Restor lens

My husband had surgery for cataracts in the spring with Restore implants. The first eye is great and good vision. The second eye done several weeks later has never been over 20-60 and now 20-100. They can only correct this eye to 20/40 with glasses and have no idea why. They sent him to a retina specialist. Everything is fine with retina. The second Dr. said that he was 1--something instead of 1/2 something (think it started with a d), but that shouldn't be a big problem. Help, anyone have any ideas?


This discussion is related to Restor Lens: Potential problems.

[Ray T Oyakawa, MD]

I believe the second doctor was stating that it is 1 diopter rather than 1/2.  

There needs to be an explanation for best corrected visual acuity of 20/40.  If not in the retina, then it is in the area of the IOL, or the cornea.

Sometimes the pupil is not centered on the IOL.  This can be fixed by using a argon laser.  Corneal irregularities can also cause a decrease in visual acuity.  
A hard contact lens over-refraction can determine if this is the problem.  Another problem could be an opacity of the posterior capsule.  If this is the case, a yag will improve vision.  However, make sure this is the cause.  After a yag, it is much harder to exchange and IOL.

[Lerbea]

Simply the problem may be the Alcon Restor IOL itself. Search the archives for the problems associated with them.

[ace399]

A Crystalens was implanted in my right eye 2 weeks ago and I could not see close up (<2 feet) without readers.  My Dr. recommends I implant a Restor lens in my left eye.  What is your opinion on this?

[peakhope]

Crystalens is best for distance and intermediate, so it is no surprise that you need glasses for near vision. I have two Crystalens HD lenses and I can read at about 16", which was better than I expected. I only use glasses for non-reading activities (like pulling out a splinter). Of course, everyone will have a different outcome.

Two weeks is not very long for a Crystalens. Your vision may continue to improve for weeks, or even months.

Supposedly many people are happy with Crystalens in one eye and Restor in the other. The two complement each other well as far as near and intermediate distance vision. However, the Restor lens does have issues with glare, so do your research before going that route.

Whatever you decide for your other eye, go in with informed and realistic expectations. No lens today is perfect for everything. And even with the right lens, it is a medical procedure, so unexpected things can go wrong.

[ace399]

How long have you had your Crystalenses?  Could you read anything on the close up eye chart at the 1 week after surgery follow up visit?

Did you use the eye exercises (word games)?  Did they improve your close up vision?
How long was it before you noticed an improvement?

At the 1 week follow up visit, I could not read anything on the reading chart.  My Dr. says that at this stage, the likelihood of getting full accomodation is not likely and that with exercise, partial accommodation is possible.

I don't like the idea of having a different lens in each eye.  I like the Crystalens, but am afraid that my eye muscles just aren't working.  

[peakhope]

I had my first Crystalens HD installed Jan 7, and my second Jan 14. My doc used atropine which caused each eye to be dilated for one week and the ciliary muscles were paralyzed for an additional week. Not all doctors do this. I also had LRI's in both eyes, and required stitches for pressure in my left, so I'm not sure if those are affecting my vision and if so, for how long.

For most of my first week in each eye, my vision was poor at all distances. I got intermediate vision first (4-6 feet), pretty-near (2-4 feet) second, and distance is still not ideal. I think I have some residual astigmatism which is contributing to that. I feel very comfortable driving, so it's not too bad.

I have not actively done the exercises because my pretty-near vision is already so good. Also, my second eye has only been de-paralyzed for 3 days so far, and I didn't want to push it. I haven't done an official test yet (scheduled for two weeks from now), but I'm pretty sure I can read J1 in good light.

It is possible that my eyes ended up more near-sighted than the -0.25 targets, which would explain my better-than-expected near vision and worse-than-expected distance vision. I'll find out in a couple weeks.

My expectation going in was that my vision (at various distances) might continue to improve for up to a year after the procedure, as my eyes and brain get used to the new lenses. I believe that was shown in long-term Crystalens follow-up studies.