Encourgement prior to Lense exchange

I guess I'm just asking for some encouragement, as after more than 2 months with poor quality  & blurry near vision  due to Restor IOLs, my best option is to change the lenses, or at least as the surgeon suggests, start by changing the non dominant eye to a monofocal for near vision. I was a -3.00  before and the feeling is I would be happier with this functional ability that I regret losing. I was not aware of the vision trade-offs these multifocals would create, and I unfortunately pretty much have all of them, though I can see distance., but need my near vision more . The thought of repeating the surgery has me really scared about doing this and worrying that it will be successful and make an improvement. (Since the original was not the expected result) So if there is anything to say to help me get through this with the hope of seeing clearly it would be appreciated.  
Thanks to anyone who offered prior responses, at least I felt someone was listening and understanding my distress. This forum has been most helpful, taking the time to listen and providing some good information.

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

You can use the search feature and archives and read the many discussion threads about ReStor IOLs.  I would suggest you get a second and third opinion about what course you take as you obviously did not do the research the first time around.

If you have never done monovision before you should know some people cannot adjust to it and glasses worn with IOL monofocal are often very hard to get use to.

JCH MD

[MsLN]

Unfortunately the pre-surgery promised benefits sounded very enticing, and no major negative risks were presented, though I asked, (barring the actual surgery). I did a little checking and spoke to a patient who had the Restor lenses done the month prior to me, he was totally pleased. At that time I could not find anything substantial to be contrary to what I was told, even asked to please not “sugar coat it”, but was assured I would see better and likely not need glasses.
Sorry if this sounds critical, but how should a patient know that they are being misled, how much searching and knowing where to look should a patient who feels trust in the doctor need to do? I should be angry for not being fully informed, so please don’t make it sound like I did something wrong by not doing the research the first time around. Something is wrong, but don’t blame the patient!  Now after the fact, I have since researched, read, written and have tried to learn as much as possible, to the point of being obsessed. It can’t be undone, so how to move forward is the question. Do I take the chance of changing the lenses and hope for improvement or just leave the impairments which is taking a mental and emotional toll. The intention is to have me go back to being more nearsighted, changing one IOL, then the other if necessary.
I have done monovision with contact lenses, and have been using a +2 contact lens with the IOL  to give me some functioning near vision, If it matters I can wear it in either eye with no problem. I could deal with this if it wasn't for the blurriness, which I hope the monofocals will resolve. And I had gone for a second opinion with a very well known Dr in Florida. Found no fault with surgery or other reasons, I was just unlucky in not “adapting” to these lenses, and  he suggested the same solutions.  Of course if I had known about the inherent problems, that the multifocals are not the panacea of vision technology, I would never have taken this risk.

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

FIrst of all mutliple studies done at multiple locations (Mayo Clinic for example) where dertailed and informed consent by physicians/nurses in which possible complications were reviewed then patients post surgery given written tests to see if they remember being informed of the complications show patients retain only about 30-40% of adverse events discussed with them, moreover you sign a consent form that includes risks such as infection, bleeding, loss of eyesight.  That means you also accept that you may need glasses, may need IOL removed, etc.  Nothing in life is risk free certainly not medicine or surgery.  You know each time you get into your automobile to drive somewhere there is a small risk of an accident and a smaller risk of serious injury or death. Yet you drive anyway because the risk is small and you need to get some place. That's the way risks are with any surgical procedure.

If you can see well with glasses (progressive no line bifocals) then that is your safest, least expensive and best option, another option would be wearing contacts. Other options such as IOL exchange involve more risks and expense.

JCH MD

[MsLN]

what you said is true, I read everything you wrote about this, but my husband, who remembers everything, was with me and the information concerning the aberrations the IOLs could cause  were never disclosed. I had even asked if I should wait a month because of an important upcoming family event, but was told I’d be fine by then. I was willing to accept the surgery risks, even the night driving halos and glare mentioned, but losing quality of vision was not mentioned, I even said I did not want to lose my near vision for putting on makeup.   And since my interests involve the need for seeing artistic fine detail, had it been mentioned I think it would have sent up an immediate red flag.  So I feel cheated, deprived of full disclosure, and that I was not really listened to or made to understand what I might be giving up.
I don’t know if glasses or contacts will correct my problem, the worst complaint being the loss of quality of near vision, with increasing blurriness with slightest of changes in light. Essentially I feel like I went from nearsighted (-3.00) to farsighted.  Which after the fact was when I found out this made me most likely to be unhappy compared to my pre-surgery vision. That was the one fact the second doctor said would have made him consider differently. I’m in my late 50’s, so quality of life is an important consideration.
Questions (if you can answer)- if my vision problems are all due to the Restor lenses, can it become worse than it is now?. What is the likelihood that monofocal lenses will eliminate the light-depending-vision-quality-fluctuations.? The thought of more surgery is frightening, but reading other people’s posts seems that all were happier, with improved vision after changing the lenses, barring any other complications. So?

[MsLN]

in addition, this may be a lot but to finish the whole senario,  if I do the lens exchange, and it was my near vision that was practical and functional that I miss, do you have a suggestion as to the type of  monofocal vision lenses I might be happiest with. Would you agree with  suggestion to just be nearsighted again ?, I would more likely prefer needing glasses for distance if near vision was made functional again. My nondominant eye has a little better vision and slightly better range, the dominant eye seems to have more visual aberrations, so I think it should be done first (Dr suggested a -2.00), is there  a possibility the other eye may then be ok and  the  one Restor lens will work ? ( he is hopeing so)
if there is an answer to any of this, you have my extreme gratitude

[MsLN]

NEW ALTERNATE DECISION – just wanted to update, in doing a lot of homework and  rethinking the situation, since inferred promises were never met, and I was denied full disclosure of side effect and trade-offs,     I am cancelling the surgery idea. I guess I have little choice but to deal with the trade-offs and blurriness when it occurs in reduced lighting and will use the contact lens which I hope will give me enough functional close vision to get by in most situations.
  I hope there may still be  some improvement, if there is any validity to the neuro-adaption time associated with the multifocals.  (if that can be addressed I would be most interested)  
Maybe the better distance will be some compensation for the trade-offs, and with the contact lens helping for near, I still seem to maintain distance in that eye too. While not thrilled about all the vision compromises and irregularities, unless the IOL exchange can be mimicked with contacts so I can realistically experience it, and find it better, I can’t take the risk of another unanticipated or worsening result.
Does this seem more sensible? But out of curiosity would any of what was previously suggested make any sense, would it work? or was it not really a  logical suggestion that involved  too much unknown speculation.
Currently OD +0.75, cyl -0.75, axis 045  OS +0.75, cyl-0.50  Axis 135        ADD 2.25  
hope I'm understanding the situation better and my new thinking is on the right track.  thank you for your kind attention