Rezoom vs Restore?

[cat47]

I am a 47 year old CPA, tennis player (USTA rated 4.0) and avid reader. I have worn hard contacts for 40 years, monovision for the past 5 yrs. I cannot play tennis in the monovision, so for tennis I use a distance contact in both eyes. Due to a tear film deficiency and pigment dispersement issue I have had difficulty seeing in all aspects of life as my vision changes with each blink.  Also, I am right handed, but left eye dominant which causes me to wear reading glasses over the monovision contacts for work.  I am very frustrated with the blurry vision and am considering lense replacement surgery.  I was thinking about the Rezoom lenses, but after reading the posts am concerned.  Any comments or suggestions?

[JodieJ]

This thread was begun a year ago, and there have recently been some improvements in technology, with the introduction of a new ReStor model and the Crystalens HD.  You might want to get more information about these new "premium" IOLs by using the search feature.  Dr. Hagan recently posted a link to a study about them.

There is so much difference in refractive error between your eyes that I'm not surprised that glasses don't work for you.  I switched from RGP contacts to soft lenses when I was in my 40's.  I'm now in my 50's and can comfortably wear most soft contacts all the time.  (My favorite is 1-Day Acuvue Moist.)  This option might work for you, too.

About three years ago, I developed a cataract in one eye only following a vitrectomy.  I ended up getting aspheric monofocal IOLs implanted in both eyes, and I love the results.  You'd definitely want to have your eyes checked by a retinal specialist if you do decide to pursue this option (due to the small but increased risk of retinal detachment).  If you do opt for RLE, you could use the new ReStor, the Crystalens HD, or aspheric monofocals set for "blended vision" (dominant eye for distance vision, non-dominant for intermediate).  Aspheric monofocal IOLs carry the lowest risk of post-op problems.  If all went as planned, you'd only need glasses for prolonged reading or seeing small print with "blended vision."  Regardless of the IOL chosen, you'd want to have a surgeon who was very experienced with that lens/correction type.  

[peakhope]

When choosing a lens, it will be important to know at what distance you read, and at what distance you use your computer. Measure either from your eyes or from the tip of your nose so you know the nearest and farthest distance you would be comfortable doing each activity.

Restor offers great near vision (reading), but not great intermediate (computer). Crystalens HD offers great intermediate vision, but maybe not near vision (depends on the patient). Since you can wear contacts, you might try experimenting with monovision or mini-monovision contacts to see if you would like it as a permanent RLE solution.

Be sure you are aware of possible glare issues with Restor (especially in both eyes). And find out whether you will have residual (corneal) astigmatism, and if so, what the plan is for solving it.

[leighann48]

I have a problem similar to cat47's.  I do not have cataracts.  I do have severe nearsightedness, complicated now by 40s presbyopia, and dry eye syndrome (possibly related to my rheumatoid arthritis) that just makes everything that much more of a misery.  I've worn gas permeable contacts for years with good results, until this dry eye thing started.  Now I have trouble wearing my contacts all day, even with wetting drops, and I have problems with intermittent blurred vision.  I can't see well at all with glasses, and never could.  (I've been told bifocal glasses are not a good option for me either, due to the kind of correction I need.)   If I get where I can't wear contacts at all, I am in a mess.  I read a lot, sometimes using reading glasses, and spend a lot of time on the computer each day at work.   I saw two respected opthamologists (one of them a very well respected cataract surgeon), both of whom suggested RLE.   The first suggested a regular lens replacement (not multi-focal).  The cataract surgeon didn't specify and I didn't know enough at the time to ask.  I called his office, and the lady I talked to said they can do either non multi-focal or the Restor multi-focal lens, though she didn't comment on my specific case.  However, reading these stories makes me worry about doing lens replacement at all.  My left eye is -18 and my right -11.  

[Laura4]

I am presently trying to cope with undesirable effects and aberrations from a Toric lens.  I strongly - repeat strongly - advise you to wait for the technology to improve.  Once you have a rezoom (for which this forum is filled with problems - also restore) it is more risky to remove.  You need to understand that adjusting both eyes to have the kind of fine active coodination you are looking for is not likely to easily happen with either a Rezoom or ReStor.  Get very clear about what goes on with middle vision, for example, and get very clear about the possiblity for other kinds of problems that affect overall quality of vision, not just acuity.

