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574673 tn?1234125978

Explanting ReStor IOL

After going through three months of blurry vision at all distances with my left eye ReStor IOL., I took the advice listed on this forum and submitted an Adverse Medical Report to the FDA. Imagine my surprise to find 50 pages of reports, over 500 of them associated with this lens. Most of them were for my model lens as well. All had similar problems to mine and none were resolved by Yag laser capsulotomy or PRK lasix to fix the power. I understand once they do the Yag it is much more dangerous to explant. Three doctors have confirmed that my capsule does not look blurry and contrary to the typical events, my vision after surgery hasn't changed, verses becomming blury later like most capsule problems. My current doctor recommended a piggy back lens for the power, which he claims is off due to measurement error. This type of procedure is not recommended by the manufacturer of the lens. I sought the opinion of MASS Eye and Ear, a world renowned facility and they said that there were risks in explanting my lens.
So now I am faced with a life of blurry vision that can't be corrected with contacts or glasses. I currently wear a contact in my "good eye", which is -7.5 with a small cataract, a +2.5 in my operated eye to even out my vision so my mid distance isn't half in and half out of focus and reading glasses! My visual handicap was better before the surgery when the only thing I couldn't do was drive at night, which I did any way.
The other alternative appears to be an explant of the left eye, continuing with the right eye wearing a contact. What are the risks of an explant? Would you replace the Restor with a monofocal for far distance and get a far-intermediate contact lens for the right? Acylic verses silicone, which is better?
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Avatar universal
Hi, I am new to this discussion but just came from my ophthalmologist who wxplained that I was not "crazy" but all my vision problems are truly from my restore lens. He did not recomend explant though because of the risk of worsenning vision. I am in Norhtern Va. Where did you go for your explant? How did you research it. I really do not want to live this way but am terrified of making a bad situation worse!

I would not ever again chose a multifocal lens. I wish there were glasses that could help me but once you have a restore lens you are stuck. Glasses do not work or help.
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Avatar universal
Hi, I am new to this discussion but just came from my ophthalmologist who wxplained that I was not "crazy" but all my vision problems are truly from my restore lens. He did not recomend explant though because of the risk of worsenning vision. I am in Norhtern Va. Where did you go for your explant? How did you research it. I really do not want to live this way but am terrified of making a bad situation worse!
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Avatar universal
Your advice is always measured and sound, and it's appreciated.

I have a dense nuclear cataract in my right (dominant) eye.

Although there are signs of cataract in my left, I don't care because I get  very good corrected vision with specs or contacts.

I have been living with the condition for two years now.

But now the cataract in the bad eye is very troublesome - best attempts to correct are a -11.5 contact lens, but now this only improves it a little.

I am 49 and have been myopic (-7.0 both eyes) all my life. Needless to say, I am well conditioned to the world of correcting vision.

I am at the stage of being saturated with information.

I am a scientist and engineer and understand optics, but have yet to be convinced about "multifocal" IOLs - the physics doesn't add up in my opinion.

Accommodating lenses make sense if they actually work. But do they work when put in the eye?

I am fastidious and love detail and color and contrast and clarity.

I can't get unbiased or measured advice from any professional, which disturbs me as I view the eye as a true wonder of the universe and it should be treated with the utmost seriousness.

I have now really got three main questions:
1. Cataract surgery bladeless by laser  OR manual phakoemulsification?
2. Consider trying an accomodating lens (still new technology I think) or abandon my eyes focussing muscles forever and insert a simple monofocal aspheric?
3. Acrylic or silicone?

I see that a lot of issues with multifocal lenses is now over 5 years old. Have things changed now in 2014?

Your comments would be most welcome.

There may be an accommodating lens in the future that truly works. Or there may be a cure for cataract by somehow bleaching the lens to restore clarity (research into this area seems to be minimal - a disgrace).

My advice to anyone is to be sceptical first and foremost.
And do not have anyone perform surgery on your eye unless absolutely necessary.
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Avatar universal
I am sorry about your husband's problems with his cataract surgery.  If you provide a bit more information someone here may be able to give you an opinion.

