Surgery scheduled for Tecnis Multifocal

[PhoenixMylo]

I am 39 and have recently been diagnosed w/cataracts in both eyes.  The right is worse and degenerating more quickly than the left.  I did my research on the various options and relevant side effects including reading a number of experiences on this board, before fully discussing lens options with my surgeon.  I went into her office leaning heavily toward the Crystalens HD.  My doctor however confirmed some of my misgivings about the Crystalens, in that the accomodation, at least in some studies seems not to last.  I had read some information and studies regarding the Tecnis and the results from Europe seem good, so that is what I have decided to go with.  I know it is very soon, as it has just gotten FDA approval, but does anyone (maybe someone browsing from Europe) or any of the doctors have any additional information regarding the Tecnis?

[ptdallas]

I am glad to hear of your success story.
I am considering Tecnis MF lenses for my upcoming lens replacement.
Just thought I'd check to see how you are doing with you lenses a couple of years later.
I appreciate any feedback that you might have to offer.

[PhoenixMylo]

Been meaning to post a follow up for a while now, and got a PM from one of the posters asking about the results, so thought I would post my answer to the forum.  I've now had both eyes done with the Tecnis.  The second was a little over a month ago.  I'm very happy with the results.  I got the left eye done first and my distance vision was 20/25 within the first week. Got the right eye done after and distance is close to 20/20. Near vision starts at about 13 inches and goes out of focus rapidly closer than that.  It extends from about 13 inches to 24 inches then gets into intermediate which is also a bit problematic but not so I can't live with it.  Computer vision is pretty good, though I do find that I need to have the monitor a bit closer than I used to with glasses.  Not a huge problem.  The only place I've had a problem with intermediate vision is in grocery stores reading labels on packages without leaning in a bit closer.

Overall I'm very satisfied with the results. Distance vision is better than I've ever had in my life and though there are some trade offs and adjustments with very near and intermediate distances I've found them pretty easy to live with and adjust to. I do definitely see some haloing effects and a bit of what I would refer to as lens flare from oblique light sources in low light conditions.  Again it is nothing I am unable to live with. The lens flare is fleeting and seems to have improved in the month or so since getting the second eye done. The halo effects at night may have gotten a bit smaller as well but are still pretty pronounced. Not to a level that it significantly hampers vision but I haven't yet chanced driving at night.  Luckily I live in NYC so don't do much driving in any case. Hope that helps.

If anyone has any questions that I haven't answered feel free to contact me.  These forums were very helpful to me as I was planning my surgery and making the decision as to which lens to go with, so I am happy to be able to give back to the community if I can.

[thiekrepus]

I have both a tecnis MF and a rezoom MF.  I wasn't completely happy with the Rezoom so when it came time to do my second eye the Tecnis had become available.  Both have halos although the Rezoom is worse.  My Tecnis lens was out of focus until my doctor put a contact lens on the eye to correct it.  It works far better and they will do lasik to adjust it (hasn't happened yet). The tecnis allows upclose vision to miniscule sizes and I can read without glasses to about 18".  The rezoom lens still requires glasses to read comfortably.  The Tecnis is not covered by insurance and initially my doctor said it would be $1500 extra.  The hospital then sent me a bill for almost $6000 that wasn't covered they said.  Make sure your doctor has it right because that amount of money is something also to consider.  I still think the Tecnis is probably the best MF out there but it's NOT going to be like the original God gave you.

[cdn_glenn]

Mid-vision for the Tecnis multifocal starts at about 18" compared to the ReSTOR 4.0's 24".  That makes the ReSTOR a little more favourable for computer work.

I've been nearsighted all my life, so my computer setup has always been with the screen just back from the keyboard.  When I'm typing there's no issue.  When I'm leaning back in my chair and surfing with the mouse I need to wear +1.00 readers.

I don't have any information on the newer ReSTOR 3.0 and check in on MedHelp from time-to-time for any updates.

[stutk]

One of my referals suggested the Tecnis Multifocal also...could you tell me if you went with that or the crystal lens and your experience??

[rwbil]

I too am looking at the Multi Focal lenses.  I just got a second opinion from an Optomologist who has implanted the newly approved Tecnis Lenses.  He still has only done about a dozen or so.  But he said initial results with his patients has been very promising.  He said one of the biggest advantages of Tecnis over Restor is it works in low lighting, which is something I am looking for.  But I am concerned about computer distance.  According to him his patients have had good computer distance reading even though short distance is officially only out to 18", which is similiar to the older version of Restor.  It does seem very hard to get really good comparisons betweent the lenses.  Maybe best to wait a few months and more data is available on the Tecnis.  If anybody knows any other sites with information on the Tecnis and if they are going to develop a lense with near vision out to 24" like the newest Restor, please let me know.    One more comment.  Originally I was interested in the Crystalens.  It seems like an adaptive lense working like your original lense would be the way to go.  But I have now seen 2 Optomologist and both said they have had more patients requesting to remove the Crystalens than any other lenses.  

[PhoenixMylo]

I've been reading on this whole subject A LOT since they figured out that it is cataracts, so I've read how important neuroadaptation is to the final result especially with a multifocal implant. Is there anything that I can do to help facilitate the process?  Eye exercises or anything like that?  I read today about a software program called Neurovision which is supposedly designed to facilitate neuroadaptation in order to maximize results after LASIK and is also used to attempt to treat presbyopia and a few other common vision problems.

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

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[cdn_glenn]

Perhaps I stressed what mid-vision was like at first.  Now  mid-vision isn't too bad.  Maybe 20/30-ish.  I haven't heard that the manufacturer changed the Tecnis Multifocal in the few years before I had mine or since.  Comparing the mid-vision of the Tecnis MF with the ReSTOR, mid range begins at about 18" up to about 48".  Vision either side of the line is sharp.  The ReSTOR mid range begins (from what I read) about 24" and goes to somewhere around 60".

What I would like to stress is vision does improve: neuroadaptation.  There are many posts on MedHelp where the patient -- usually less than one month after surgery -- is very unhappy with their multifocal IOL.  (Me too.)  I noticed improvements in one, three, six and so on months.  Going with a multifocal IOL involves a "leap of faith" that vision will improve over time.

[PhoenixMylo]

Thanks.  I thought the mid range vision was better on the Tecnis.  That's one of the reasons my doctor recommended it.  Design modifications maybe?  You said you had yours done 2 1/2 years ago?  I'm so worried about this.  Not the surgery, that's pretty routine so doesn't really bother me.  Just that I'm going to have to live with this choice for a very long time.

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

I have no experience with the Tecnis Multifocal aspheric IOL.

JCH MD

[cdn_glenn]

I think I'm the only one posting on MedHelp who has Tecnis MF.  On the plus side they give me very sharp near vision and excellent distance vision.  Mid-vision was very poor at first, but after about a year and a half mid-vision was good under bright light.  Also, compared to other multifocal IOLs they seem to have no issue with low light.  On the negative side I experienced ghosting and halos.  These anomalies diminished over several months to where it was tolerable.  I had to learn to ignore anything still visible.

I did want to have accommodative IOLs similar to the Crystalens implanted, but technology for accommodative IOLs wasn't as advanced 2-1/2 years ago.  My surgeon advised me to go with a multifocal lens.

You should be able to click on my name to see a list of my posts.  Good luck!