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Avatar universal

Restor Lens IOLs

Hello, I sure hope someone out there can answer some of my questions.
Two weeks ago I had Restor Aspheric IOL lenses implanted into my eyes and small slits made to correct the astigmatism. I was told the lenses would give me almost perfect near & far vision and good intermediate vision. They did warn me that I may experience rings and halos around lights at night. (I had no idea how bad this would be)
Since I love to spend all my free time outside and on the waters fly fishing the thought of being rid of my progressive glasses was a dream come true.
Right now my distance isn't too bad but not nearly as clear as it was before with my glasses. My near and intermediate vision is terrible. Everything is a blurr. I can't read anything unless its about 10 inches away and working at the computer is really difficult. Text on a white back ground looks as if someone has taken a light grey highlighter to it and white on black is almost painful. I work as a draftsperson for a busy engineering firm and if I can't see I can't work! My right eye is the worst as far as pain goes and I always have a dull headache which seems to be from eyestrain or bright lights.
What I need to know is:
Is this normal?
How long does it take for the lenses to "shrinkwrap" as they say to the where they're supposed to be?
Do most people have good results immediately or are they just as scarred as I am in the beginning?
I look forward to any advise you can give me.



43 Responses
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517208 tn?1211640866
MEDICAL PROFESSIONAL
Dear blurr,

I would recommend that you speak with your eyeMD about your symptoms. It takes about three months for people to adjust to some of the changes you describe.  Not everyone adjusts perfectly.  I would speak with your doctor clearly about each activity and whether a prescription, light or reading distance can be adjusted to obtain clearer vision.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
Helpful - 1
Avatar universal
You are yet but another that has experienced the results of the Restor lens and they are not good.  I had the  dreaded Restor implanted in July and it was a horror.  I had it explanted  in August and had a monfocal lense exchanged. Quite a dramatic improvement. Do some research on Restor, iols and multifocal lenses in the forum and archieves.  You will find a lot of information.  Good luck.
Helpful - 2
Avatar universal
Thanks for your reply.
I'm to see the doc this Wednesday.
Will post what he says.
Helpful - 0
Avatar universal
check out the info on this forum befor seeing the doc,
Helpful - 1
574673 tn?1234125978
Sorry you are experiencing such distress and poor vision with Restor.
While some people do adapt and this can take a while, some of the problems you are experiencing are common with Restor lenses.
I had one Restor implanted and then explanted after six months last December. I replaced with a Toric Monofocal by Alcon and wear a contact lens in my natural eye.

Definitely check the forum both experts and patients in the archives.
You may find some relief with glasses over the Restors. Under no circumstances agree to a YAG lazer procedure until you are completely satisfied that you will keep your Restors. A Yag will make an opening in the back of the capsul and explant will be difficult to do and many doctors will not do this after a YAG.

Good luck and try not to lose hope. You will eventually find the Road to good vision.
londonbridge
Helpful - 1
Avatar universal
Dear Blurr,
If you check the archives of the Expert forum or click on my username, you will find a thread entitled "Which monofocal lens is best (after multi explant)". It documents my own experience, as a patient like yourself, with the Restor lens.  I started the thread after I had made the decision to have both Restors removed and replaced with monofocal aspheric lenses.  You will find quite a bit of info there, and my opinion of the Restor is also in some of my other posts.

From the moment I opened my eyes I felt absolutely stressed and dismayed with the horrible effects (and they are indeed horrible) that you describe.  I just wanted to tear my head off my shoulders, and this went on for nearly 4 months.  Some patients say they did not have these effects, or that they were minimal.  Others suffer a much worse reaction.  You are not alone.  This I can tell you with certainty - the quality and clarity of *correctly inserted* monofocal lenses beats the Restor hands down, and you do not have the brutal and awful period of "adaption" (if you ever manage it) that noone ever seems to mention truthfully when touting the lens.  There is no perfect solution, so with the monos people most likely need glasses for some things, or risk binocular imbalance with each eye set for a different focal point.  There is no free lunch.  I am totally delighted with the quality of one of my eyes set for distance, the other eye (also set for distance) is having complications unrelated to the lens, but I would be in heaven if it were as good.