-  What kind of IOL did your husband have implanted in each eye ?
-  Were there any complications during the surgery?
-  Has he had any other complications in his eyes aside from the change in vision from before to after the cataract surgery?  
-  Did any of the second, third and fourth opinion doctors have suggestions what what options there might be for your husband to improve his vision?

Good luck with your visit to Bascom Palmer.  
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Avatar universal
My husband had cataract surgery, one eye in June, the other a month later. He is unable to see below eye level, has been continually dizzy and nauseous and is unable to step up or down a step without holding on to me. He is constantly miserable. We have had second, third and fourth opinions, all of whom said they will not install this type of lens in their patients' eyes. Of course we paid almost $5000 over and above Medicare and United Health. We are going to Bascom Palmer in Miami to see what they recommend. We welcome any suggestions. Has anyone gotten their money back?
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Avatar universal
Also what is your vision now? 20/20 ? Do you need readers and how is your intermediate distance/long distance. thanks again.
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Avatar universal
What type of lens was put in your eye after removal of the RESTOR? Is ReStor a mulitfocal lens? I have a cataract in left eye and I thinking the ArcySof monofocal with blue blocking light. Arcy IQ?

Thanks for any information you can give.
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Avatar universal
i still recommend Dr. Price in Indianapolis Indiana - he successfuly explanted my restor lens and restored my vision with monovision lens implants.  He is a world renouned eye surgeon.  
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Avatar universal
Dr Price in Indianapolis Indiana was awesome for explanting my Restor lens (which had me blind)
He corrected my vision that the other screwballs destroyed
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Avatar universal
Gina, i do medical records and coding for a hosptial and i was duped into getting the Restor lens and i was BLIND like you afterwards.  It was a disaster and nightmare.  prior to that "lasic consult" I wore monovision contacts with great succes. was just getting tired of the gas perm contacts and wondered about lasic correction  INSTEAD  the schisters told me i had cataracts and the RESTOR lens would make me see near and far perfectly.   After one job loss and 4 months of the place telling me to be patinet, I went to a specialists in Indianapolis in, price vision group and they explanted the restor and with great success put in monovision lens and restored my sight..... I wish you the best - i understand your difficulty... i urge you to get them explanted before they scar into your eye,  mine were nearly too late.   nyoka
i dont know where you live but Dr Price is the best in Indiana
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Avatar universal
ARE YOU SAYING ONCE YOU HAVE THE YAG YOU CAN NOT HAVE ANY OTHER PROCEDURE? CAN YOU TELL ME ABOUT THE PROCEDURE YOU ARE TALKING ABOUT HAVING AND HAVING RESTOR LENSE REMOVED?
Helpful - 0
4420448 tn?1354311196
I too am very unhappy with my RESTOR lense. The doctor now wants to do the YAG surgery, but, I am very concerned that this will not bring any relief. And I am very concerned about having the RESTOR lens removed and  having a mono-focal inserted instead.
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Avatar universal
RESTOR HAS BEEN THE WORSE MISTAKE I HAVE EVER MADE. I WOULD ADVISE ONLY A PERSON THAT IS DECLARED LEGALLY BLIND TO ATTEMPT IT. I AM SCARED TO DEATH THAT MY EYE'S ARE PERMANENTLY RUINED. I HAD A RENOWNED EYE SPECIALIST THAT HAS PERFORMED THE PROCEDURE FOR 10 YEARS IN CHARLOTTE NC TO PREFORM THE RESTOR PROCEDURE ON MY EYE'S. I HAD IT DONE OCT.13, 2012 - YAG NOV. 7 I HAVE SEEN NO IMPROVEMENT AT ALL ! I SAW  20/20/ DISTANCE VERY CRISP AND CLEAR IN BOTH EYE'S BEFORE THE PROCEDURE AND 20/100 - 20/150 IN CLOSE UP IS WHY I HAD THE PROCEDURE GOT TIRED OF READERS, BROKEN ARMS ON GLASSES, SMUG ON GLASSES, COULDN'T KEEP UP WITH THEM.  MY EYE'S ACHE, WATER, AND I WISH I COULD GO TO BED AND NEVER WAKE UP. I AM A POSITIVE PERSON AND LOOKING TO WAKE UP AND SEE IMPROVEMENTS AND THERE ARE NONE. I CAN SEE WITHOUT READERS BUT IT IS FRUSTRATING WHEN YOU LOOK AT THE WORDS YOU HAVE TO FOCUS LIKE A LENSE ON A CAMERA.. THEY PUT TUBES DOWN MY TEAR DUCTS AND THEY ARE UNCOMFORTABLE.I WOULD DO ANYTHING TO HAVE MY EYE'S BACK THE WAY THEY WERE BEFORE THE PROCEDURE!      
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Avatar universal
I a male age 46 and was diagnosed with a cataract in my right eye at age 42. My vision was better than 20/20 in my left eye at age 42 (20/17). My right eye was 20/20 at age 38 before the cataract and 20/200 at age 42.

