How long for crystalens to come into focus ?

[LynnVet11]

I had cataract surgery 7 weeks ago.  My distance with the crystalens is better, but like looking through vaseline.  My up close vision and monitor distance is much worse than it was before and I'm seeing double.  My surgeon says it can take 2-3 months to come into focus.  I'm very concerned and quite anxious.  I work on a computer 8 hours a day and don't want to pay for my glasses to be upgraded twice.  Any suggestions ?

[LynnVet11]

What are the risks of having Crystalens removed and replaced with another lens (not crystalens).  Its been 9 months and still have double vision.

[LynnVet11]

I have now had the tear ducts plugged...it helps a little with the dryness.  I have had so many people complain about the burning with Restasis, I thought I'd try this first.  I have also had the YAG procedure 5 days ago.  Is it unusual to still see floating remnants of the cataract ?  My upclose and intermediate vision is still double.  I am now of the mindset that I either got the wrong strength (doubtful as two people measured me), I was not a candidate or the lens is defective.  I'll be seeing my surgeon this next Thursday and I want some serious answers. This has been a 5 month nightmare and I'm really losing faith that my eyesight will ever be restored.

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

I forgot to say we rarely us tearduct plugs anymore. Restasis is much better and much more successful. Restasis is the most widely prescribed eyedrop in the USA. My wife has been on Restasis for about 6 years with fabulous results.

JCH MD

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

Our practice doe not use "permanent" plugs that go below the surface such as the "Smartplug".  They are diffiult and sometime impossible to remove, frequently irritate the eye and require an operation by an occuloplastic surgery to removed.

All "permanent" plugs in my opinion should look like a tiny umbrella where the  pointed top is above the lid edge and consequently easy to remove.

I would be absolutely certain your lower plugs are not "Smartplugs" or any plug that is completely buried in the tear duct and cannot be simply removed. You can search the literature on the net and find numerous reports of excessive irritation and complicated expensive removals from "buried" plugs.

We just put plugs in the lower opening in the lid.

JCH MD

[LynnVet11]

I've had temporary plugs put in both the upper and lower tear ducts.  I do notice a slight improvement with the dry eye.  I go back in 2 weeks for permanent plugs.  Do you recommend just the lower...as my Dr said a permanent plug would be put in the lower and a 3 month temporary in the upper...then permanent plugs in the top if I do well.  Does the lower duct do more draining than the upper ?  I'd prefer just the lower if the upper doesn't do as much.  Still no difference in the double vision up close...ok with glasses.

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

You might think about a second opinion.  You also may need to just start wearing progressive bifocals most of the time for your best vision.

I cannot tell if your problem is related to the IOL power put in your eye or other factors.

JCH MD

[LynnVet11]

I picked up my new glasses last week. For the first time in 4 months, I can see upclose and monitor distance.  I am relieved about that.  I will have the laser treatment in 4 weeks to hopefully get rid of the "clouded" effect that i have had since day one. The plugs will be put in this coming Tuesday and I'm hoping will help with the dry eye. All in all....only my far distance is any better with the crystalens. ( Up close and monitor are still double). If these are a prescription, is it possible the wrong prescription was put in ?  I'm still very upset with the results that cost me so much money out of pocket. As a  single mother trying to get 2 sons through college, this has really been a devestating outcome and a complete waste of funds.  Thank you for your past advice...its been helpful.

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

It's quick, simple and painless. I did three thrusday and the longest took me 2 minutes. A cold laser (Yag) is focused on the posterior capsule and cut with the laser. You sit at an instrument with your chin and head on a rest. Drops are put in before and after to dilate the pupil and keep the pressure down.  Normally you are released to normal physical and eye use activities. Some MDs see the person several hours after treatment, some see the next day some see in a week. Use something like Google Images and search Yag laser capsulotomy and a picture will show you what tissue is cut.

JCH MD

[LynnVet11]

Can you tell me more about the laser treatment used when the cataract tries to grow back ?  I am going to have to have that done and probably the plugs.  Removing the implant isn't financially possible for me to even consider.  As long as the glasses improve the double vision, I'll just have to live with it.

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

Putting tear duct plugs in the lower lid is quick, easy, safe and usually painless. The plugs may stay in the eye up to several years although there is a rarther high rate of them coming out usually from rubbing the eye or using a washcloth on the inside corner of the lids.

I think it important not to use a "smartplug" or other tear duct plug that is pushed deeply into the tear duct and cannot be removed easily. These, in my experience, can cause lots of problems that require surgery to remove.

If the plug made a huge difference to you and later came out you could have another plug put in, the lower tear duct closed with cautery or start on Restasis.

Clouding of the membrane behind the IOL is common and occurs in about one in 3 people with modern IOLS, older IOLs from the 80s and 90s clouded over about 90% of the time.  You should be absolutely sure you do not wish to do an IOL exchange before the yag capsulotomy is done as once the capsule is cut open it makes and IOL exchange more difficult and problem prone.   Cycle through the Today's Pulse on this page and read the paper I wrote on treating dry eyes.

JCH MD

JCH MD

[LynnVet11]

Its been three months since the crystal lens surgery.  My distance improved but my upclose and monitor are stll bad.  I am seeing double, which is something I did not do before surgery.  My visit yesterday with my surgeon was a follow up.  I will get my glasses upgraded.  The Crystal lens has been a huge disappointment and had I known it would only improve my distance, I never would have done it.  I won't do it again.  My surgeon suggests that I have my bottom tear ducts blocked.  He says is a simple procedure with good results for people with dry eye. Can you give me any advice in this area ?  Also, I am told that my cataract is growing again and I need a laser procedure to clear it up. Once again, he says its not unusual.  I just have to come up with the money for these procedures.  I'd appreciate your opinion.  
Thank you for your time.

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

Yes, best of luck. Please let us know how you do.
JCH MD

[LynnVet11]

I did read many posts.  It would appear that I am not alone.  I am praying that another month makes a difference. My results so far are not what the brochure promised.  I'll post again at my three month point and final appointment with the doctor...and hoping I have good news to report.  Thank you for getting back to me so quickly.

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

Use the search feature and archives to read the many posts about healing and recovery with Crystalens and other premium IOLs.   If your vision is clear with glasses it not likely a problem however if not clear with glasses it may be a problem. Consider a second opinion.
JCH MD