Like you I am a very active person, and value my distance vision most, therefore I am more tolerant of needing glasses for close up such as print, computer, and on occasions to polish up the intermediate vision to about 3.5 feet such as when in bookshops.  Once the glasses are on, the clarity of closer vision is excellent, no penumbral blur or bleeding of colours, no sense of strain - I had those same effects with the Restor.  I see very well for all practical purposes, and find pulling glasses on and off my nose to read print, find coins, and get that extra bit  texture occasionally to have mere nuisance value, just as it did pre-cataracts, and well worth it for the overall quality.

Because your eyes have their own unique configuration, I would not state that your vision would be the same as mine with monofocals, and there are different ways of setting them up.  You might perhaps be more or less glasses-dependent, I don't know.  However the downsides of multifocal lenses have been experienced by many other patients on this forum.
I was a cataract patient, half blind, but with very good pre-cataract vision, only a little middle-aged nearsightedness, so this may have helped my good outcome.

My own choice (in Australia) was a bilateral explant, which is a *very* serious decision carrying it's own risks - and only the individual person can ***** if this is a risk worth taking.  If you are so unhappy I would seriously suggest getting additional opinions from other surgeons who do monofocal lenses, and doing this *quickly*.  The awful catch-22 with multi lenses is that they "supposedly" come good for most (but not all) people after 12 months, but the consensus of Dr's opinions to me was that if you want them out, the sooner the better.  I didn't think I could live with them, and into the bargin the lens power was incorrect.  Is your's correct?  I would (and have) begged others not to get multis, but once they're in, the whole picture becomes much more complicated.

I hope this has helped you.  Search this site on keywords such as Restor, explant, monofocal, modified monovision etc, but remember we are mostly just patients like you - so you do need the expert advice of an ethical surgeon who will try to give you the best possible results and will be able to advise what you could realistically expect.  Be wary of recommendations to get YAG or Lasik until certain you want to keep the lenses, as this configures your eye to the Restor!

Best regards, Restornomore
Helpful - 3
Avatar universal
Thank you both for your help. I will definitely take your advice and do more research. Something I should have done in the first place. My doctor is supposed to be the best in town with a very good reputation. When they recommended the implants I had no concerns and believed I would come out of this with better eyesight than before because thats what I was told. I feel extremely stupid for going ahead with the surgery. I did not have cataracts and only wanted to be free of wearing glasses.
Stupid stupid stupid!

Blurrrrrrrrr
Helpful - 0
Avatar universal
You are not stupid .I juimped at the chance not to have to wear glasses and my dr juimped at the chance to make money.  It was up to the doctor to fully inform us. Maybe we were lax in asking more questions. If I was told more I never would have had that Restor implanted in the first place.I was told very little and I believed what I was told.  I stopped at the first  eye but the doctor was pushing me to have the other eye done right away.Thank goodness I found this forum  I went to another surgeon for the explant. .Search the forum and you will see the post between me, londonbridge,restornomore and Jodie J. I got such encouragement from them. Good luck, There  definitely is hope.for having good vision again.
Keep us posted disappointed66   (no more)
Helpful - 1
Avatar universal
Dear Blurr,
I understand completely your feelings of rage and regret - I felt exactly the same way. It is utterly shameful the way "reputable" doctors flog these things - bad enough if the surgery was necessary, but absolutely wicked when there is *no such thing* as a presbyopia-correcting lens with current technology!  I was told that "everyone loved" the lens and treated like a complete weirdo for not loving it as well.  You were conned, I was conned, many patients on these boards were led astray by the very people we should have been able to respect and trust to help us.  People tend to equate the phrase "don't need glasses" with "see well" - they are not the same thing at all!

I felt totally used as it was repeatedly flung in my face that I "was blind before" in response to every protest I uttered about these awful things.  The night vision for starters nearly drove me insane, and I *loved* to walk at night, so that part of my life was completely destroyed.  With the monos, night vision is much more sane and normal.  The very stressfulness of going rapidly blind quite young distorted my judgement and I thought I was just being a sook (Aussie for whimp) about what was supposed to be routine and mostly successful surgery. Here *some* Drs tout the "premium" lenses at younger patients who are sitting ducks if unaware of the issues.  If only I'd had the sense of disappointed66 and refused to have the second eye done. Try not to get diverted with regrets though, you have the rest of your life ahead of you, and need some improvements.

