For Dr. Hagan Crystalens and medications

[Rita732]

Is there any indication that certain medications will prevent clear near vision for Crystalens users?

I had the lens put in this past April.  While my distance and intermediate vision, except for computer use, is good, my near vision is not.  I was told before surgery that I wouldn't need glasses to read, which is the reason I paid the extra money for Crystalens.  Now that I still need glasses, the Crystalens rep is researching to find out if the medications I am taking for Depression/Panic Disorder might be the problem why I am having such bad results.  My surgeon has only started using Crystalens this past March.  She was waiting to make sure the new generation of the lens was good.  She said I am the only patient who is having a problem with near reading.

Thank you

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

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[Rita732]

I was going to wait until we got to some sort of agreement regarding this problem before I asked for a script for new glasses.  Now that I'm more informed about Crystalens, I can see there is nothing that can be done to improve my near vision - it is what it is and nothing I can't live with.  I'm going to call tomorrow for an appointment and get my old glasses changed.  

Thanks so much for your help and support.  It is much appreciated.

Rita

[JodieJ]

IMO, you have every right to feel angry.  The written information you were given about the Crystalens (which you quoted elsewhere) promised excellent near and intermediate vision without correction.  Your surgeon promised the same.  And the Crystalens simply doesn't live up to these inflated claims.

Dr. Kutryb, who has implanted the Crystalens, stated elsewhere on this forum that this lens provides only about .5 diopter of near vision (an insignificant amount) according to his own research.  I've never seen a post on this forum or elsewhere from a Crystalens recipient with good distance vision who didn't need readers.  Yet your surgeon has told you that you're her only Crystalens patient who has a problem with reading.  This really  doesn't make sense.

I hope you manage to get a refund on that $4000 "premium" lens fee.  Meanwhile, you'd probably be feeling a lot less frustrated if you got some progressive glasses (with plano tops) for near and intermediate vision tasks.  At least you won't have to keep putting them on and taking them off when you're cooking.  

[Rita732]

Thank you for your comments.  Actually my problem isn't in the Crystalens themselves.  The problem is I specifically stated to my surgeon that I didn't want to wear glasses ever again and asked about Crystalens.  She agreed they would do the job, so I gladly paid $4000 extra for the lens.  Simply put, I didn't get what I paid for.  If I had been told I would still need to wear glasses with the lens, I would have just gotten the monofocal IOLs and saved myself a lot of money.  

[2ndsight]

most of us cannot read computers and newspapers with Crystalens, and we don't know yet whether the new HD model is any better since it was just approved in July.

Rita it sounds like you have had a very good outcome except for that detail, and there isn't any guarantee that you would have been able to read with the monofocal lens, everyone is different and there are countless posts on this forum from people with monofocal IOLs who need glasses for many close vision tasks in addition to reading. Everyone's eyesight is different and many people have worse outcomes and complications after cataract surgery, just read the posts on this board. You can get good optical quality reading glasses and in time you will be so used to them you won't think about it any more although I understand that it is upsetting now.

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

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[Rita732]

She told us Thursday that she does not use ReStor or other multifocal lenses for the reasons you cited.  I know she waited all this time to use the 4th generation of Crystalens until she got really good reports from her colleagues who have been using them since they first came out.  So she is very cautious.  They gave her glowing reports.  I don't know if they didn't tell her of any complaints they had regarding near vision because their patients knew beforehand they would need glasses for reading, etc.  

That is where the problem is...no one told me I would need glasses for close-up reading.  She admitted I was never told.  Why she didn't know beforehand is something I don't know.  If I had known back in April what I know today, I would have saved my money and gone with the monovision lens.  

Two of my friends who also happen to be her patients, got the monovision lenses and both can read their computers and newspapers without glasses.  One only uses glasses for doing cross-stitch.  Do you know how that makes me feel?  They have what I wanted all along and it cost them nothing.  I made an apple pie today and had to use my dime-store glasses just to read the recipe.  I had to keep taking them off and on - putting them down and then couldn't find them.  I was so frustrating and inconvenient that I felt like giving up and walking away.  This is worse than having to wear glasses all the time - the very thing I was trying to prevent having to do.

I have no idea what solution she is going to come up with.  I don't know if there is one.  All I know is I didn't spend thousands of dollars to get this outcome.  I am so disappointed and feel gyped.  

Rita

[JodieJ]

It's true that Crystalens is sometimes used with ReStor, which does provide the best near vision of the multifocal/accommodating IOLs.  But ReStor often involves other issues, such as glare, halos, starbursts (and an inability to drive at night), "waxy" vision, and a long adaptation time (up to a year.)  Several people with ReStors who have posted on this forum have complained that they still need readers for seeing small print.

Professional publications and seminars for cataract surgeons have focused extensively on the issues related to multifocal/accommodating IOLs during the past couple of years.  It's amazing that your surgeon is unaware of all this.  Maybe she needs to spend more time reading her journals and receiving ongoing professional training.

[Rita732]

Thank you so much for your reply.  This is the first time I've heard of using two different types of lens.

I know my surgeon will find this very enlightening.  She is interested in finding out everything she can about Crystalens.  

RMB

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

There is in indication in medical research papers than medications play a role in how Crystalens works.  Crystalens usually works excellent for distant vision, good for intermediate and only fair for reading.  ReStor is excelent for near, fair for intermediate and not so good for distance. Many good surgeons use Crystalens in one eye and ReSTor in the other.


Remember that about 75% of multifocial IOL  patients use glasses over the IOLs for some things.

JCH MD