Yet another ReStor question

I have read most of the ReStor threads here and I've found them quite informative... and a bit discouraging. I post this question because we'll be going to see the MD tomorrow and want to figure out the right questions to ask, as he's proven to be a difficult person to communicate with.

My wife (42 y/o) had a ReStor IOL implanted on her left eye a week and days ago and she has three sympthoms:

1. The lens shakes a bit when she moves her eye. I can see this whe looking at her pupil with certain light conditions that cause a reflection in the lens. The lens just shakes as if it was loose.

2. No near sight at all, she can't see any clarity closer than 4 yards or so.

3. Permanent "ghosting" or "double image" at any range.

She says that the vision has been improving but I was under the impression that improvement specially on near sight should be evident right after the operation.

Is important to add that she needs surgery in the other eye and MD is suggesting a monofocal IOL for next week or so. She's very scared she won't be able to read or write again even using eyeglasses.

The doctor has not been clear about the expectations we can have and possible alternatives. He never warned us about near sight issues with monofocal IOLs and we found out about ReStor two days before the operation. MD said it was a good choice and didn't warn us about possible complications of ReStor either. He's arguably a very respected doctor but I'm just think that the procedure didn't go well and he does not want to tell us.

He says she should wait it our for a couple more weeks but doesn't commit to any estimates; I would be OK if he told us what to expect, anything, any figure like 50%, to 80% improvement or none at all, it's just that not knowing feels worse than knowing.

So I know her symptoms are common (but #1, that one worries me). Just wanted to ask you what is your opinion and experience and what you suggest us do or ask the doctor. In return I can commit to keep the forum posted on any developments, so this can remain as yet another source for people investigating this type of procedure.

Thank you very much for your time.

Antonio

[Ray T Oyakawa, MD]

1 is normal.  However,  She should be seeing better than what you describe.  It sounds like her doctor does not do many of these lenses.

I would get a second opinion before surgery in the other eye.

Dr. O.

[JodieJ]

There have been a lot of posts on this forum during the past few months from unhappy ReStor patients.  For some people near vision does improve over time, but for others it does not.  Several people posting here have had their ReStors explanted and replaced with monofocal IOLs, with good results.

I'm not an eye care professional, but it's hard for me to understand why everything within 4 yards would be blurry unless your wife is quite farsighted with her ReStor (i.e., it's the wrong power).  The ghosting might be due to uncorrected astigmatism.  You might ask about these issues.

It sounds like your surgeon provided little (or possibly no) information about the possible options for correcting vision with cataract surgery.  Yes, it's true that if both eyes are corrected for good distance vision with monofocal IOLs, your wife would need glasses for reading and using the computer. (In this case, everything within arm's length would be blurry without glasses--but this is certainly better than having everything within 4 yards blurry!)   Alternatively, with a mini-monovision correction (distance vision in dominant eye, intermediate vision in nondominant eye), she would only need glasses for prolonged reading or seeing small print.

Getting good results from a "premium" IOL (like ReStor or Crystalens) generally requires a surgeon who is very skilled and experienced at implanting them.  Please follow Dr. Oyakawa's advice and get a second opinion from such a surgeon.  Don't consider a surgery for the second eye until your wife is satisfied with her vision in her first eye.  (And I suspect that she might be happier if the surgery were performed by someone other than Doc #1.)

[antoniodlp]

Thank you Dr. Oyakawa and JodieJ for your responses.

I think I went very overboard with the 4 yards mark, is more accurately at arm's length.

That's all true about the doctor and yes makes a lot of sense to get a second opinion.

[antoniodlp]

We went to the doctor today and after a long discussion the doctor said basically that:

1. She needs to adapt to the 'ghosts' and that she's overly aware of them now but won't be later. Basically she's as good as it gets for her eye+IOL combination and even though some improvements will be noticeable in the following months the biggest improvement will come from her adapting to the lens.

2. The cataract in her right eye is affecting her overall vision and he's quite sure that implanting an IQ monofocal IOL on the right eye will do wonders as both eyes will compensate. He was very insistant about this and said he didn't mind if another doctor did the procedure (implying he's not in it for the money).

3. If she ReStor does not work out after a couple of months he can replace it with an IQ monofocal IOL.

He did spend some time answering our questions this time around. I told him we should have had this lengthy conversation before! not after the surgery. My wife is les anxious now and more hopeful, but I think we're still going for a second opinion before getting the other eye operated.

[JodieJ]

Yes, yes, yes!  Get a second (and perhaps a third) opinion from doctors who are very experienced with ReStor before doing anything to the second eye.  (Your doctor's suggestion that the second eye get a monofocal lens is curious and suggests that he may have little experience with ReStor.)

[disappointed66]

I had the Restor implanted  in my left eye and it was nothing but a horror.  I thought I was going to have a nervous breakdown.   It just was not right and I did not want to wait to find out if it would improve or not. I changed surgeons.  I had the Restor explanted after one month of suffering and exchanged for a Tecnis Monofocal lens for distance.  I have since gotten the right eye done also with the Tecnis for distance, a little stronger. My insurance paid for these lenses.

I am 66 years old. My vision is great. I have remarkable night vision.  I only need glasses for reading small print, not even for the computer. As Jodiej said get another opinion.  I am not a professional, but I never heard of having a multifocal (Restor especially) in one eye and a monofocal in the other.   Usually they push to have another Restor, and that was something I absolutely refused to do.  This forum helped me with my decision.

Good luck.