crystalens in one eye?

[clintb]

I have developed a cataract in my left eye at the age of 44.  Definitely need surgery, the question is whether to get a crystalens or the regular lens.  I am not so much worried about the extra cost, although I do not want to throw money away.  Mainly I am worried about some of the posts I have seen on the crystalens.  Second, given my age and that my right eye will continue to need reading glasses and require higher strengths as I age, I had one doctor say I should get a regular lens.  On the other hand, one doctor is pushing the crystalens saying that, in time, I will likely have a catract in the right eye that can be replaced by a crystalens.

Any help and info would be greatly appreciated!

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

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[starman6600]

Excellent thought Dr. Hagan.   Will do.
Frank

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

If you are post RK see a highly expeienced corneal specialist and have a corneal topography. Sometimes lasik can be used to even out some of the irregular astigmatism that RK causes and that can help the vision even without cataract surgery and even more after cataract surgery.

JCH MD

[starman6600]

Thanks Dr. Hagan for sticking to your guns re your preference for the monofocal lens for post RK'rs like me and for others.  While I am one of these RK characters who are still shopping around for the right lens (and still hoping for the "miracle" accommodative/multifocal lens) please know that your comments are always beneficial  as I go through this process.  Because good night vision is important to me, I am keeping in mind that the Tecnis or the Acrysof IO will offer this feature more than the CrystalensHD.  Thanks again.

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

1. Its much better, in my opinion the best of the three premium IOLs.
2. You do the research by reading the hundreds and hundreds of posts from people with multifocal IOL problems
3. Probably about $3000-$5000/eye out of pocket  no insurance company pays for the extra cost of a multifocal IOL and I don't blame them.

JCH MD

[clintb]

Do you believe the hd has corrected the problems with the 4 and 5 that produced many of the complaints?

What are the risks of the crystalens hd compared to a monofocal lens?

What is the increased cost of the crystalens hd compared to a regular monfocal lens that should be covered by my insurance?

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

For the purposes of the study we classified the Crystalens as a multifocal lens but inserted a sentence that optically it is a accommodating IOL.  Yes we did look at the three types of USA premium IOLs and the Crystalens (not HD but 4 and 5) and ReStor had the fewest complaints and ReZoom the most. There were no "happy:" ReZoom patients in the 6 month study of some 300+ discussion strings.

We have started a second study in with we will look at all posts on these two eye forums in all of 2008 and compare results of ReStor, ReZoom and Crystalens. We hope to have that study published by mid 2009.

I should be able to post in a public access area our first study once it is received by our subscribers which will be in about 7-14 days.

JCH MD

[peakhope]

In this case, are you treating Crystalens as a "multifocal"? Sometimes people do, sometimes they don't, so I have to ask.

Did you analyze the differences between the multifocals? Empirically it seems that Crystalens patients are WAY less likely to be "very unhappy" than folks who have other multifocals.

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

Multifocal IOLs patients are many times more likely to post problems here than than monofocal IOLs based on the first study that Dr. Kutryb and I did of complaints posted during a 6 month period last year.  (multifocals at less than 1/10 the volvume of monofocals yet there were 10 times more complaints about multi than monofocal).

JCH MD

[peakhope]

Dr. Hagen seems to exaggerate a bit in the last paragraph there. I was not willing to risk *anything* or spend *anything* to get rid of my glasses, yet I still chose Crystalens HD. You do need to be willing to pay *some* extra, and to take on *some* additional risks.

I wanted to be able to see distance and intermediate (computer) vision without glasses, and didn't like the idea of monovision. If I end up being able to see up-close (and the results are promising so far), that's a bonus.

Read as much as you can, talk to as many people as you can, don't rush into anything, and make the best decision for yourself.

[clintb]

When you say "risk anything" how much risk is involved with the new hd lens that is not present with the regular IOL.

If I get the crystalens I was planning on using Jeffrey Whitman

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

I'll boil this down to the basics (you can read for hours from previous posts).

If you want the best possible vision, best night vision, lowest risk of complications, don't want to shell out thousands of dollars extra and don't mind wearing glasses some or most of  the time get a aspheric monofocal IOL.

If you will spend anything and risk anything not to wear glasses then consider the Crystalens HD implanted by a very skillful, very experiences surgeon like Dr. Ray or someone of his caliber.

JCH MD