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My Cataract Surgery with the Crystalens Trulign Toric IOL
Cataract Surgery
At my annual eye exam June 19, 2014, my optometrist said that new glasses would not help a lot anymore, due to my cataracts. He recommended an opthamologist who did multiple types of implants, about 30 miles away.
On July 9, 2014 I had my cataract exam. Lots of tests. Had a nice long discussion with the Doctor about my options.
Monofocal lenses; set for distance, with a .5 to .75 diopter difference for better reading. Cheapest, fully covered by Medicare and my BCBS insurances. But would probably need glasses for ALL distances because of astigmatism.
Multifocal lenses, Tecnis or AcrySof ReStor. Premium lens so out-of -pocket costs of around $2000 per eye. NOT recommended due to many patient complaints. Astigmatism is the enemy of mutifocals.
Toric lenses, recommended for my astigmatism correction (about 1.5D in each eye). He does not do torics with traditional surgery because the results are so much better with laser and the Optiwave Refractive Analysis (ORA) System to insure correct placement and power of the lens. He uses Verifeye, which is the new version of ORA and says it give excellent results. But would probably need glasses for reading and intermediate (computer distance) vision.
Accommodative Toric lenses, Crystalens Trulign. Same as the Torics, but with the probability of good vision at all distances, including reading. May need drugstore readers for reading small print or low-light situations, such as menus in a restaurant. Out of pocket cost of around $2500 per eye. Laser and ORA are also included in that price.
His 1st recommendation is the Crystalens Trulign, 2nd the single vision torics.
At my annual eye exam June 19, 2014, my optometrist said that new glasses would not help a lot anymore, due to my cataracts. He recommended an opthamologist who did multiple types of implants, about 30 miles away.
On July 9, 2014 I had my cataract exam. Lots of tests. Had a nice long discussion with the Doctor about my options.
Monofocal lenses; set for distance, with a .5 to .75 diopter difference for better reading. Cheapest, fully covered by Medicare and my BCBS insurances. But would probably need glasses for ALL distances because of astigmatism.
Multifocal lenses, Tecnis or AcrySof ReStor. Premium lens so out-of -pocket costs of around $2000 per eye. NOT recommended due to many patient complaints. Astigmatism is the enemy of mutifocals.
Toric lenses, recommended for my astigmatism correction (about 1.5D in each eye). He does not do torics with traditional surgery because the results are so much better with laser and the Optiwave Refractive Analysis (ORA) System to insure correct placement and power of the lens. He uses Verifeye, which is the new version of ORA and says it give excellent results. But would probably need glasses for reading and intermediate (computer distance) vision.
Accommodative Toric lenses, Crystalens Trulign. Same as the Torics, but with the probability of good vision at all distances, including reading. May need drugstore readers for reading small print or low-light situations, such as menus in a restaurant. Out of pocket cost of around $2500 per eye. Laser and ORA are also included in that price.
His 1st recommendation is the Crystalens Trulign, 2nd the single vision torics.
3rd Year Update.
My distance vision was 20 - 20, and I had no problems reading the smallest paragraph on the reading chart. My eye pressure was 12 & 13, wonderfully low. They did digital retinal photographs of my eyes this time. First time I have ever seen the inside of my eyes. Wow! Macula in great shape, all the blood vessels looking good, and the optic nerve showing no problems. My surgeon is pleased and my next appointment is in another year.
The Trulign, the toric version of the Crystalens, has turned out to be a winner for my cataract surgery.
My distance vision was 20 - 20, and I had no problems reading the smallest paragraph on the reading chart. My eye pressure was 12 & 13, wonderfully low. They did digital retinal photographs of my eyes this time. First time I have ever seen the inside of my eyes. Wow! Macula in great shape, all the blood vessels looking good, and the optic nerve showing no problems. My surgeon is pleased and my next appointment is in another year.
The Trulign, the toric version of the Crystalens, has turned out to be a winner for my cataract surgery.
11 Comments
Thanks for the post. I love happy stories. We use the Crystalens in our practice very successfully including the toric. Starting to gather complaints here and in medical literature that the new Symfony has problems that have been overshadowed by the enthusiasm of happy respondents
KayakerNC - thanks for the new update on your success with the Trulign IOL!
What was the pressure in your eyes prior to getting cataract surgery in comparison to your very low current readings of 12-13.
I'm on eye pressure lowering eye drops so I hope that ly the surgery might eventually lower my pressure enough to at least eliminate one of the two eyedrops Rx I have.
With the Trulign IOLs, have you ever noticed if you could "see" into the ultraviolet region? Would appear as a purple glow or haze and the ability to see a glow from a UV black light that other people cannot see. I heard that some crystalens IOL patients had that UV vision due to less of a UV filter in some versions of that IOL, possibly corrected in later versions?
