I had cataract surgey and implant of Restor 3 lens in Sept 2009, with improvement in distance (20/30) but very poor near vision (can't read AT ALL uncorrected) and poor intermediate. I cancelled the 2nd planned cataract surgery for the other eye (currently 20./400 but can read well with that eye uncorrected and don't want to lose the reading ability. I am an avid reader and teacher of reading!.
The doctor (very well regarded in NY, famous for problems other doctors can't fix) said problem is that my pupil is large and doesn't contract for near vision. We tried pilocarpine in Oct, 4x daily at 1 % solution, started this about 4 1/2 weeks after surgery.. My near and intermediate vision improved greatly but after 2 days,but I had a severe reaction ( redness, tearing, pain, swollen eyelid) and the inflammation and pain continued until recently, was on steroidal antiinflammatory- prednisolone (which elevated eye pressure and created new problems). I still have pain which concerns me. I now take Systane several times day for dry eye,, but still have pain since the pilocarpine in Oct, and as I said, the inflammation lingered for a long time but now is gone..
He wants me to go back on pilocarpine, but, lower dose, 2x daily and try again since it helped the near/intermediate vision..
I recently had another opinion and was told that some of his Restor 3 patients have have had problems like mine, that problem isn't with pupil size but with Restor 3, and this MD said he no longer uses it on patients. He also counseled against pilocarpine, said I'd be trading near vision for diminished distance vision, plus pilocarpine can have other side effects.
Any information on Restor 3, which is fairly new? I have been following the threads, though which Restor is used isn't mentioned.
Any recommendations on using pilocarpine again ? I'm frightened since I had such a hard time, but it helped my near and intermediate vision for the 2 days I used it.. Side effects? Does it diminish distance vision? If that is true, then there is no gain-- the only benefit I got from the cataract surgery was improved distance vision.
Any information on pupil size and difficulty with cataract surgery? the doctor under whose care I am currently says I would have problems with all multifocal brands, not just Restor,and monofocal would have been even worse for near vision. He recommends a YAG (I see him in a week) for opaque capsule, but I am afraid of being locked into the lens I have, Restor 3, if I do the YAG , as I know that makes any explant very problematical,but don't know if I have any options. The doctors I've seen think the capsule doesn't explain the problems with near visiion, but would clear up some of the distance problems. Do other people have similar problems with pupil size? THis is all new to me-- never told before there was a problem with pupil size.
The 2nd MD said to live with what I have-- distance vision in the eye that has the Restor, and near vision with the eye that had the cataract, as I can read with that eye without glasses ( before cataarct surgery,I used to read with both eyes, with a mild RX for glasses, or sometimes no glasses). That cataract is getting worse over the last few months (now 20/400!) and don't know if I can postpone surgery indefinitely, but right now I CAN READ with that eye, and I don't want to lose that.
What should I do about intermediate vision? It is very poor- difficulty with computer, shopping, cooking.
The doctors don't seem to think glasses or contacts would help, as my eyes are too divergent and the brain can't accommodate. Any thoughts/ experiences with that?
also, in Nov, i was having so much eye pain, I decided to go off all medications, which was a mistake, as i went off prednisolone 4x daily to zero, and had a rebound reaction. It increased the inflammation, and am now light sensitive, which I never was before. I read the insert in the prednisolone box and it said to stop taking prednisolone if there is increased pain, so I did-- I didn't know it had to be tapered off gradually. I am now tapering it off but am still light sensitive. Might the light sensitivity diminish over time? I was experimenting with light bulbs that simulate natural light, which actually helped my reading a great deal, but it was the same weekend that I had stopped taking the prednisolone