If you reconcile yourself to needing glasses at least some of the time, you may well be able to achieve top-quality distance vision with aspheric monofocals & *maybe* have OK closer vision helped with glasses - here's where you need *expert* and ethical advice, I can't make promises about outcomes.  I sound like I'm pushing an explant and don't mean to as there's *so* much to consider, including the possibility of being worse off if things go wrong - I just feel for anyone stuck with the Restor!  My explant Dr told me the operation was rather like "old fashioned" cataract surgery involving a larger incision, and the chief risk being the lens would develop an attachment to it's moorings and not want to come out, so the sooner the better.  I was lucky and found (via my GP) an excellent and very skilled surgeon - so don't be afraid to seek many opinions, you needn't go ahead with anything that makes you suspicious.  I'd stick with surgeons who don't use multis, and who are completely upfront and honest and willing to answer any questions myself.

You can still get a bad result with monos if lens power is incorrect, or surgery done poorly.  Nothing is easy is it?  Wishing you the best in this difficult time.

Regards, Restornomore
Helpful - 0
Avatar universal
Well I had my eye exam last week and my sight at the 2nd week mark was 20/40 & 20/50. The week before it was 20/25 & 20/30 and post-op it was 20/20 & 20/25. My sight is progressively getting worse!
Reading and working at the computer is still very difficult and I'm getting lots of headaches. Near and intermediate vision is still terrible, really blurry with ghosting and double vision. Night time is horrible and makes driving quite scarry. My distance isn't too bad but not completely clear and in no way as good as it was before with my glasses. I'm also having trouble with bright lights and glare in the daytime and need to wear sunglasses even on the cloudy days.
I'm to be tested again today and will see my surgeon this time. I really hope he will have a solution for me even if it means removal of these Restor lenses and implanting another type. I've been reading about monovision and will ask him if I would be a good candidate.
My biggest concern is what if the next ones aren't right for me either? Then what?
Helpful - 0
Avatar universal
Hi, I'm the other ReStor sufferer.  I was wondering what your doctor said at your most recent appointment.  I have my appointment today and I'm planning to be tougher this time and show him some of my research.  I have an appointment for a second opinion tomorrow.  

Of course, all these doctors promote these lenses so we'll see what the second one says.  I was never told anything about the possibility of waxy vision.  Yet, in my research, I found that doctors are talking about it so I find it hard to believe that my doctor had no idea about it.  

I found an article in Eye World by a doctor who started his article by stating, "Many of my patients who have received one of the 300 ReStor multifocal lenses that I have implanted experience mild to moderate "waxy" or "hazy vision."  He goes on to state that almost 5% of his patients experience a severe form of waxy vision  (VVD).  These cases require explantation and iol exchange to relieve their symptoms.  I'm not sure if mine qualifies as severe, but to me it is unacceptable.  Were it not for my other eye, I wouldn't be able to see street signs.  I have to sit about 5 feet away from the TV because everything is blurry.  If I had been told about the possibility of waxy vision, I wouldn't have taken the chance.

I'll try to post what my doctor and second opinion doctor tell me.  
Helpful - 2
Avatar universal
I should've said in the post above  that I have to sit 5 feet from the TV when the contact is out of my other, unoperated eye (-5.50 myopia).  In other words without my unoperated eye, my life would be pretty unlivable thanks to this ReStor lens.  I don't think I'd be able to drive or pass a vision test for driving.
Helpful - 1
Avatar universal
Good morning. My appointment yesterday was rescheduled to tomorrow afternoon. From what I've read most people with our problems have had thier lenses replaced with others to give them either monofocal or monovision. I'm not sure which way I'll go yet but no matter what these Restor have to go. I just can't function the way things are now.
Good luck with your doctor today. Maybe a few tears would work. lol :(
Helpful - 0
574673 tn?1234125978
Sorry you are both experiencing Restor woes. The same was true for me and I was grateful for having one unoperated eye -8.0 with a contact lens to depend on. Do read all of the posts mentioned and find a trustworthy eye surgeon, they are out there, who will explain all of your options. Most of the people who posted on this forum who had their multifocals explanted and replaced with monofocals have been very satisfied, myself include. It is distressful to have to go through all of this but there can be a good resolution eventually.
londonbridge
Helpful - 1
Avatar universal
Hi...I've read your story Londonbridge.  Glad it has worked out for you after explanting the ReStor.  