What was the pressure in your eyes prior to getting cataract surgery in comparison to your very low current readings of 12-13.
I'm on eye pressure lowering eye drops so I hope that ly the surgery might eventually lower my pressure enough to at least eliminate one of the two eyedrops Rx I have.
With the Trulign IOLs, have you ever noticed if you could "see" into the ultraviolet region? Would appear as a purple glow or haze and the ability to see a glow from a UV black light that other people cannot see. I heard that some crystalens IOL patients had that UV vision due to less of a UV filter in some versions of that IOL, possibly corrected in later versions?
Dr. Hagan, how have been your patient results with the Trulign IOLs? Has there been any cases of significant rotation of the toric lens? Has the Trulign been better, worse, or about the same results in that respect than monfocal toric IOLs you have used?
The number of Trulign is much smaller because newer technology but rotation has not been a common problem.
My eye pressures were on the low end prior to cataract surgery in 2014. 14 & 15 if memory serves. Nope, I've not noticed any uv vision glows, and despite my best attempts, I don't have x-ray vision. Oh well.
Thanks
I had my second cataract consulation this past week with an eye surgeon at a top rated clinic (Shiley Eye Institute) associated with a university (UCSD).
It was different than my first since here the eye surgeons are also professors and have a couple of their residents/students with them, he would show them a technique looking at my eyes and they would repeat. Also one of the residents would come in first and do some examinations on my eyes with the slit lamp and then go outside the door and I could here the doctor (prof) quizzing the student about the diagnosis. Before that a couple techs took some measurements including for the cornea.
Finally when I got to meet the eye surgeon himself, he suggested for my right eye which has almost 3D cylinder corneal astigmatism, either a monofocal Toric (he does both Alcon and Tecnis IOLs) or the Trulign toric accomodating IOL. He has quite a bit of experience with the Trulign and Crystalens and told me of the special process he goes thru with the Trulign (using some kind of retainer ring?) and extra steps post-op including keeping the eye dilated for at least a week. However since the Trulign doesn't have very high cylinder models (highest cornea cylinder model ~1.83D) for my right eye it would leave probably 1D+ cylinder astigmatism uncorrected unless LRI was done as well, but he warned that LRI can become uneffective in some cases a couple years later, which I have read about as well.
So due all the extra complications and risks with Trulign at least for my right eye, a monofocal Toric IOL set for distance vision since thats my dominant eye would seem to make the most sense. I prefer the Tecnis monofocal Toric over the Alcon and this eye surgeon doesn't care which one - he did comment that the blue filter in the Alcon has no evidence of helping anything.
My left eye has only a very early stage cataract that hasn't effected vision yet, so I will probably have to wait on that one and just use a RGP contact for that eye, set for mini-monovision, intermediate distance focus which I had done a few years back successfully with the right eye set for good distance focus which I hope to achieve with a monofocal Toric IOL in that eye.
This eye surgeon did not recommend the Tecnis Symfony IOL due to some reduced contrast sensitivity, he effectively lumped it in with the multifocal IOLs. I may consider it however for my better left eye in the future, but set for a little nearsighted offset (-0.75D) for an improved mini-monovision. However I may still go with another monofocal Toric in that eye in the future as well. Thats a future decision for that eye.
This eye surgeon does not use femtolaser, but seems highly experienced and skillful with the manual diamond blade even with the premium IOLs. He does use ORA for realtime refractive checking.
Their out of pocket extra costs for a monofocal toric IOL is $1495, for crystalens or trulign IOL its $1995, and for multifocal (including Symfony) IOLs its $1895. Use of ORA is $485 extra.
So for a monofocal toric IOL with ORA its just under $2000 extra. This is about $1600 less than the first clinic I got a consulation at that uses femtolaser and does a lot of LASIK so they include any laser touchups if needed in their higher price.
Since my right eye has glaucoma the eye surgeon did not recommend any LASIK procedures for that eye anyway. Interestingly, both the eye surgeons in the two cataract consults I have had, commented after viewing the optic nerve in the dilated exam, they both didn't see any or very little damage to the optic nerve, so maybe my glaucoma was caught fairly early?
It was different than my first since here the eye surgeons are also professors and have a couple of their residents/students with them, he would show them a technique looking at my eyes and they would repeat. Also one of the residents would come in first and do some examinations on my eyes with the slit lamp and then go outside the door and I could here the doctor (prof) quizzing the student about the diagnosis. Before that a couple techs took some measurements including for the cornea.
