Crystalens update

[Eye-Kant-C]

Just a quick update. I have a post-op appt. with surgeon tomorrow. I'm gonna try again to beg for contacts to make me slightly nearsighted in hope that I'll regain a little closeup/intermediate vision.

I am resigned to living with the flashing/glare issues and I know I could be a lot worse off than I am. I am learning to live with it and it seems to actually be getting a little better in the last couple weeks. My heart goes out to those who are worse off. Our vision is so precious. I'll let you know how the visit goes. Have a good day!

[turbojoe]

good luck im kind of dealing with the same thing.. well vision problems anyways haha.. i hope your visit goes good!
Joe

[John C Hagan III, MD, FACS]

Hope eventually you arrive at when you want to go.

JCH III MD

[JodieJ]

I have two comments.

1) You should not be "begging" for contacts to make you slightly nearsighted.  In this particular instance, your doctor is your paid consultant--not your boss or your father.  We're talking about YOUR vision.  There is absolutely no medical reason why you cannot experiment with "modified monovision" in your non-dominant eye, using a disposable contact lens.  You could try .75D  for a week or two, then adjust the power up or down slightly (if you want) to get the vision that you're most comfortable with.  (Maybe you could even get a few sample disposable contacts in different powers to take home with you.)  This method will give you the best possible correction for you, with flexibility.  If your doctor refuses to do this (extremely doubtful), then you should go to another doctor who will--probably an optometrist who specializes in fitting contact lenses.

2) In my opinion, you owe it to yourself not to become passively resigned to living with your flashing/glare issues.  I hope that they will improve on their own, but they may not.  The practice of ophthalmology is extremely specialized today, and no practitioner can possibly be aware of every treatment option, especially when it comes to new technology like multifocal/accommodating IOLs.  If your doctor cannot treat your problem, you need to consult another experienced surgeon (or surgeons).

I have posted my own experience elsewhere.  During the months following my retinal surgery, my affected eye teared almost continuously.  My retinal surgeon and several other specialists I consulted told me I'd have to "learn to live with it" (and be grateful that I could read the 20/20 line with that eye).  I did not want to live with an eye that was constantly tearing, so I did my own online research and then wrote to the authors of articles about my condition.  This led to a solution that immediately stopped the excessive tearing.  My point here:  You shouldn't become passively resigned to living with a problem because one doctor can't help you.    

[Eye-Kant-C]

Hi --

I saw my surgeon today and he said I have an extremely good range of vision between the 2 eyes: one for close and one for distance. And I again said yes, they are each great ... separately. But I didn't WANT monovision. I want to try a contact in the "near adjusted eye" that's not as strong, since the one I had (-1.50) was overcorrecting that eye for distance. And he couldn't seem to understand that I realize if I get a little less distance, I'm okay with that since the Crystalenses don't seem to be accomodating much, if at all and I only did this surgery to regain some near vision. He said but before you had the surgery, you didn't have much intermediate at all and I told him, no -- that's not true. I never needed "readers" for the computer and other intermediate things, such as seeing the food I'm preparing/eating! Only for actually reading.

So, I think he finally gets it. I don't like mono-vision, but would be willing to try the modified/blended vision as you have suggested. He gave me a (-1.00) contact and still doesn't want to give me anything to "dim down" my 20/20 distance in the other eye to get back a little close-up vision. He's so afraid I won't be happy to lose the distance vision in that eye. I don't really need to see the spots on a ladybug at 1/2 mile away, but I do need to see what I'm eating!!! (LOL)

So, even the (-1.00) contact was still extremely good for distance 20/15 and I said I'd really like to try one even less than that sometime. Luckily he had one and gave me a (-0.50) to take with and I'm thrilled to say it's MUCH better than being overcorrected and also better than the IOL alone (a little blurry for distance). I am going to push for a (+0.25 or so) for the other eye to try for slight nearsightedness to see if I can gain any closeup in the distance eye. Sure can't hurt to try.

If the Crystalenses are accomodating at all (not sure, but they may be???) I read that if they are set to overcorrect for distance, that negates the closeup vision you would have gotten from them. That may possibly be the problem I have with the one and the other needs just a little bit better distance, since it's set for closeup.

I want to give it more time to see if the flashing is really getting less intense. It seems to be better. He really believes that it's the actual retangular-ish edges and not the round optics in the center that are causing the problem and the capsule may "frost" over the edge better in time to cut down on the glare. I'm actually starting to be able to tolerate it pretty well, so either I'm getting used to it or it's getting better. I'll research more on possible solutions, though.

I'll keep you posted -- next appt. in 4 weeks. Until then ... thanks for talking!

[John C Hagan III, MD, FACS]

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[JodieJ]

I think that by experimenting with disposable contacts, you can get the exactly the right correction for you.  And it's totally flexible.

Overcorrecting distance vision with the Crystalens would definitely negate close vision, and I it wouldn't enhance distance vision.  I'd think that a little laser correction enhancement could fix this.  From what I've read, even in the best case scenario, the ability of the Crystalens to accommodate is modest (i.e., can provide good intermediate but not close vision).  But you could get similar results with monofocal lenses set for modified monovision AKA "blended vision (-.75D to -1.00D), with no premium IOL surcharge.  There's supposed to be a new Crystalens model coming out next year with more accommodation capacity.

Keep us posted on your progress.

[Eye-Kant-C]

I heard about the new lens coming out -- too bad I didn't know about it when I was making my decision on this!!! I wasn't in a hurry, since I didn't have cataracts.

[JodieJ]

I

[Ashley52]

Jodie,
You know more about multifocal lenses than most doctors.  Kudos.
Two months ago the flashing and "edge view" of my Crystalens were driving me crazy.  Today, it's still there but it seems to have moderated and I have adjusted.  It's true what they say about this but hard to fathom when you are going through it.  It sounds like Eye-Kant-C is having a similar experience in this regard. If I had it to do over again, I don't think I would have Crystalens though I'm not sure what the best alternative for me would have been.

[John C Hagan III, MD, FACS]

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