My problem is this. I have a terrible phobia of having my eyes "probed". Some conditional things. I take Synthroid and Allopurinol. I have very pale blue eyes and have always been very sensitive to sunlight.

Is it possible to take anti-anxiety drugs like Halcyon before these procedures?

Given the good state of vision prior to cataract is there a predisposition to a negative outcome with a Multifocal lens?

Any known drug interactions with the above listed drugs?

Thanks in advance for any help.
Helpful - 0
Avatar universal
Dear Dr. Hagen, You said:
"Ask yourselves: If I was told BEFORE SURGERY that I might need glasses some or most of the time even with a ReStoR IOL and I was told that my night vision would be bad and that optical abberations might be a big problem (dysphotopsia) would I have had the surgery ?"

I just stumbled upon this website yesterday! I would not have selected ReStoR implants for my eyes if I had been told this by my ophthalmologist. Because I had nearly mature cataracts, I would have gone ahead with cataract removal but selected single focus implants for both eyes. I am a retired M.D. (family practitioner) who , 5 years ago, switched from my previous ophthalmologist to my current one after reading a newspaper article (it may have been an advertisement) that the latter's clinic was inserting multifocal implants that often eliminated a patient's need to wear reading glasses after cataract surgery. Before the surgery I do not recall my surgeon's mentioning of the likelihood of bad night vision problems and dysphotopsia postoperatively. He did mention that some patients saw halos but that these usually were transient side effects. His staff provided me with literature that discussed the side effects of ReStoR implants. The literature did mention that some patients experienced halos and discussed the usual major side effects such as eye infection and retinal detachment. In retriospect, as a physician I should have done more research on the ReStoR implants before slecting them for my own eyes.Right after surgery I noticed large halos and long radial rays/light streaks emanating from the light sources. My ophthalmologist assured me that these side effects would lessen with time as my brain adjusted to them. He has told me this several times on followup visits. With time my mind apparently converted what used to be halos to large circular ghost images (having a radius of about 4 to 5 times the diameter of the light source, for example) Now, after 5 years there has not been any significant reduction (at most, 5 to10%) in the ghost images and long radial rays. I feel that the overall result of my cataract surgery has been a loss of at least a third of my visual acuity at night. I've continued to drive some nights but have almost collided 2 or 3 times with other oncoming vehicles. For me, the worst driving conditions may occur at dusk when most vehicles have their headlights on but some have not turned them on. On an out-of-state trip 2 months ago, for example, while driving on an unfamiliar highway, I made a left turn at an intersection after carefully looking several times (as I always do) to ascertain that no vehicles were approaching. A little into the turn my right seat passenger yelled out a warning. I hit the brakes and stopped in time. I think that the light streaks and ghosts from other vehicles may have partially obliterated my view of that oncoming one.
Following this recent close call I decided to return for another consultation with my surgeon. Last week he did an extensive exam, refracted my eyes and ran several tests, which included a retinal scan. He assured me that everything looked fine (from the outside looking inward, that is! - not from the inside looking out which is what matters most to me). He told me that there was not much that he could do to correct my nighttime impairment. He also stated that removal of the ReStoR implants might result in considerable permanent damage to my vision because the implants were cemented into my eyes. By this I understood that they were cemented to the insides of the capsules. My daytime vision also is not all that acute. With eyeglasses my distant vision is 20/40. I do not see well at any distance and must wear separate eyeglasses and other glasses for reading and working at the computer.