Finally when I got to meet the eye surgeon himself, he suggested for my right eye which has almost 3D cylinder corneal astigmatism, either a monofocal Toric (he does both Alcon and Tecnis IOLs) or the Trulign toric accomodating IOL. He has quite a bit of experience with the Trulign and Crystalens and told me of the special process he goes thru with the Trulign (using some kind of retainer ring?) and extra steps post-op including keeping the eye dilated for at least a week. However since the Trulign doesn't have very high cylinder models (highest cornea cylinder model ~1.83D) for my right eye it would leave probably 1D+ cylinder astigmatism uncorrected unless LRI was done as well, but he warned that LRI can become uneffective in some cases a couple years later, which I have read about as well.
So due all the extra complications and risks with Trulign at least for my right eye, a monofocal Toric IOL set for distance vision since thats my dominant eye would seem to make the most sense. I prefer the Tecnis monofocal Toric over the Alcon and this eye surgeon doesn't care which one - he did comment that the blue filter in the Alcon has no evidence of helping anything.
My left eye has only a very early stage cataract that hasn't effected vision yet, so I will probably have to wait on that one and just use a RGP contact for that eye, set for mini-monovision, intermediate distance focus which I had done a few years back successfully with the right eye set for good distance focus which I hope to achieve with a monofocal Toric IOL in that eye.
This eye surgeon did not recommend the Tecnis Symfony IOL due to some reduced contrast sensitivity, he effectively lumped it in with the multifocal IOLs. I may consider it however for my better left eye in the future, but set for a little nearsighted offset (-0.75D) for an improved mini-monovision. However I may still go with another monofocal Toric in that eye in the future as well. Thats a future decision for that eye.
This eye surgeon does not use femtolaser, but seems highly experienced and skillful with the manual diamond blade even with the premium IOLs. He does use ORA for realtime refractive checking.
Their out of pocket extra costs for a monofocal toric IOL is $1495, for crystalens or trulign IOL its $1995, and for multifocal (including Symfony) IOLs its $1895. Use of ORA is $485 extra.
So for a monofocal toric IOL with ORA its just under $2000 extra. This is about $1600 less than the first clinic I got a consulation at that uses femtolaser and does a lot of LASIK so they include any laser touchups if needed in their higher price.
Since my right eye has glaucoma the eye surgeon did not recommend any LASIK procedures for that eye anyway. Interestingly, both the eye surgeons in the two cataract consults I have had, commented after viewing the optic nerve in the dilated exam, they both didn't see any or very little damage to the optic nerve, so maybe my glaucoma was caught fairly early?
I also asked the eye surgeon for my second consultation about his experience with any needed rotations for Toric IOLs.
He replied in his history of cataract surgery (15 years or so) he could only count 2 required him to do a rotation out of 1500+ or so.
He also noted virtually no difference in tendency to rotate between Alcon, Tecnis, and Trulign IOLs. Though he has hear anecdotally that Alcon has less, but that hasn't been confirmed by his own experience.
He replied in his history of cataract surgery (15 years or so) he could only count 2 required him to do a rotation out of 1500+ or so.
He also noted virtually no difference in tendency to rotate between Alcon, Tecnis, and Trulign IOLs. Though he has hear anecdotally that Alcon has less, but that hasn't been confirmed by his own experience.
Okay. It's your call.
The eye surgeon also confirmed that earlier crystalens models let thru some of the UV spectrum, as a former coworker had told me he experienced until he had his IOLs replaced with a newer version of the crystalens a couple years ago. The Trulign model being newer hasn't had that issue, and filters out all the UV spectrum.
I have my first cataract consulation for my right eye with a top local eye surgeon next week. She is experienced in the latest IOLs including Trulign and Symfony, and they have the advanced femtolaser and ORA equipment as well.
Since my right eye has moderate stable glaucoma (VFT shows only affects one quadrant peripheral vision) its important to select an IOL that provides good contrast sensitivity, also I desire a lower risk of poor night vision effects from halos, starbursts, etc. So of course that means I am not interested in the multifocal IOLs. I also put priority on distance and intermediate vision over near/close reading vision, so my goal is glasses free for distance and intermediate (computer, smartphone) vision and reading glasses when needed for closer reading especially of fine print. In the right eye I have -2.75D cylinder, 170degree astigmatism with -0.75D spherical (spectacle plane).
Since many Symfony IOL patients here have reported night vision issues (halos, circles, etc around lights) my top IOL choices are instead: Trulign (toric) or Tecnics Monofocal Toric. The Trulign could give me the distance+intermediate range I desire but due to limited cylinder range models may require in addition LRI/AK, while the Tecnics Toric has higher cylinder models available and probably the highest contrast sensitivity of available IOLs.
