IOL's-Positive experiences

[Art0512]

Many if not the majority of comments on this site seem to express negative experiences with IOL implants, particularly those involving crystalens and multifocal IOL's.  I would like to hear from those who have had positive experiences with those kinds of IOL's as well as positive experiences with the monofocal variety of IOL's. In addition it would be helpful to me to hear what those folks  did that believe contributed to a positive experience.

By the way after consulting with my regular ophthalmologist yesterday I have decided to hold off on cataract surgery and IOL implants until they worsen to the point where my normal life activities are severely affected. Thanks to all who have shared their experiences . You have helped me tremendously in arriving at what I think is a wise decision for me.

[mgrody]

I have a family member with monofocal IOLs and wanted better intermediate and near vision without resorting to monovision.  My Dr. said he was doubtful that blended monovision would give me the outcome I wanted.  Multifocal lenses were ruled out because I fly aircraft at night and wanted to avoid halos and flashes as much as possible. So far I believe the additional cost for Crystalens has been worth it as the implanted eye now has 20/30 distant, superb intermediate, and I can read newsprint at about 14-16 inches with that eye. I have had zero halos or other light-associated problems. The jury is out until I recover from the remaining implant, but, if it works as well as the first one, I'll be happy with the outcome and the cost.

[Restorsucess]

Hi,
Well, you can't go on reputation only and what you read on the web.  You need to have a good feeling about the surgeon, staff and facilities also.  Besies the one I chose, I visited another one... he had a plush waiting room complete with home made cookies, and gave me a high quality shiny folder with all kinds of literature and CD.  He also charged $1800 more than the surgeon I chose, AND I found out he TRAINED with that same surgeon.  Although he was to me a viable choice for a surgeon, I wasn't going to pay for atmosphere and cookies.  I was paying for vision.

Here is the website for my surgeon.  Out of the 3 there, I chose Dr. Dudley.  There is information on him on this website which is impressive, mainly to me his experience.

http://panasee.com/

He is a man of very few words.  Not much of a conversationalist.  He never discussed with me crystal lens, ReZoom, or really too much in depth on the ReStor.  He did his questioning, and in his expertise, decided on the best lens for me.  (combination of lifestyle, and eye measurements I suppose).  I believe he uses the ReStor often.  I think besides the experience of knowing what to use, the skill of the surgeon is also a big factor.  (On HOW that lens is placed in your eye).  Of course my opinion is "he's an expert" on it.  Mine are perfect.

I like the part under the surgeon's tab on the website about the two surgeons there actually inventing some of the instruments used.  I'll tell you one thing, if that's what he used, they work GREAT.  No discomfort, and the procedure was over before I even realized it began.

I will add, that at the other surgeon I went to for a consult with the fancy waiting room, I spoke to the assistant after I talked with the Dr., and asked about the crystalens.  She stated the Dr. didn't use those anymore, as he had only did two implants... AND also two explants.

I think when you walk in to talk to a surgeon the first time, you got to start out by telling him what you would like to end up with.  Then he can respond with what he can do to make that happen.  If he says, "well, I haven't had much success with that lens (or procedure, etc.), BUT....", .......Then you know he's going to try to steer you to something else.  Which might be good, or might be something you may not want.  Depending on that, is how you decide you feel about the surgeon himself.

Out of my whole thing..... I liked the idea that he DIDN"T give me options on lens.  After evaluation, he just knew what would work best for me.  We did talk briefly about monovision lasik at first, and I said a flat out no to that.  (I can't stand that feeling).  So, he said ok.  Panasee then.  He pulled out a picture book to and told me what the surgery all entailed.  I did have warm fuzzies when I walked out.  Rest of staff professional, but warm, helpful and nice to talk with.  Oh yeah, and as far as literature... I got a "brochure" (no high end shiny folder.. LOL!)

You can take into consideration other people's experiences with the procedure, and how it was determined what lens they got.  But you can't go much on other people's results....  No two people have the same set of eyes.  I think you know there is no guarantee on "absolutely no glasses will be needed for anything".  Along with the examining a surgeon's background and experience, it really came down to a "gut feeling" with Dr. Dudley.

Hope I'm helping you and not causing you to get more confused on choosing someone!

[Restorsucess]

Art0512, I agree with your comments on the large amount of negative results posted.  A person should take what they read with a grain of salt when considering IOL surgery, as success stories aren't posted as much.  I know that was my case.

So I came back and posted on the following discussion concerning my success.  Everyday I reflect how fortunate I am to have such wornderful results with the ReSTORs.

http://www.medhelp.org/user_journals/show/144225

This is what I've summed up from my experience:

1. Don't go into surgery with 20/20 expectations.  I went in and had decided if I could get away with wearing glasses at least HALF the time, I would be happy. I was WAY more happy then with the actual results.

2. My surgeon and I talked a bit about lifestyle, work, recreation.  I put my trust in him to choose the correct lenses for me.  It's very important you choose a surgeon at the top of his field that has done tons of these surgeries successfully.

3.  Not everyone gets the same results, and no one has the same set of eyes.  What didn't work for one, may work for another.... and is also very dependent on the surgeon too.  From what I read on some posts, I guess I don't know why people are trying to decide themselves what lens to choose.  I mean, shouldn't the surgeon be the best one to decide?  I certainly wouldn't choose my own antibiotic if I had an infection.....

