem. In all likelihood you did not cause your problem. Give yourself a break, these forums are filled with similiar problems.

JCH III MD

[jefields]

[John C Hagan III, MD, FACS]

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[jefields]

Thanks to you both for your knowledgeable and helpful remarks. Regarding the current Crystalens in left eye, the doc did a refraction test (more than once) and there was no power that corrected the blurriness. There is even some fuzziness to the intermediate and near range, although I can still read in those ranges. In my latest doc"s visit last Monday, he determined that the lens is not moving at all. I guess that means the accommodation feature doesn't work. I really do need distance in this left eye though, as it's my dominant eye...also the one used for photography. I don't know if one can retrain the other eye to become dominant???

I am not sure what blended vision with aspheric monofocal lenses is. I'm guessing one lens is for close and one for distance? I also don't know what the "aspheric" term means. I'm wondering if that would work when I'm painting (I'm a full-time artist). I am looking at constantly shifting my eyes among several different distance ranges. If the Crystalens on the left eye would eventually accommodate distance, I'd be okay with that.

I do have the new ReSTOR in my right eye now. Of course everything is pretty blurry now, as it's only been about 5 hours since surgery (Eye is shut right now), but I would like to think the eye is going to give me some distance...at least enough to drive. My doc did discuss this with me and this was his recommendation when we met on Monday. He said we could decide at the post-op visit tomorrow whether to continue with the scheduled explant or try to work with the Crystalens. I have read the article on the combining of Crystalens and ReSTOR which promises possibilities.

Thanks so much for your concern and for taking the time to share your thoughts and information and expertise.

jefields

[John C Hagan III, MD, FACS]

Aspheric is a way of manufacturing an optical system such as an intraocular lens to minimize higher orders of optical abberation. It gives a sharper vision and less problem with glare at night. The lens does not focus it is monofocal.

Training the other eye to be dominant when you can see out of both eyes in not very successful.

Hope all goes well. Let us know in a month or so how "happy:" you are with your situation.

JCH III MD

[JodieJ]

I'm keeping my fingers crossed till I hear your verdict on your ReStor.  I hope it gives you the distance vision that you want.  I don't think you should make a decision about your left eye until you know how well the ReStor is doing.  Keep us posted.  

[John C Hagan III, MD, FACS]

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[jefields]

Thanks for your concern. I have returned from my doc visit this morning and already have pretty good distance vision in the right (restor) eye...so much better than my left eye, and better than my pre-op cataract'd right eye, so that's progress. The near didn't show much, as my eye is still somewhat dilated. My doc went ahead and scheduled the Crystalens explant for next Thursday, but we will meet again the day before and re-evaluate all of it before proceeding.

The doc did say that he doesn't believe the Crystalens is going to improve on distance at all. He discussed last week's testing of it, said it is sitting in the back on the lens area, just as it should be, but is not moving one iota. However, it is giving me decent intermediate and near vision. So my choice is whether to risk the intermediate vision I currently have. I will have to wait and see how the restor comes along in the next few days. If the eyes were reversed and the better distance was in my dominant eye, that would be good. I guess it's possible, too, to learn to do my photo shoots with my right eye.

Anyway, doc advised against waiting any longer than another week to explant, if we decide to go ahead with that. I appreciate his caution in this. So right now...I just have a wait a few days and keep an eye on the vision progress of the restor lens.

jefields

[JodieJ]

I'm very glad to hear that the ReStor seems to be working out for you.  I hope that very soon you'll be satisfied with your overall results.  Keep us posted on your progress.  Best wishes.  

[John C Hagan III, MD, FACS]

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