I have read articles how for a good refractive result with Crystalens/Trulign IOLs an eye surgeon with lots of experience specifically with these lenses is a must. As well as to reduce the risk of the possibility of its unique "z-syndrome"
Anyone have any good questions I should ask the eye surgeon at my consultation (includes a full dilated exam) next week? I also have a second one scheduled next month with a second eye surgeon at the top eye clinic in my area of San Diego, CA.
Since my right eye has moderate stable glaucoma (VFT shows only affects one quadrant peripheral vision) its important to select an IOL that provides good contrast sensitivity, also I desire a lower risk of poor night vision effects from halos, starbursts, etc. So of course that means I am not interested in the multifocal IOLs. I also put priority on distance and intermediate vision over near/close reading vision, so my goal is glasses free for distance and intermediate (computer, smartphone) vision and reading glasses when needed for closer reading especially of fine print. In the right eye I have -2.75D cylinder, 170degree astigmatism with -0.75D spherical (spectacle plane).
Since many Symfony IOL patients here have reported night vision issues (halos, circles, etc around lights) my top IOL choices are instead: Trulign (toric) or Tecnics Monofocal Toric. The Trulign could give me the distance+intermediate range I desire but due to limited cylinder range models may require in addition LRI/AK, while the Tecnics Toric has higher cylinder models available and probably the highest contrast sensitivity of available IOLs.
I have read articles how for a good refractive result with Crystalens/Trulign IOLs an eye surgeon with lots of experience specifically with these lenses is a must. As well as to reduce the risk of the possibility of its unique "z-syndrome"
Anyone have any good questions I should ask the eye surgeon at my consultation (includes a full dilated exam) next week? I also have a second one scheduled next month with a second eye surgeon at the top eye clinic in my area of San Diego, CA.
12 Comments
Good luck
Only my right eye has a cataract that has progressed far enough to limit corrected vision to 20/40 or worse, while my left eye has only a very early stage cataract detected (no noticeable effect on vision since it can still correct easily to 20/15 or better and excellent contrast sensitivity) that could take several years to require surgery in that eye.
The left eye's eyeglasses Rx is -0.75 -2.00C x178 for reference.
If my right eye after cataract surgery gets corrected near plano (eliminating its current astigmatism and low myopia) would my eyes work OK together with a bitoric RGP contact for distance vision in the left eye only?
The last 3 years I've worn progressive eyeglasses, but prior to that I wore bitoric RGP contacts in both eyes for nearly 25 years and RGP or hard contacts for years before that with good results.
How would eyeglasses work together with my current left eye Rx and essentially a clear lens in the right eye (other than for progressive with a +2.0 add)?
Of course depending on the outcome of the right eye cataract surgery, I might consider doing RLE on the left eye prior to the medical need for it, since I assume it will in a few years need it if the early stage cataract in that eye progresses.
The left eye's eyeglasses Rx is -0.75 -2.00C x178 for reference.
If my right eye after cataract surgery gets corrected near plano (eliminating its current astigmatism and low myopia) would my eyes work OK together with a bitoric RGP contact for distance vision in the left eye only?
The last 3 years I've worn progressive eyeglasses, but prior to that I wore bitoric RGP contacts in both eyes for nearly 25 years and RGP or hard contacts for years before that with good results.
How would eyeglasses work together with my current left eye Rx and essentially a clear lens in the right eye (other than for progressive with a +2.0 add)?
Of course depending on the outcome of the right eye cataract surgery, I might consider doing RLE on the left eye prior to the medical need for it, since I assume it will in a few years need it if the early stage cataract in that eye progresses.
What is your age. And confirm your LE is -0.75 sphere -2.00 axis 178
I will turn 63 next week.
Yes my left eye is -0.75 sph -2.00 cyl 178 axis
My right eye with the stage 3 cataract was -0.75 sph -2.75 cyl 170 axis (before the cataract effects made that eye 1.5D more nearsighted)
Yes my left eye is -0.75 sph -2.00 cyl 178 axis
My right eye with the stage 3 cataract was -0.75 sph -2.75 cyl 170 axis (before the cataract effects made that eye 1.5D more nearsighted)
With that left eye prescription, the left eye gets 20/15 or better distance vision.
Most people would have trouble using the eyes together with Plano in RE and your LE distance correction. Some, I could not give you a number would be able to adjust to it. Since you LE does not have cataract if you did not adjust post surgery the LE could have lasik or femtosecond laser to reduce difference between eyes.
Would a bitoric RGP contact in the left eye be easier to adjust to then eyeglasses with a corrected right eye (post cataract surgery)? Since the RGP contact kinda eliminates the astigmatism in the left eye by taking over for the corneal surface and the spherical power correction in the left eye is minimal - in fact the last time I got contacts the eye doctor was able to reduce the left eye contact to "plano" since the contacts tended to make my cornea less myopic (temporarily of course, goes back after a few days without contacts).