I'm not sure what to think now that I've seen my doctor again.  He dilated my eye and he said everything looks great.  He is very convincing; even convinced my husband who was ready to blame him for everything.  He said that the blurriness was more with the earlier ReStor and my case is very different.  I do see clearly every early morning upon first awakening.  It lasts a couple of hours and then the blurriness starts.  I fell asleep on the sofa the other night in the evening and when I awoke, my vision was improved.  In addition, I had perfect vision for a few days after the surgery.  

He's never seen nor heard of anything like this and suggested that I could get a second opinion and suggested I try Restasis to see if the tear film has something to do with my problem.  My eyes feel fine so not sure that I have dry eyes. He said he could explant the ReStor and put in a monofocal but given my fluctuating vision, he wouldn't know what power lens to put in.  I might still have the same problem afterwards.  I'm going for an independent second opinion tomorrow so will get another perspective.  He said I could wait a few months before explanting to see if the Restasis works.

Now I'm more puzzled than ever and unsure what to do.
lurr.  At least your symptoms aren't as strange as mine.
Helpful - 1
Avatar universal
I too had better vision right after surgery but it has been down hill ever since. Definetly try different drops. The first drops for dryness that I used was the Refresh Tears. They contain preservatives and after a week the outer surface of my eyes were burnt and I had to take 2 days off work and use extra thick gel drops every hour. It took a good 4 or 5 days before the soreness and dry sandy feeling went away. I'm now using the Refresh Plus in the single-use containers that are preservative free. Good luck tomorrow and keep us posted as to what your second opinion has to say.
Helpful - 0
574673 tn?1234125978
To alicia606
I have not read your original thread but it sounds like your Restor implants were fairly recent? It is possible that your cornea is still stabilizing which could account for fluctuating vision. I know other people who had good vision in the morning which deteriorated and eventually improoved when their cornea healed. I agree eye drops could help. At any rate a second or even third opinion is important before taking a drastic step such as an explant. I know it is hard to be patient but it is important to weigh all of the options carefully. My Restor was explanted successfully a full six months later.
To blurr
Thanks for the information about eye drops. I never considered the effects of the ones that have preservatives. I do use the refresh individuals which seem to help alot.
Helpful - 2
Avatar universal
Thanks for the suggestions.  I'm now using Refresh and the Restasis.  I had my surgery 4 weeks ago.  

I went for my second opinion and came home depressed and confused.  He is an older doctor and doesn't care for multi-focals and doesn't think I should have gotten it since I have glaucoma.  He is also not a fan of explanting lenses and didn't recommend that route for me.  He only does about 2 a year and obviously doesn't like doing them.  The doctor who put them in says he does about 5-6 explants a year and made it sound like no big deal.  Who to believe?  Who to trust?

Now I'm faced with the decision of what to do with the other eye.  Do I leave it alone though I have a small cataract which is barely affecting my vision, do I put a ReStor in that eye, or do I put in a regular monofocal in that eye -- that's assuming I keep the ReStor in my left eye if it the vision ever becomes stable.  I do okay with wearing a contact in that eye and with the ReStor in the other eye.  I'm leaning toward not doing anything until my cataract affects my vision in that eye and then getting a monofocal.  Not an ideal situation since the ReStor works best when in both eyes.