However whether or not to mix lenses for a blended vision would be a patient decision if the results weren't too good after having the first eye done.  Personally I wouldn't want to risk mixing lens.  I'm the type that would rather risk wearing glasses for some activities than risk having some wierd visual distrubances from 2 different lenses.  The doctor plopped some glasses on me one time to simulate monovision one time.... no thanks.  I'm one that doesn't like the effects!

Good luck to you when you decide to have surgery!

[Michael J Kutryb, MD]

To mgrody,

how would it have been any different if you had just had a monofocal IOL left at -0.75 or -1.00 ???  Isn't the idea of the crystalens to give you near and far???  Why go through the extra expense for the first eye?

[yarrow]

I AM enjoying my sight!  It amazes me to see things that I had kind of lost track of.  Restorsucess, you have brought up an interesting point--that of reasonable expectations.  I did not expect *perfect* vision with this implant.  As you say, with all the negative feedback from unhappy patients, plus the results of surveys like Dr. Hagan's, an absolutely perfect result is not yet the most likely outcome with these multifocal implants.  However, my feeling was that my vision could hardly get any worse, and if it were better in several ways, why, that would be a vast improvement!  And if it should turn out that I have to wear glasses for some tasks, it is still an improvement on not being able to see anything clearly.  

As it stands now, I feel that the extra cost of the premium lens is well worth it--for me, and probably for other carefully selected patients.

[Restorsucess]

It is good that someone else has posted good results from their ReStor D1.  There aren't many that search out this site unless they are contemplating surgery, or had a problem post surgery.

I noticed, with your successful surgery also, that your surgeon tested you up and down, inquired on your lifestyle, and then chose the lens that would suit you.  Same as you... I "put my eyes in my surgeon's hands".  There is no way I could make a decision on that.  I'm no eye doctor....

Also, I think expectation does have a lot to do with it.  Losing glasses at least MOST the time was my hopeful expectation.  I knew there was a chance that wouldn't happen... I may need them for computer, or reading, or for driving at night.  I knew bad halos at night could be a result also.  I took an educated risk I suppose you could say.  There was a whole page (maybe it was two....) of all the stuff that could go wrong.  I had to read and sign that.  My results were so much better than I had hoped for.

Just a personal view; I'm kind of glad the surgeon didn't decide on the Crystalens.  I understand those need to work with your eye muscle.  At the rate my all my "original equipment" is being replaced by "aftermarket" as I get older, I don't want to depend on THOSE to keep working too until I'm gone. LOL!

Anyway, nice that you posted here yarrow.  Have fun with your new sight!  I'm having a ball!

[yarrow]

I recently had a multifocal IOL implanted and posted my results on another part of the forum, but I think my comments also belong here:

For most of my life, I have been farsighted with otherwise excellent vision, requiring readers only for presbyopia as time went by.  Then one eye developed an evil, centrally located little cataract that grew rapidly, and in short order I could not read except with the brightest light. No prescription lenses gave me good vision, of course, and ultimately, it was obvious that my right eye was rapidly becoming non-functional except as a rough sensor of the presence of light.

Two days ago, my surgeon exchanged my cataract with the reStor D1, and I have to admit to being amazed by what I can see now.  In spite of some corneal swelling, I can use the computer without glasses. I read the newspaper without glasses. I can read the captioning on the rather small TV across the room without glasses. At the gym or a restaurant, I can see the distinguishing features of every face in the room without glasses.  I can see the oranges on the tree in my back yard, some forty feet from the window, as bright  individual fruits rather than as strangely doubled globs.  I can see the individual pines on the skyline of the mountains behind our house, some two miles away.  When I drive at night (yup, can do that, too), there are no halos--none--and the glare from oncoming lights is far, far less than I experienced with the cataract as it was.  I have not experienced any neuroadaptation that I am aware of.  And this is all before the slightly troublesome swelling of the cornea has gone down.

Obviously, every patient has different needs and expectations, but my surgeon is a smart, experienced guy who measured my eyes seven ways from Sunday, listened to what I hoped for with surgery, and chose the right lens for me.

I'd do it again in a heartbeat.

[Art0512]

Thanks Restorsucess
Your info was very helpful. A few more questions:
How did you decide which eye surgeon to use? What was your selection process? How did you obtain reliable and valid information on the qualifications and abilities of the different surgeons you considered before deciding on one? The major concern I had on the one eye surgeon I have consulted with was that he only discussed the crystalens with me and did not even mention the monofocal option to me. In addition his surgery technician really put down the monofocal IOL's as "government issued". That really turned me off. I doubt very seriously that I will use this surgeon when the time comes because of these two reasons, although he supposedly has a very good reputation.
And,

[londonbridge]

I think you have made a wise decision to wait. There is no harm in waiting as I understand it as a patient. I have been satisfied with my monofocal set for intermediate distance. I still wear a contact lens for far distance. (I had a Restor that was explanted).
Good luck and glad to be of help.
londonbridge

[mgrody]

I'm a 70 y.o. male with developing cataracts in both eyes.  About a month ago I had the cataract in my non-dominant eye removed and a Crystalens 50 IOL implanted. I also had a LRI to reduce 1.00 astigmitism.  The 50 lens was used instead of the HD because my Dr. said he had more confidence in the final result with the 50.  We agreed that for the first IOL distant vision would be computed to be .75 myopic for better reading ability.  So far, the results have exceeded my expectations.  I can read pretty well with the Crystalens eye and have excellent intermediate vision. The distant vision is less than perfect, but quite acceptable.  I'm scheduled for the procedure in my dominant eye next week and the plan is to try for distant plano in that eye.  If it works out as well as the first procedure I'll be 20/happy.