Probably but since that is only your distance RX you would still need glasses to read and for near.
Yes I understand that I would require glasses for near and possibly computer work, thats where I was at before cataracts with my contacts. But that would be the same if I eventually have cataract surgery in both eyes with monofocal toric IOLs for distance vision. Or I could do a slight monovision since my left eye corrects to 20/15 or better, that eye could handle 0.5D defocus easily to get a little better intermediate vision.
Of course if I can successfully go with a crystalens/trulign IOL that could get me to distance and intermediate vision (initially in the right eye) and glasses only for close up reading and fine print.
So those are my two possible choices as I see it now. Either Trulign Toric IOL or Tecnics Toric IOL in the right eye, plus bitoric RGP contact in left eye until it requires cataract surgery in a few more years. Then I would have a similar choice for the left eye then.
Of course if I can successfully go with a crystalens/trulign IOL that could get me to distance and intermediate vision (initially in the right eye) and glasses only for close up reading and fine print.
So those are my two possible choices as I see it now. Either Trulign Toric IOL or Tecnics Toric IOL in the right eye, plus bitoric RGP contact in left eye until it requires cataract surgery in a few more years. Then I would have a similar choice for the left eye then.
You are wearing me out. I'll hold off any further comments. I think at this point you need to work it out with your surgeon.
After my first cataract surgery consultation, they actually suggested a contact for my left eye would work OK but not glasses of course. However they indicated that after the right eye cataract surgery since my two eyes would be sufficiently different, that they could get the left eye cataract surgery covered by insurance as well so I wouldn't have to wait years for it to get worse.
This eye clinic did the most extensive set of tests on my eyes I've ever had, the tech used over 6 different machines before my eyes were dilated. One of the machines even took dozens of pictures automatically for getting the corneal measurements at the time of the consultation exam. I was impressed how far they went. Took over 2 hours for everything.
The only issue for a monofocal toric IOL they only have used the Alcon Acrysof IQ, where I would prefer the newer Tecnis Toric for its improvements over the Alcon especially in the area of glistenings would could reduce contrast sensitivity after some years, and thats important for my right eye with glaucoma.
This eye clinic did the most extensive set of tests on my eyes I've ever had, the tech used over 6 different machines before my eyes were dilated. One of the machines even took dozens of pictures automatically for getting the corneal measurements at the time of the consultation exam. I was impressed how far they went. Took over 2 hours for everything.
The only issue for a monofocal toric IOL they only have used the Alcon Acrysof IQ, where I would prefer the newer Tecnis Toric for its improvements over the Alcon especially in the area of glistenings would could reduce contrast sensitivity after some years, and thats important for my right eye with glaucoma.
When I had my surgery (2014) the Symfony lens wasn't an option stateside.
Hopefully you can find a surgeon experienced in both lenses so you can get recommendations based on actual patient experience, good and bad.
Good luck, and keep posting.
Hopefully you can find a surgeon experienced in both lenses so you can get recommendations based on actual patient experience, good and bad.
Good luck, and keep posting.
2 Comments
Your experiences with the Trulign Toric IOL over the past couple years is fascinating and your excellent night vision with little or no halos/starbursts is very promising, compared to experiences of some with other newer IOLs.
I'm considering Trulign Toric IOL as well as others (Symfony toric, or monofocal Toric) for my right eye which now has a cataract far enough along that the eye can't be corrected to better than 20/40 or so.
However I have about 2.75D cylinder astigmatism (spectacle plane) in the right eye, so perhaps that is too much for the Trulign to correct sufficiently? The monofocal toric IOLs appear to be available in higher cylinder models (4+) so I may have to go with one of those for my right eye. However in the future, my left eye has 2.50D cylinder astigmatism?
I'm considering Trulign Toric IOL as well as others (Symfony toric, or monofocal Toric) for my right eye which now has a cataract far enough along that the eye can't be corrected to better than 20/40 or so.
However I have about 2.75D cylinder astigmatism (spectacle plane) in the right eye, so perhaps that is too much for the Trulign to correct sufficiently? The monofocal toric IOLs appear to be available in higher cylinder models (4+) so I may have to go with one of those for my right eye. However in the future, my left eye has 2.50D cylinder astigmatism?
2 Comments
My left eye has <2.00D cylinder, so I may be able to use a Trulign IOL in that eye in a couple years or so when that eye's cataract progesses far enough.
Has anyone successfully used a Trulign toric IOL in an eye with greater than 2.50D cylinder?
Has anyone successfully used a Trulign toric IOL in an eye with greater than 2.50D cylinder?