Laura4

[Laura4]

I am presently trying to cope with undesirable effects and aberrations from a Toric lens.  I strongly - repeat strongly - advise you to wait for the technology to improve.  Once you have a rezoom (for which this forum is filled with problems - also restore) it is more risky to remove.  You need to understand that adjusting both eyes to have the kind of fine active coodination you are looking for is not likely to easily happen with either a Rezoom or ReStor.  Get very clear about what goes on with middle vision, for example, and get very clear about the possiblity for other kinds of problems that affect overall quality of vision, not just acuity.

Laura4

[JodieJ]

I have one more thought if you do opt for refractive lens exchange.  Apparently, you've been told that this procedure would resolve all your current issues.  However, none of the IOLs mentioned above would correct your astigmatism, which would impair your vision all distances.  (The ReStor lens is reportedly especially sensitive to even mild astigmatism.)  You would probably need an additional post-surgery LASIK procedure for satisfactory vision with any of the multifocal/accommodating lenses.  (Astigmatism-correcting multifocals are currently under development.)

Please do your homework before proceeding.  The archives of this forum contain a wealth of info.  And I hope that you'll get many more responses to your post.

[JodieJ]

In all honesty, I don't see a solution in which you can avoid wearing glasses, at least some of the time.  I would definitely not recommend ReZoom (reputedly the worst of the currently available multifocals) or ReStor (marginally better if you don't mind glare and halos at night, plus a loss of intermediate vision--and you might still need readers or progressive glasses!)  And who knows how these IOLs would affect your tennis game.

Have you consulted a refractive surgeon to see whether you are a candidate for laser vision correction?  You could either do a monovision correction or correct both eyes for distance.  (If you had no astigmatism, you might be able to tolerate a soft 1-day disposable contact lens in one eye to create/eliminate monovision.)
  .  
If you wanted to do a refractive lens exchange, probably your best bet would be monovision with aspheric monofocal IOLs.  (You could also correct both eyes for distance.)  You might also consider surgery with the accommodating Crystalens, although it is hardly problem-free.  (Try using the search function on this website.)   Unfortunately, there will certainly be better multifocal/accommodating lenses on the market in the not-too-distant future, but you would not be able to take advantage of them if you had surgery now.

The only other alternative would be to wear progressive glasses full-time.  In this case, I'd suggest that you get designer frames (think Gucci, Prada, Chanel, Marc Roberts, Face-a-Face-Paris, etc.) with thin, progressive lenses.  They'll be expensive, but you hopefully won't hate them.

[cat47]

I do already wear glasses over both my working (monovision) and tennis (distance only) contacts in order to read.  My reason for considering the surgery is the unclear vision I get with a lense in my eye. This is due to a multitude of issues.  One: tear film problem leaves deposits on my lenses with each blink.  For this I am currently using hot compresses for 20 minutes a day along with a lense scrub without great results.  Two: a pigment problem where my lense rubs against my eye and causes pigment to break off and float around the eye.  The more activity, the pigment floating causing blurred vision. Three: after wearing hard contacts for 40 years (the toric soft lenses did not work for me), I have rough, worn ridges on my eye that makes a contact hard to fit and causes a blurry spot on the inside corner of my eye where the ridge is.  Consequently, my eyes are very uncomfortable in the contacts and with more activity (I play competitive tennis), my vision worsens considerably.  This is why I am considering lens replacement.  My understanding is that the lens replacement should solve the "dirty" contact vision, the pigment problem and the contact fitting issue.  Of course, if I still can't see....

[JodieJ]

Well, you probably have good reasons to be concerned about ReZoom.  If you use the search feature of this forum, you'll find many posts from some very unhappy recipients of ReZoom and ReStor.  And you're considering getting these lenses even though you don't have cataracts!  It's significant, I think, that few (probably virtually no) cataract surgeons would want these IOLs in their own eyes.  However, If you can wait until you actually need cataract surgery, there are bound to be far superior IOLs available.

If your monovision contacts don't work well for you at your job, why don't you try readers (or progressive glasses with plano tops) over two distance contacts when you're at work.  Alternatively, you could get progressive glasses made to be worn over your monovision contacts.  Either would probably give you much better vision that what you have now.