Is Laser tough up the best answer for Restor Lens???

I had a Restor lens put in about two weeks ago. I am 39 and never had issues with my eyes before the cataracts. After putting the Restor in my right eye it seems that my distance vision (10-15 yards and further) is blurry. Can't make out faces from this distance?

I take it that the lens caused an astigmatism? Dr. said I could do a laser touch up to improve this. He said that this should help my distance vision and maybe will extend my near vision out a bit. So I take it that if my near vision was 10-12'', it might go to 12 to 15'' away from my face?

Is the Restor lens and the way it matches up to my eye causing the astigmatism?

If I need laser touch up on the Restor and this extends other visions (near and intermediate) plus I have to put up with all the night time issues? Why not just replace the lens with a standard len for distance and live with a little blurriness up close? Seems the Restor is blurry at different distances anyway? I don't want to get down a long path and then the Dr. tell me that I have to live with it...

So, my options are as follows?

1. Put Restor in the left eye as well and then do laser to touch up the problems I am having?

or

2. Explant the Restor in the right eye and put distance in both eyes (and use glasses when needed)?

If I do the second option could I still have an astigmatism after the standard lens is put in? Or are these less common since the standard is set for one distance only?

****My hope....is that I could do distance in both and get lucky enough to still be able to read holding things far away from my face? It's just nobody can give you an exact distance of when that blurryness is going to happen. (1 foot? 2 foot? 3 foot? I have read some blogs that people say they can still see fine up close including computer screen and some small print?

Please help....

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

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[JodieJ]

How about another option altogether.  Try out a contact lens or glasses to see how much your ReStor vision is improved with an astigmatism correction.  If there's not much improvement, then don't go for a second ReStor.

With monofocal IOLs set for distance in both your eyes, you will be dependent on glasses for most near and intermediate vision tasks.  I think that this would involve a major adjustment for someone 39 years old who has never worn glasses, and I don't believe that you will be pleased (at least initially).

[confusedbob11]

Yes, I tried a contact lens yesterday and it did omprove my distance vision. But it made my near vision worse? Will laser correction do the same thing or will the laser only improve the distance site?

Also, it seems the Restor eye is getting a little worse each day? It's still OK but seems very tempramental.

My Dr said I could do laser surgery in about a month or two and see if I like it. Then if I don't he said he could explant it and put in a standard monofocal? I know YAG should not be done if I want the Restor out later, but wonder if Laser will make it more complicated to explant? I trust my Doctor and know he is probably leading me in the right direction, but would value other opinions. Not thrilled with the Restor and with all the nighttime headahces not sure if it's worth it?

Also, why do the Dr's on these site reply but don't say nothing??? I know they get tired of saying the same thing over and over. But a simple response would help, not just say search and read threads. I have read hundreds of threads and still have questions.

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

To answer your question I would need to know what your "refractive error" is and what your vision is with that RX. Explanting an IOL is often a bigger surgery than the first one and not without risks.

Anything like laser that improves your distance vision will make your near vision worse.

You are 39 if you did not have cataracts in 1-4 years you would need glasses for near and distance (presbyopia).

Laser will not help night dysphotopsia with the ReStor and glasses may neither.

If your vision is good with a progressive bifocal in the operative eye the safest and least expensive option is to wear progressive bifocals most of the time.k

JCH MD

[JodieJ]

I assume that your doctor was referring to a refractive procedure like LASIK when he spoke to you about having a laser procedure.  I don't think this would make it more difficult to explant your ReStor.  Given the results of your contact lens experiment, I think that LASIK would improve your distance vision but impair your near vision with ReStor.  Since you trust your doctor, you should be asking him these questions.

I'm not an eye care professional.  My impression is that people who get the best results from ReStor have the following:  healthy eyes (e.g., no retinal problems, no dry eyes), an experienced surgeon, no astigmatism, small pupils (more common in older people).  You may not have the last two traits.  If you exchanged your ReStor for a monofocal IOL set for distance vision, you could see for yourself (literally) what your near and intermediate vision would be like with two distance IOLs by covering your second eye.  This would enable you to make the best decision about where to set the focus of your second monofocal lens.

[confusedbob11]

Thanks for replying.

It seems by doing Laser that I should have just gotten the Monofocus in the first place if my near vision is going to change a little due to the laser surgery?

Could this refraction issue still happen with a monofocus set for distance? If, so can this be fixed with Lasik?

Dr. John, when you say bigger surgery is it about the same risk as having a regular cataract removed? My Doctor said the risk were about the same?

Also, the big reason I am scared of doing Monofocal set for distance is I am scared that my near vision is going to be horrible or not fuctionable for certain things. Like seeing my food on a plate, or shaving, or seeing my kids faces clearly when they are next to me?

I feel the way Dr's or nurses say your going to lose your near vision and have to wear glasses that's it's going to drive me crazy???

I know if I go distance/distance that I won't be able to read smaller print. but will a kids face or coffee cup look blurry from a foot or two away???

Thanks for any help you can give. Still stressing so much I feel like I am having an ulcer...

[JodieJ]

Stop worrying.  As I stated above, you can try before you buy.  If you exchange your ReStor for a monofocal lens set for distance, you can see for yourself what your near and intermediate vision would be like with both eyes set for distance vision by temporarily patching your second eye.  Based on the results of your assessment, you can either get distance vision in your second eye or go for intermediate vision (i.e., mini-monovision).

Yes, LASIK can correct refractive error with a monofocal IOL.  

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

Yes the risk of  IOL exchange is roughly comprable to original surgery.  If you've read lots of posts yo know many many people have problems far worse than yours. Wearing glasses for near vision or even all the time is not the end of the world.

JCH MD

[confusedbob11]

Thanks for your comments they have been very helpful.

What lens do you have? And what advantages or disadvantages are there to the ones you chose?

I guess I just need to make a decision already. I think I have all the info I need but it seems that you still need a little luck to go your way.

Thanks,

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

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