Yes-- I have had a nightmarish 2 years since cataract surgery and the placement of a Truign Toric lens in one eye. Had Lasik 10 yrs prior. Vision has been hazy and blurred off and on (distance, mid) for 2 years (to date). This lens was never going to correct for my near vision and I was prepared to wear reading glasses, but hoped for distance and mid-vision. I've had one PRK and 3 subsequent Yag posterior capsulotomies. My distance vision improved somewhat after each procedure,but significant hazing always returned. This was further complicated by a retinal tear, hemorrhage and resultant floaters (one yr ago).So now 2 specialists are involved trying to figure out if the front or back of my eye or both is causing the haze. Contacts (even the scleral ones)would not correct because of my astigmatism so progressive eyeglasses were prescribed to wear full time. Eyesight has further deteriorated and compromised (heavy hazing) with eyeglasses now not helping. Next step: a risky vitrectomy. I'm now getting 2nd and 3rd opinions, worried that the lens was actually compromised in some way by 5 rounds of lasering! I wish I had been conservative and gone with a standard lens. I cannot drive at night and struggle to read and use computer with my glasses. I'm 59 yrs. old and am pretty distraught at having to live with this result forever. My vision is far worse than with the cataract. Do your research !
2 Comments
I had the Trulign installed in both eyes with the right eye dominant for distance and the left eye for close up reading. After 7months I am so disappointed. My distance is very good but reading is horrible. I have to wear readers, I still do what they call pencil exercises to try to get both lenses to work together which has been useless. The doctor said it could take a long time so keep doing the exercises. At about 5pm everyday I start to get clouding and fuzzy. I cant drive at night at all. I cant read the signs or see the road. Now I have a black dot in my right eye. The experience was not good and if I had to give a recommendation don't do Trulign and do your homework. If you don't mind glasses just do a normal surgery and save the brain damage and disappointment. It wont get better.
Thank's for sharing your experience.
Thank you for your sharing your experience with the Trulign Toric lenses.I am nearsighted, farsighted, and have a very bad astigmatism and have worn glasses since I was 10 months old. I am 44 and developed an early onset cataract in my right (dominant) eye at the age of 41. I have been (un)patiently waiting for the progression to meet the insurance requirements. Vision is very cloudy in right eye, and I have now started developing a cataract in my left eye that I told my eye dr. I suspected but he didn't see. I finally went for a consult with a cataract surgeon, thinking I hadn't progressed far enough for insurance to pay I paid out of pocket for the consult only to find out it is well past the requirement and that I do indeed have the left eye cataract as well.
I went to another doctor recommended by my eye dr.( for a retinal blood vessel issue the 1st cataract surgeon suggested I have looked at prior to any surgery) This doctor is also a cataract surgeon, and covered by my insurance as the 1st one is not. I am scheduled for surgery on the 14th and 28th of July, and am going with the Trulign Toric lens. I am really nervous about surgery on my eyes, but super excited to be able to not have to wear contacts and cheaters, or my bifocal thick glasses to see and read. I was wondering if I made the right choice, but after reading your post I think I did. Thanks again.
Somewhere in FL
I went to another doctor recommended by my eye dr.( for a retinal blood vessel issue the 1st cataract surgeon suggested I have looked at prior to any surgery) This doctor is also a cataract surgeon, and covered by my insurance as the 1st one is not. I am scheduled for surgery on the 14th and 28th of July, and am going with the Trulign Toric lens. I am really nervous about surgery on my eyes, but super excited to be able to not have to wear contacts and cheaters, or my bifocal thick glasses to see and read. I was wondering if I made the right choice, but after reading your post I think I did. Thanks again.
Somewhere in FL
1 Comments
Today was my annual visit (1 yr 10 mo from surgery, 1 yr 7 mo from YAG).
Everything is going great!
Distance is 20/20, reading is excellent. Near, far, and in-between are still good.
Next visit scheduled 1 year from now.
My surgeon is happy, I'm happy.
Everything is going great!
Distance is 20/20, reading is excellent. Near, far, and in-between are still good.
Next visit scheduled 1 year from now.
My surgeon is happy, I'm happy.
Congratulations and hopes for a continued recovery!
And yes, the healing process has a big effect on how quickly your vision improves, but you seem to be doing great!
I hope you can keep us informed as you go further with this process.
And yes, the healing process has a big effect on how quickly your vision improves, but you seem to be doing great!
I hope you can keep us informed as you go further with this process.