Although I presently am 76, I am in relatively good health and anticipate that I may have 18 to 20 years more of life (My parents died in their mid 90s and their parents lived just as long if not longer than them. I have no chronic illnesses at present and have neither smoked nor consumed alcohol or other harmful drugs. After confessing to my wife of my nocturnal impirment, she insisted on being my chauffeur at night. I've also given up flying airplanes. This was due to being afraid that I would not be able to spot other airplanes while in flight. Night landings also might be extremely hazardous for me.

Reading this long thread about explanting ReStoR implants has given me some hope that my vision may be restored to a near normal state - instead of having to live with my visual impairment for another 20 years. I live in California, several thousand miles away from the experts in Massachusetts and Connecticut who were described to have successfully removed some ReStoR implants. I am, however, 3 or 4 hours drive away from Stanford University, UCLA and Univ. of California, Davis. Might I be able to find ophthalmologists at one of these institutions with the expertise to successfully remove my current implants and replace them with single focus ones? I know that I should be able to pose this question to my ophthalmologist during a subsequent visit. In the meantime, however, I am going to be trying his suggestion of wearing polarizing lenses with two-surface anti glare coatings. I am going to comply even though I had to suppress myself from stating that I really need the polarizing, anti glare lenses between my fresnel implants and my retinas. Thanks for any comments or suggestions you might have.
Larry L, M.D.
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574673 tn?1234125978
I have been wondering how you are doing. It sounds though that you have found a doctor who is logical and methodical in helping you explore and weigh all of your options. That is important and why I ultimately went with MEEI. They did not have only one answer but let me evaluate all of the possibilities.
Believe me I understand and feel your frustrations. I think no option is perfect and one has to weigh the risks and benefits obviously. I am happy with my choice, but I still do not have a perfect situation. My new eye works great at one focal point, (about 14"- 3')which I am most grateful for. There is still some blurriness (could be the capsule, but not significant enough to warrant doing anything). I still need a contact in my dominant eye and I plan to get glasses over top to hopefully sharpen up reading for both and distance for the IOL eye.  So I guess what I am saying is that even if you decide to live with the Restor eye, do not regret making that choice either.
Best wishes and keep us posted.
londonbridge
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Avatar universal
Your feelings make complete sense to me.  What is your doctor suggesting in the event that you don't attain complete satisfaction with your ReStor vision?
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662703 tn?1226271428
Londonbridge and Lerbea, I am so glad you had good results!
I am trying to use glasses to see what vision would be like if the ReStor worked correctly. I have glasses for far that vision work pretty well. The image is a bit too sharp, and now that both eyes are working together, I really notice the highlight problem—on ALL light sources, including rings in very dim light, and the light of white paper around type. In bright light, they work all right but in dim light, they are a problem. There is still a strong dependence on the cataract eye, which is progressing steadily, unfortunately.
On order are glasses for reading—the ReStor has never worked well for that, but maybe with a new, stronger prescription they will work better. I have drugstore readers but I am trying to make both work together, which means different corrections for each eye. My doctor recommends COMPLETE satisfaction before going forward with the PRK. He is conservative, which is good.
I am torn…I cant help but feel that I am going thru a lot of expensive invasive surgery to make a product that doesn’t work well, work a little better. If this were a car or a dishwasher, I would have protection by the “lemon law”—this way, we put our eyes and pocketbooks on the line to correct design flaws. It is not a good feeling. Sorry, I am a bit discouraged today. It is good to hear that others are solving the problem—that always gives hope. Aleif
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574673 tn?1234125978
Glad to see you found the thread I started about Restor.
I posted a comment in the expert forum as well.
Like Lerbea, I did notice that the ghosting, double images, contrast sensitivity and large halos and glare were gone once I got rid of the Restor. The quality of vision is much improoved and feels more natural. I am planning to correct any remaining vision with glasses. Since I did not do my dominant eye at all, I need to continue to wear a contact lens in that eye, because I can no longer wear glasses without a contact lens due to the big difference in my two eyes, my original eye still very myopic, -8.0 and my new eye slightly near sighted (my choice).
Good luck. Consider all less invasive procedures carefully. Weigh the possible benefits and whether these will be sufficient to give you the quality and quantity of vision you need and deserve. Be aware of the risks of explanting and find a surgeon who will give you an honset evaluation of whether this is a reasonable option along with any risks. Good luck!
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Avatar universal
To Gina00
I had the dominate eye Restor lens replaced with the AMO astigmatic lens.  Immediately I could tell the ghosting was gone.  I still had misalignment of some images i'd guess to say but with the new glasses it is all cleared up in the new surgery eye.  My left eye still has the Restor in it.  I'm waiting to see if the dominate eye will compensate for this.  