I've thought of getting a third opinion but will that confuse me even more?  I'm weary from all this.
Helpful - 0
Avatar universal
Hi blurr,
I had both cataracts removed in the past 2 weeks.  I too, had great reservations about the multifocal lens vs. monofocal lens. My optometrist recommended monofocal lenses and my surgeon acted like there really wasn't a choice but the ReSTOR multifocal lens. I decided on the ReSTOR lenses.  After the first surgery I could almost immediately see distance well.  There were faint pink halos the first night.  The post-op instructions indicated that the pink tint was from the bright lights of the operating microscope and that they would fade away.  They did, and were gone by the second day.  Close up and intermediate vision returned 3 days after surgery.  I'm now 2 weeks and two days post-op and can see extremely well.  Results were pretty much the same for my second eye except that the distance vision did not clear quite as quickly.  Reading vision and intermediate vision were noticeably getting better much more quickly than the first eye. Distance vision now great in the second eye and reading and intermediate vision is now crystal clear in both eyes. Distance vision is crystal clear in the my first eye. I'm extremely pleased with the results so far.  When eating out I can read the smallest print ifrom the menu even in dim light.  My wife is jealous that I can see objects and read signs at great distances when driving.  I don't quite understand what you mean by "shrink wrap"  but this is what I have experienced since my operations.  I do see slight halos from oncoming cars, but they seem more like "fish eyes" to me. For me they are more pronounced in daylight than at night. I asked my Dr. about this and he said that they are normal and will go away by the first year.  He said that the brain will automatically learn to ignore the optical abberations with time.  We'll see.  I did not have any astigmatism problems though, and could be why I am experiencing good results. Summing up, I am extremely pleased with the ReSTOR lenses.

I wish GOOD LUCK to all!

Helpful - 2
Avatar universal
I'm very happy for you roncun and only wish I had the same results.
I saw my surgeon today and he said he could put in monofocals but I would need progressive glasses for close up work and wouldn't see much of anything without them. I'm worried about the distance that the new lenses will be set to. I really hope I will be able to see the people across the table from me with them?
My doctor is the best ophthalmologist here in Alberta so I have complete trust in him. I'm the first of all his patients that has had these severe problems. He told me to stop using the anti-inflammatory drops and come back next week for more tests. He said the drops may be contributing to my blurriness and I may still have some swelling in the back of my eyes. There is also a slight fold in the capsular bag of one eye.
He can do the surgery next Wed or Thurs but after that he will be away for 3 weeks. If I wait until he comes back that will be 2 months since the Restor's went in. I don't know what to do. Wait and see if my sight improves over the next 4 weeks or have the monofocals put in now and then deal with whatever the out come will be?
I've got a few days to think about it but I'm feeling quite desperate right now.
Any advice out there?
Helpful - 0
Avatar universal
I feel for you having to make such a tough decision as I'm torn also.  I'm not sure what effect the slight fold in the capsular bag means.  How is the other eye that doesn't have the fold?  What does your doctor recommend?  My understanding is that it wouldn't make much difference if you waited an additional month or two.  I'm waiting at least another month before deciding.  Londonbridge I believe waited quite a bit longer than that and had successful explants.  It may make sense not to act in such haste and wait to see if the ReStor lenses can be made to work.  There are definite advantages to having near vision.  My right eye with the contact leaves me with no near vision.  If I had both eyes like that I think I'd have to have readers around my neck at all times.