So far I would say your results are not only good but spectacular. You will not find any large studies on nystagmus because that condition is relatively unusual, is usually associated with poor vision and would be a condition that exempted a person from being part of FDA studies. You might be able to find one or two case reports if your search hard. You might want to discuss once more with the surgeon the choice of IOL power on the second eye. There is a lot of information the surgeon and patient get from the first eye. First is how well the predicted post-op refraction (residual refractive error) agrees with the pre-op predictions based on the formula used. Ideally there is an error of no more than plus/minus 0.25 diopters. Second and very important. What is the distance vision in the operated eye? If the person is wildly happy but would like a little more help with very small print at near sometimes the distance IOL power is reduced to leave the eye a little more myopic. If the opposite is true and the person wants better distance vision uncorrected than the IOL power may be tweeked to leave the eye with no residual refractive error (0.00 refractive error). Better these discussions occur BEFORE the surgery
Oh, I forgot to mention I am scheduled to have the Trulign lens implanted in the left eye on Tuesday, May, 24, 2016.
Re: Trulign IOL in a person with congenital nystagmus
Hi, I am a 44 year old male with relatively mild horizontal congenital nystagmus and astigmatism and I am posting this because I had a difficult time finding information concerning Trulign IOL implants in a person with nystagmus. Since the 3rd grade, I wore glasses and since the 7th grade, I have worn soft contacts, which have corrected my vision fairly well even though I played football and other sports and activities my entire life without many issues, but, contacts have not worked as well recently in terms of comfort and vision clarity. Over the years I frequented America's Best eye care chain for an annual checkup and prescription, but this year I went to an opthamologist for an opinion on other options. After the various tests, I also learned I have cataracts. The doctor told me I was not the best candidate for Lasik (which he performs), or the Visian ICL (which he performs), but that cataract surgery would be the best option for me and the Crystalens Trulign toric IOL would be the only good option for my condition should I choose to have surgery. On Tuesday, May 17, 2016, I had the Trulign Lens implanted in my right eye via the Phacoemulsification process rather than the Femtosecond Laser process and a patch was applied. Surgery was no big deal and I actually talked to the doctor while he did the surgery. I went back to the clinic for a post op the next morning, May 18, 2016, and the patch was removed. I don't know if I was still dilated, but, my near vision wasn't good, my arm's length vision was 20/30, and my distance vision is somewhat blurry, but I don't know what the visual measurement is. Near vision was not expected to be good right away. After the healing process, I will have exercises to perform in order to strengthen the ciliary muscle to take advantage of the accommodating feature of the Trulign lens. More dilating drops were administered which will keep my eye dilated for 7 days. I understand this is for eye healing and lens position purposes. Of course, I have a regimen of eye drops to continue using until my doctor says I can stop. Since I am dilated, I suppose I won't be able to know what the distance vision results are as of yet, and I do have halos around bright lights and some minor star bursts, and I am a little nervous about this, but, I am excited to say that when I wake up in the morning, my night stand clock is almost crystal clear in the right eye. I was severely nearsighted in that eye before and I couldn't even make out what time it was. I have another post op appointment today, May 20, 2016, at 2:25 p.m. and I will post more information as I experience it.
Hi, I am a 44 year old male with relatively mild horizontal congenital nystagmus and astigmatism and I am posting this because I had a difficult time finding information concerning Trulign IOL implants in a person with nystagmus. Since the 3rd grade, I wore glasses and since the 7th grade, I have worn soft contacts, which have corrected my vision fairly well even though I played football and other sports and activities my entire life without many issues, but, contacts have not worked as well recently in terms of comfort and vision clarity. Over the years I frequented America's Best eye care chain for an annual checkup and prescription, but this year I went to an opthamologist for an opinion on other options. After the various tests, I also learned I have cataracts. The doctor told me I was not the best candidate for Lasik (which he performs), or the Visian ICL (which he performs), but that cataract surgery would be the best option for me and the Crystalens Trulign toric IOL would be the only good option for my condition should I choose to have surgery. On Tuesday, May 17, 2016, I had the Trulign Lens implanted in my right eye via the Phacoemulsification process rather than the Femtosecond Laser process and a patch was applied. Surgery was no big deal and I actually talked to the doctor while he did the surgery. I went back to the clinic for a post op the next morning, May 18, 2016, and the patch was removed. I don't know if I was still dilated, but, my near vision wasn't good, my arm's length vision was 20/30, and my distance vision is somewhat blurry, but I don't know what the visual measurement is. Near vision was not expected to be good right away. After the healing process, I will have exercises to perform in order to strengthen the ciliary muscle to take advantage of the accommodating feature of the Trulign lens. More dilating drops were administered which will keep my eye dilated for 7 days. I understand this is for eye healing and lens position purposes. Of course, I have a regimen of eye drops to continue using until my doctor says I can stop. Since I am dilated, I suppose I won't be able to know what the distance vision results are as of yet, and I do have halos around bright lights and some minor star bursts, and I am a little nervous about this, but, I am excited to say that when I wake up in the morning, my night stand clock is almost crystal clear in the right eye. I was severely nearsighted in that eye before and I couldn't even make out what time it was. I have another post op appointment today, May 20, 2016, at 2:25 p.m. and I will post more information as I experience it.
