Which intraocular lens to get?

[reader61]

I am very nearsighted, have astigmatism, lots of floaters and now have cataracts.  Am scheduled for surgery on first eye in a month.  Dr recommended multifocal Rezoom for left (dominant eye) and Restor for right eye.  I've worn glasses since 5 yrs old and contacts (hard, soft, toric) off and on over the years.  I read a lot and can read comfortably without my glasses albeit close.  I'm concerned that insertion of multifocal lenses would result in mandatory glasses for both near and far - which would be less convenient than my current vision correction.  I expect I would NOT be in the 90-92% who don't need glasses after surgery.  Should I be looking at plain lens, monocular to correct near or far vision, or multifocal?  If I have to have corrective lenses after surgery, my preference would be the current relationship between my near/far vision.  If I still will need glasses, multifocal lenses do not appear cost effective.  Also, what is the real difference between insurance provided and aspheric IOL like Tecnis.  If there any benefit to my getting multifocal contact lenses to approximate the surgical results before making my decision?

[John C Hagan III, MD, FACS]

Take the time to review the many posts from people unhappy with multifocal IOLs especially ReZoom. Under no circumstance would I ever recommend a patient have a ReZoom IOL. In a Jan eye surgery meeting here in Kansas City over 200 eye surgeons in a show of hands NONE would have a ReZoom put in their eyes. TELLS YOU SOMETHING.

Most successful and least expensive have monofocal aspheric IOL like Tecnis put in eye with modified mini-monovision option.

If you are prepared for the extra risk and expense of multifocal IOL and don't mind wearing glasses over them sometimes than use Crystalens for distance and ReStor for reading eye.

No real advantage to using multifocal contacts as they do not approximate the multifocal IOL experience.

JCH MD

[2ndsight]

many, MANY complaints about ReZoom on this board. also several patients who were nearsighted before surgery and could read comfortably without glasses have complained about making an adjustment to a monofocal distance lens and not being able to see up close without glasses.

the new Crystalens HD might work for you, you might still need weak glasses for some things but it might give you the best range of vision.

[John C Hagan III, MD, FACS]

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[reader61]

I've seen all the adverse info about ReZoom and decided to eliminate them from contention.  Since I'm pretty sure I would be in the group whose vision would not be fully corrected with multifocal it would mean continued use of glasses or contacts.  I'm inclined to think that a combination of monofocal lenses and correction of astigmatism would provide the best long term solution for me.  Then I could just wear soft contacts. Of course then there's the additional decision of near or far vision correction.  I did have contacts in the past with one eye for distance and one for near, but found after a couple of weeks that I was getting headaches and not seeing real well at either distance.  It's why I thought, even if it would be an additional cost, getting multifocal contact lenses as a test before the surgery could give me an inkling of what my vision would be like and avoid $$$$ if I didn't like the result.  Dr Hagan said that would not be a reasonable evaluation.  I'm also concerned about night driving and don't want to limit my independence and multifocal lenses seem to have more halos, reflections, etc.  
There's too many choices!!
I really appreciate your input to this very important decision

[ddmerchantindia]

You could check a comparision of lenses on the following link

http://cataractsurgeryindia.in/intraocular_lens.htm

[John C Hagan III, MD, FACS]

PLEASE STOP POSTING THE COMMERCIAL WEBSITE TO EVERY QUESTION ABOUT INTRAOCULAR LENS. I NOTE THE 'MERCHANT' IN YOUR NAME.

THE PHYSICIANS OF THE AAO EYECARE FORUMS