Problems with Crystalens

My experience with the Crystalens has been far from satisfactory. At 67 I have developed cataracts in both eyes which resulted in blurred vision, a double image, and extreme glare especially at night from on-coming traffic. I have been nearsighted with astigmatism in both eyes all of my adult life but always could be corrected to 20/20 with glasses or contacts.  

After researching the marketing hype on the various IOL's both multi-focal and accommodating and I decided that the Crystalens HD was what I was looking for in an IOL. Glare and clear night vision is a very big issue for me and the Crystalens promised the best results in minimizing glare. I found a practice in the southwest Florida area where I live that specializes in inserting the Crystalens and signed up to have both eyes corrected over a two week period. The first implant was done on my dominant right eye. It started out ok but after the second day I realized something was wrong. My vision had gone from near sighted to 20/100 far sighted. I asked, how can this be off so far? The explanation was that this is not an exact science. In the following week their optometrist made a corrective lens for my glasses, left eye nearsighted and right far sighted, lost most of my depth perception in the process and my near vision was obliterated even with the glasses. No accommodation at all. The glare and star burst effect was much worse than with the cataracts. I postponed the surgery to the left eye until the right eye situation can be corrected.

Within another week the vision in my right began to cloud like a thin bluish white haze. This resulted in a high level of glare from night lights, many times worse than the untreated left eye. The doctor scheduled me for a yag laser treatment to open the capsular  membrane. This did not change the haze situation as far as I could see. The doctor then scheduled me for Lasik surgery in the following weeks to correct the far sighted condition. After this surgery my vision corrected to about 20/40 far sighted even though the doctor guaranteed this would correct my vision to 20/20 and allow accommodation to occur. Wrong again.

Now five months after the original surgery I have a situation where it is almost impossible to drive after dark because of halos, visual glare, star bursts around lights and haze that blots out background images like signs. My eye has a lens that is  way to strong for the eye's natural size. My cornea has been reshaped to compensate for the incorrect lens prescription and that is still not correct. I question the need for the yag laser treatment when it was performed because I have a cloudy film that seems to float in and out of my central vision. What keeps the edges of the incision created by the yag laser from floating in and out of the visual field? Does the yag laser treatment make it impossible to ever have this lens explanted? And what about the accommodation that I paid $3000.00 more for per lens?
The main reason for selecting the Crystalens was the accommodation function and low glare. It failed me on both fronts. I am wondering if I even got the right lens. Is there any way to tell what IOL is in my eye after its implanted? One last question, is Tetraflex lens approved in the US and does anyone have any experience with this lens?

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

1. The yag blows the central membrane into tiny pieces which are pushed back into the vitreous where they often float about. There is no way to prevent this. Know that about 70% of people you age have floaters.
2. No you have have the IOL explanted even with a yag capsulotomy. It just makes it more difficult.
3. You can use the search feature and archives to read the many posts about people having the same problem. Crystalens is the best of the bunch.
4. You should have been given a card that has the IOL serial # and optic power. You can get that from your surgeon if you don't have it.
5. I don't know the status of the tetraflex.
6. I suggest you get one or two additional opinions on your problem

JCH MD