1 Comments
This is very interesting and encouraging! Congratulations.
Also Ive already had my left eye done and am not happy having a mono focus lens, will I be okay just having one accomadating lens?
How do I know if I have astigmatism post lasik, is it on the card I got after lasik from the surgeon?
Lasik should not present a problem however most people who have had lasik by an experienced surgeon do not have enough astimatism post lasik to need a toric IOL
I would absolutely choose the Crystalens Trulign if I had to do it all over again. It is the Cadillac of IOLs available in the USA.
Of course, every wallet is different, but in my case the additional $2250 per eye was not a burden.
And every eye is different, my farsightedness and astigmatism were in the moderate range so YMMV.
Of course, every wallet is different, but in my case the additional $2250 per eye was not a burden.
And every eye is different, my farsightedness and astigmatism were in the moderate range so YMMV.
Thanks for your posts KayakerNC. I've paddled the Nantahala; nice river. And thanks fort the very helpful posts. If you had to do it all over again would would still choose the Crystalens?
For what its worth I had quite bad astigmatism in both eyes
I can excellent distance and very small print but can identify with what your friend has said regarding menu in a dimly lit restaurant
I can excellent distance and very small print but can identify with what your friend has said regarding menu in a dimly lit restaurant
I think a lot depend on your vision going in. I was moderately far-sighted with moderate astigmatism, and my results were all I could hope for.
I have a friend who had the toric lenses and he only needs glasses for very small print and dimly lit restaurants. So he's happy.
Insurance and Medicare (if applicable) does pay for 2nd and 3rd opinions before surgery, so definitely get appointments with the best professionals you can find.
Good luck and keep us advised on your journey.
I have a friend who had the toric lenses and he only needs glasses for very small print and dimly lit restaurants. So he's happy.
Insurance and Medicare (if applicable) does pay for 2nd and 3rd opinions before surgery, so definitely get appointments with the best professionals you can find.
Good luck and keep us advised on your journey.
Oops, hit post by accident before editing typos. I meant of course that you might reconsider whether to use the doctor you went for the surgery. View talking to another doctor as not merely getting another opinion before using the first, but as part of hunting for a new surgeon to use for the procedure.
It seems rather surprising a doctor would tell you there was no toric accommodating lens, even if they didn't personally use it. Unless it is a misunderstanding and he merely meant that *he* didn't offer a toric accommodating lens in his practice since he doesn't use the Trulign, it would tend to suggest the doctor doesn't keep up with the very basic developments within his old field. If he isn't up on the latest IOLs, I'd be curious what other very basic developments in the field he isn't up to date on. If it were me, if he truly didn't know about the lens, I would consider not merely talking to another doctor as a "second opinion", but reconsider whether to use the doctor you talked to rather than another option.
Of course since you mention accommodating lenses it seems you are aware that even with a toric monofocal you'd likely need glasses for some distances, its only a tiny minority that somehow manage to read with a monofocal lens set for distance. Monovision can provide some more near vision, but there is still a decent chance of needing glasses for near at times.
I've seen some sources suggest that odds may be somewhere around 50-50 that you'll still need reading glasses with any version of the Crystalens, but I don't have a study offhand. Even though most people get a benefit from the Crystalens, there are some where it doesn't seem to provide accommodation, i.e. it winds up being closer to a monofocal, which is why I considered other options instead. The other premium lenses available in the US are multifocals which can provide better near (and/or better intermediate) than a monofocal but have a higher risk of glare or halo issues than a monofocal or the Crystalens. (I chose to go outside the US for the newer Symfony lens which is a new type of lens, but I assume like most people you aren't considering that option).
Of course since you mention accommodating lenses it seems you are aware that even with a toric monofocal you'd likely need glasses for some distances, its only a tiny minority that somehow manage to read with a monofocal lens set for distance. Monovision can provide some more near vision, but there is still a decent chance of needing glasses for near at times.
I've seen some sources suggest that odds may be somewhere around 50-50 that you'll still need reading glasses with any version of the Crystalens, but I don't have a study offhand. Even though most people get a benefit from the Crystalens, there are some where it doesn't seem to provide accommodation, i.e. it winds up being closer to a monofocal, which is why I considered other options instead. The other premium lenses available in the US are multifocals which can provide better near (and/or better intermediate) than a monofocal but have a higher risk of glare or halo issues than a monofocal or the Crystalens. (I chose to go outside the US for the newer Symfony lens which is a new type of lens, but I assume like most people you aren't considering that option).
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