Night driving is out of the question for me. The lights are so bright and I can't judge distance.  Still it's the restor that's giving me problems.  
If I think I can live without having to drive much at night I won't have the other lens replaced.  
I was scared for a few weeks after the replacement exchange but glasses cleared it right up.
If I'd known about the Adverse Reports with the FDA I would not have had the Multifocal used for my eyes.  My old doctor and staff told me there were none.  HA.

My vision in the dominate eye with glasses is almost perfect.
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Avatar universal
I'm not a doctor, so you should definitely discuss options with yours, and probably get a second or third opinion as well.

You didn't really describe your symptoms. If your only problem is astigmatism, I would think that you should be able to wear glasses to correct it. If that works, you could get LRI's. They are a quick and relatively painless, low-risk procedure. Or you could wait a few months and get a PRK. Astigmatism could be causing or enhancing other visual effects with your lenses.

Definitely don't let yourself get pushed into a yag. And you should quickly but carefully evaluate all of your options before going with the relatively drastic explantation to switch to another lens. It may or may not be your best choice.

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Avatar universal
I'm sorry to read about your poor results.  In your place, I'd waste no time getting additional opinions from the best cataract/refractive surgeons in town, especially those who are very experienced with multifocal IOLs.  You might try calling the ophthalmology department at a major medical center and requesting an appointment with their senior staff member who specializes in cataract surgery.  If you're considering explanting your IOLs, don't agree to a yag procedure--it will make the explant more difficult and risky.
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Avatar universal
I am looking for some advice from someone who has had their multifocal lenses replaced. I have a Restore in my left eye and Rezoom in right. I now have astigmatisms in both eyes I didn't have before and my left is 20/100. I feel like I'm blind, I can't work (I'm an RN) or drive. The sugeon says it's these "finicky lenses", I would like him to try to do his job with this eyesight he's left me with! How did you end up with deciding what to do?
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574673 tn?1234125978
Thanks for the update and for not saying anything too. I think it is good that they don't automatically say they can explant anything with no problem. I have talked to other practices who were willing to try anything and I did not choose those practices. I prefer someone to be conservative. Ironically I was also there yesterday at 1:00 for my second post op. I again expressed how sastisfied I was to them. I still have some blurriness due to the medications and some high eye pressure so I have a new medication. I trust Dr. Melki absolutely and I know he would be completely upfront about the risks and benefits. So it sounds good. I will keep you in my thoughts.
My vision seems to be coming in right on the money. I wanted mid distance in my nondominate, former Restor eye and leave my dominant eye for distance, with a contact for now and if needed down the road another monofocal. The blended vision gives me a nice range without glasses so I am happy with my decision. Their measurements and choice of the torric Acrysof lens for me seems to be just right. Once you have a surgeon and a practice you trust it I think it is best to express your preferences and then let them do the choosing.

My best wishes to you. Keep me posted.
londonbridge
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