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Eye Care  (Expert Forum)
 | 
IOL Choice
Answered by
Michael J Kutryb, MD - Ophthalmology, Cataract Surgery, glaucoma, Laser Vision Correct
Kutryb Eye Institute - Titusville
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.

IOL Choice

by TheHammer251, Jul 03, 2009 12:44PM
Hello,
Have cataract extraction surg scheduled for 7/15 and 8/5.
Have decided on Tecnis Multifocal...
Thoughts on Tecnis Monofocal O.U. and accept wearing glasses for reading in exchange for a safer and simpler
post-op course?

by Michael J Kutryb, MD, Jul 05, 2009 06:46PM
I'm really trying to stay on the sidelines here since this is a decision you need to make in conjuction with your doctor.  Please read the posts here by using the search feature with key words like rezoom, restor, crystalens, tecnis multifocal.  The crystalens HD would be my vote for a presbyopia correcting implant as long as you clearly understand that you would need to probably wear reading glasses some of the time and possibly even distance glasses sometimes.  This is definitely not a perfect science.  I have not seen any compelling evidence that the tecnis multifocal would have less side effects than the restor or rezoom.  A monofocal aspheric is also a wonderful choice if you don't mind wearing reading glasses  and if blended or mini-monovision is done you might not need reading glasses as much as you think.

Michael Kutryb, MD
Member Comments (6)

by OldNavy966, Jul 03, 2009 08:32PM
whish I could help.   I am thinking the same thing.  If you wore glasses before and don't mind it a whole lot, I would say stick with it.  

by Glad4Help, Jul 04, 2009 01:08PM
To: TheHammer251
I am scheduled for my first cataract surgery next week.  I decided to go with the aspheric monofocal, which I am told will give me very good distance vision, and I will use multifocal glasses to correct the rest.  I have been wearing glasses all my life so am used to them and I didn't want to take any chances with technologies I think are still in development.

This website was very helpful to me in making a decision.  When you search this forum, you will find lots of posts that address your concerns.

Good luck.

by londonbridge, Jul 04, 2009 02:32PM
To: The Hammer
I agree completely with the others. Many multi focal IOL patients wind up needing glasses for some tasks and the risks of having problems is higher. Go with the monofocals, they have been around for over 40 years. I had a restor and had it explanted and replaced with a monofocal in January. Good luck.
londonbridge

by cdn_glenn, Jul 05, 2009 09:21PM
To: TheHammer251
I've had Tecnis Multifocal IOLs for nearly three years.  My surgeon was excellent and I believe the best results were achieved.  I can do the finest close-up work and have wonderful distance vision.  With multifocal IOLs there is time needed (several months, or longer) to adjust to seeing with them.  For me it was about six months with a few more changes noticeable after about a year and a half.

Issues that remain: 20/30-ish mid-vision in low light.  I need to wear +1.00 readers to see clearly between 18" and 48".  I have a pair at work, but rarely carry a pair on social occasions.  Also I still have halos and ghosting, again most noticeable in low light or with high contrast objects.  It's definitely not like it was in the first few months and I just "live with it".

The Crystalens HD would provide more natural vision, but it takes time and practice to achieve near vision.  Many still need reading glasses.

Monofocal lenses are the most reliable, but are set for either distance, near or a combination of distance/near-or-mid (monovision).

Use the Search feature of this Expert Forum and the Eye Care Community to posts on your topic.

Best of luck!

by TheHammer251, Jul 06, 2009 08:27AM
To: Michael J. Kutryb, M.D.
Hello Dr. Kutryb,
Thank you for your kind and thoughtful response to my posted question. I am currently considering several options.
As you suggested, monofocal ( Tecnis1) bilaterally, possibly with a mini-monovision prescription is one.
I had previously settled on Tecnic multifocal before reading of the many side effects and problems associated with
multifocal lenses. The Tecnis website states a 94% patient satisfaction rate. Is this just a result of carefully worded questionnaires?
I also had previously had considered the Tecnis multifocal in my left eye and the Chrystalens in my right (dominant) eye. This is beginning to sound like not such a great idea.
The third option, as agreed upon with my surgeon is 2 Tecnis multifocal lenses.
I will call my surgeon and discuss these options as well as the option of 2 Chrystalens implants with the mini- monovision prescription.
I really would like to avoid a problematic post op course with frequent returns for re-evaluation and further procedures.
I am starting a new job on 9/15 and do not want to have to arrange for time off etc.
Thanks again and best regards
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