Restor

I am an er physician that over 1 yr ago was talked into having restor lens implant. I originally went for lasix consult which I was told I needed. But when I stated I wish there was a lens implant that would eliminate the need for glasses then suddenly the dr re-examined my eyes and said I had stage one cataracts and I was a candidate for a multifocal lens implant. To make a long story short....if u are active, love golf, are a pilot, or drive at night.. Do not have this surgery. The FDA needs to re-evaluate this. As I told my ophthalmologist after.."this is the dumbest thing I have ever done. No longer am I safe to drive at night. I can no longer play golf without someone telling me where the ball goes as after 100 yards I can not see the ball in the sky. My focal distance is 12 inches only. In other words at 15 inches I can not read. I could go on and on but I'm going to leave u with this analogy. If u are a limb amputee then a prosthetic will help but just because u have limp pain when exercising is NOT a reason to have the limp severed just to have a prosthetic. This procedure should be reserved only for those with severe vision. And just for the record an earlier eye exam by another showed no cataracts. Why did I have the surgery...the promise of having, as the brochure declares, clear vision near and far. They even have a picture of people playing golf like u will play like u have never before. I'm telling u now don't believe it. Do not have this done unless u are damn near blind. There is no excuse for these implants otherwise

[yarrow]

I am an ordinary housewife with reasonably good eyesight, allowing for presbyopia, until cataracts suddenly and aggressively read their ugly little heads in just a few short years.  But a little over a year ago, I really was having trouble doing the most ordinary things (I am a craftsperson and seamstress), even with a magnificent array of glasses in every room, and powerful lights everywhere.

My opthalmologist examined me, and observed that with my short eyeballs, lack of astigmatism, and good retinas, I was in his estimation an excellent candidate for the reStore D1.  This man is conservative and avoids 'pushing' surgery, but at that point I was pretty desperate to be able to resume my normal activities.  Since I had been wearing reading glasses for around twenty years already, I was comfortable with them on my face or hanging around my neck, so I was neither encouraged nor discouraged by the doc's note that only about 15% of recipients of this lens were able to abandon glasses.

To my surprise, I am among the 15%.  A year and a half later, I read without glasses except in certain, specific, low light conditions.  Without glasses, I can read street signs in the middle distance (day or night), and I can see individual trees on distant peaks.  I drive comfortably at night, too, although I do have some slight haloing if I concentrate on seeing it, but my night vision is so much sharper now that night driving is a pleasure.

For carefully selected patients who have excellent, thoughtful surgeons, these multifocal lenses can indeed provide youthful eyesight once again.  I am a living, breathing example of that, but I also know that my outcome is rare.  Those who are offered miraculous results should beware the hype, look at the whole thing with caution, and do a lot of research.

[rej12]

You are certainly fortunate. I personally know of only three people that have had restor done and all are miserable. I know many that have had the single focal lens implanted and they are very happy. They do of course have to wear reading glasses but can see clearly day and night. One I play golf with is one that watches the golf ball for me. Another important point for anyone that has had the restor implants and are unhappy is not to have the YAG augmentation. Once done I don't know, although I'm still looking, any physician that would remove the lens to replace it as the YAG lasers out chunks of the natural sac the lens fits in making it almost impossible to properly position the lens which increases the risk for blindness through possible glaucoma or infection. Again I'm happy for u. As for me I can not go through the rest of my life seeing like this. It has affected my quality of life and made work more difficult. I will find an expect, and may have found one and risk blindness to have the restor lens replaced with the monofocal

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

Dr. rej12: If you will do a literature search you will find that Dr. Mike Kutryb and I have published 3 papers in the medical literature about the dissatisfaction with multifocal IOLs. We found that patients with multifocal IOLs (at that time ReStor ReZoom and Crystalens) were 23 times more likely to post problems here than monofocal IOLs.  Your problems are called dysphotopsia. Additonally you may have so called wax paper vision.

I would suggest 2 or 3 second opinon. You may need to consider an IOL exchange for a high quality aspheric monofocal IOL.

Thanks for you comments, I agree with most of them.  Good luck.

JCH MD

[rej12]

Thank u so much for the advice. My understanding from a friend who's an ophthalmologist  who examined my eyes afterwards, and I have to admit had advised me against having the restor implants stating my eyesight was not bad enough, tells me it would be very difficult to find anyone to do an iol exchange after having the YAG. However he did give me a Dr. Chang's number to call for a consult. I live in Arkansas and California is a long way off. Is he right about the YAG and if so do you recommend any one closer. Another disrupting side effect of the surgery is the amount of floaters I now have. And I don't mean just the little hairy black dots, I mean greasy large plaque floaters that cause almost total blindness when present. These have become more prominent over time. Worse in the right eye which is the eye I had an iop of 50 post surgery requiring emergency vitrectomy.

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

1. You may need to be checked by a retina-vitreous specialist to make sure there are no holes, tears or thin areas that need to be treated prior to an IOL exchange.
2. I have e mailed some nationally known experts in IOL problems asking for a name of someone near you. This is the recommendation:

I would suggest Jay McDonald, M.D.



McDonald Eye Associates

3318 N. North Hills Blvd.

Fayetteville, AR 72703

Phone: [phone]

Toll Free: 800-262-4405

JHaganMD

[JodieJ]

All of the happy ReStor recipients seem to have the following characteristics:  healthy eyes (no retinal problems, no dry eyes, etc.), no astigmatism, small pupils, and a surgeon experienced with ReStor.  In addition, a recent report suggests that having higher order aberrations are also a contraindication for multifocals.  (HOHs are slight corneal abnormalities--please don't ask me to define them further,)  Apparently, HOH created major visual problems with a multifocal IOL; these problems disappeared after the multifocal was explanted and replaced by a monofocal lens.  

[cwatt1]

I had ReSTOR +3's implanted in both my eyes this year.  Consider me one of the lucky ones, I guess, because I'm quite happy with them.  To add to Jodie's comments, It is also important to realize that a multifocal lens may require further post-op corrective measures to achieve optimal vision.  I my case, I did have astigmatism that was eliminated with LRI's.  Corneal astigmatism was worse in my left eye, and it took 3 separate LRI proedures to get rid of it.. I agree completely with Jodie that it is very important to find a surgeon experienced with ReSTOR, and who will screen his/her patients appropriately.  Pupil size is also important.  My surgeon examined my angle Kappa (the angle formed between actual line of sight and the pupillary axis before he recommended ReSTOR.

[rej12]

Thanks. I will call him this week. I would gladly wear reading glasses again and be farsighted again. I am also an ex crop duster with 10000 hours before changing professions. Haven't flown in years but always had plans to, for pleasure that is. Right now would not be safe

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

Good luck. My father was killed crop dusting. Way to dangerous way to fly.

JCH MD

[rej12]

Sorry to hear that. I had two friends die from crashes. It was a crash I had that I should not have survived that led me to seek a safer profession in my late 20's.

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

Good career move.
JCH