Roncun, you are lucky to have such good results with the ReStor, and according to my doctor representative of his happy ReStor patients.  Obviously, they work for a lot of people or I can't believe all these doctors would continue to implant them just for the money.
Helpful - 1
Avatar universal
I remember seeing a chart on the wall in my surgeon's examination room.  It matched the varioius lenses with certain eye condtions.  The ReSTOR lens was not listed for use with astigmatism.  My wife was with me and she said, "I have astigmatism so I guess that if I had a cataract I wouldn't get the ReSTOR lens."  Each case is different, however, and I'm sure that your doctor selected the best lens and treatment regime for you. I asked a nurse in the surgical center how many lenses my surgeon had explanted.  She thought for a minute and then said that she could only remember one in the three years that she was there.  She said that the doctor really didn't want to take it out and waited quite a long time to see if there was any improvement before explantation.  I, too, have complete trust in my surgeon.  He is Harvard trained and teaches at the Wills Eye Institute in Philadelphia and also has a private practice.  I know that he has extensive experience in cataract surgery.  On my second surgery I was #25 of 32 cataract patients that day.  But, he was never too busy to answer any and all questions that I had.  I even requested a special consultation before the first surgery. I had so many questions that I wrote them down on a piece of paper as I thought of them so that I wouldn't forget them.  I guess what I'm trying to suggest is 1) There seemed to be a sense of urgency in your post. 2) After further testing would your doctor be available for consultation to discuss results and options? Before possible surgery next week? 3) Because your surgeon said he can explant next week, does this mean that he is convinced that they should be explanted?  At that time? If so, why? Has your doctor already decided to explant prior to getting the test results and will the tests give him any info that might influence his decision to or not to explant?  4) Should your and your doctor's decision to have surgery hinge on his vacation schedule?  Why?  4) What does your surgeon expect as the best outcome for your case? Worst?  5) Should there be a second opinion? ..... Your surgeon should welcome and encourage your active participation.  You say that you only have a "few days" and feel "desperate".  I don't think that you should feel this way.  I wish you the best and may I suggest that you can use this time to get more info from the tests, your doctor, and other sources to get your best possible outcome.    Ron
Helpful - 0
Avatar universal
If you got monofocal IOLs set for mini-monovision (distance vision in dominant eye, intermediate vision in non-dominant), you would probably only need glasses for prolonged reading or seeing small print.  However, even if you chose to have both IOLs set for distance, you'd do just fine at a dinner party without your progressive glasses.  (Do your friends who never needed glasses until they developed presbyopia wear their readers to socialize or to have dinner with their spouse?  Mine don't, unless they need to read a menu.  Your vision with IOLs set for distance would be about the same as their vision, and you'd need to wear glasses about as often as they do, i.e., for sharp near and computer vision.)

I'm not an eye care professional, but I've  that it is better to do an explant sooner rather than later.  It's good to have faith in your doctor, but the choice of whether to have your ReStors explanted (and, if so, the refractive targets for the monofocal replacements) should be made by YOU.  (It's YOUR vision, after all.)  So my best advice is to make a decision soon.  
Helpful - 0
574673 tn?1234125978
roncon - I am pleased for you that you are happy with Restor and I think that speaks volumes about finding the very best eye surgeon as the folks at Wills eye hospital obviously are. Wills is consistently rated one of the best in the world. I think for the right patients they obviously can work. The problem is for people that may not fit the the proper profile i.e. astigmatism, high myopia (like myself, the Restor had only recently been aprooved for my prescription etc.)
alicia606 - Sorry this is such a dilema for you. An explant is neither no big deal or something to avoid. It is also not wrong or unsual to seek several other opinions, preferably from a highly experienced eye surgeon at one of the top research hospitals even if you have to travel. Mine was two hours away but I definitley would have traveled farther. Even my surgeon, one of the top in the world had not done many explants but I trusted him to do the surgery because of his skill and honesty. He told me that he would not proceed if when he got in there it was too risky.


I too have a small cataract in my other eye. For now I have left it and will eventually set it as close to plano as possible as my nondominate IOL is set for intermediate. I wear a contact for distance (-7.5).

From what I have read one can do fine with a Restor in one eye and a monofocal in the other so do not be persuaded to get another Restor as this will  likely double your problem. Never proceed with the second eye until you can be satisfied with the first.

While it is best to do an explant sooner rather than later, you do have time if you are uncertain. I waited six months while I pondered all my options and sought opinions.Believe me when I tell you, you will know when you have found a surgeon you can trust and that is what it will come down to.

to blurr - yes inflamation and steriod drops can definitely affect vision. I too had a fold in my capsular bag, but a very experience surgeon said many people have this and that it didn't account for the poor quality of my vision with Restor. I believe him . Under no circumstances have a Yag procedure done to make a hole in the capsular bag. Hardly any one will want to risk explant after that. I would wait a little while to see if vision improoves, but not too long once you have determined that your vision is stabilized with the multifocals and that is the best you can do.

Good luck and best wishes to all.
londonbridge
Helpful - 0
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