restore lenses

[8315]

i had a restore lens put in six weeks ago and still don't see clearly.  middle vision is just o.k. have no reading vision and far is blurred.  How long does it take for the eye to get adjusted?

[Michael J Kutryb, MD]

I'm not sure that "adjusting" as you put it is going to help your problems.  I would have your surgeon look for things like residual refractive error, astigmatism, posterior capsule opacification, lens or pupil decentration, macular edema or epiretinal membrane, dry eye keratopathy and other possible causes of blurred vision.  If no definite cause is identified, it may be that you just do not adapt well to the lens and you need to talk with your surgeon about what can be done to try to improve the situation.  There is a certain subset of restor patients that have issues as you may have seen by using the search feature on this site.

MJK MD

[val42]

I just signed up to have ReStor lenses in both eyes post-cataract surgery for $4500.  I am having 2nd thoughts after reading some older posts.  When I asked which series of ReStor he would use, he said the box would read D-1.  I could not find anything about that on the internet.  I did read a study that stated + 3.0 D ReStor was better than + 4.0 ReStor.  I emailed the surgeon's tech about which one he would use, and she has not answered.  I do have dry eyes.  I now wonder if it would be better to have the "modified monovision" correction that was mentioned in another post.  As I understand it, you set one eye for distance & the other for intermediate & wear reading glasses only for very close work.  This would be very acceptable to me.  I just do not want to have to go around with a pair of glasses on a string around my neck.  Any help is appreciated.  I have been back to the surgeon twice because the 1st time I just said "OK" to surgery, did not pick any lenses.  I am afraid to go back again & ask more questions...

[londonbridge]

Please, please read my posts on Explanting Restor Lens by londonbridge. I would highly recommend going with blended monovision. That is what I ultimately chose having gone through 6 months of suffering with Restor having it explanted in the end. Blended monovision has left me without needing to wear glasses most of the time, except for some close work. Furthermore there is no extra charge to do the basic monovision, although I did a toric for a slight astigmatism. Check the posts on this forum about distances to set for this type of vision.
The quality of vision is much much better with the newer monofocals than with Restor. In my opinion you give up good quality sharp vision with no glare, halos, ghosting when you choose a lens that is suppossed to do it all. For some people it may, but not for me and many others.  I have also read that multifocals are getting to be older technology with the cutting edge in lenses being the newer versions of the acommodating lenses, like Crystalens. Above all find the best qualified and skilled surgeon you can and get several opinions. Your eyes are too precious to take any chances and you owe this to yourself. No matter what anyone says cataract surgery is not just a simple procedure with no risk. Take care.

[val42]

Thank you for commenting.  I am tending to want to cancel the ReStor & get the blended monovision as described by Dr. Hagan somewhere else on this site (I'm new at this & not sure where I am right now!)
What you said and an answer from someone on the other site makes sense.  I just feel like a nut for changing my mind so often, but, as you said, it's my eyes.
This surgeon is excellent & has done a lot of surgeries, but it's to his benefit for me to get the ReStor.  He did not mention the blended monovision, only one for far & one for near.  I don't think I want that.
I have til April, so I am going to think about it & contact him again.  I can also go to another doctor if I'm too embarrassed to go back to the 1st one.  I'm not sure how many of these visits my insurance (Medicare advantage plan) will cover.
Thank you again for responding.
PS:  my doctor did say if I get the monovision he charges $2100 to laser it if it is not right.  Doctor #2 who did a friend's did not charge her for touching up via laser.

[londonbridge]

I am glad you are taking the time to explore your options. Never feel embaresed to ask questions or even to question your doctor. After having problems with my Restor I went to several other experts for opinions. This site has a list of the top eye hospitals in the country and you might want to consider if you are near enough to any of these.
I think it is important to keep in mind that there is no perfect answer and no perfect vision, even though the ads and hype over multifocal lenses will lead you to believe this. I think it comes down to when and for what purposes will you be willing to use some type of correction either glasses, contacts, laser etc following your cataract surgery. Restor is generally noted for near and far with less good intermediate. Many many tasks require intermediate vision like cooking, grooming, talking to people etc. Dr. Hagan and another forum member JodieJ have had very informative posts on blended monovision, which is what ultimately led me to choose this option when I explanted the Restor. They describe the typical focal distance that is set for each eye. Naturally this could vary with each individual and there is a small margin of error, meaning your target may be off by as much as .5 to 1 diopter. This is the case with Restor as well. ( I came out moderately farsighted, which was not a good place to be) Mainly the choices are one eye for near/ one eye for intermediate for good reading and intermediate distance. You would most likely need glasses for distance. Or, what I chose was Dominant eye for distance (still my natural eye with a contact until I need cataract surgery)/ Non dominant eye with Acrysof Toric IOL for intermediate. I still need reading glasses for some tasks but function well otherwise.
A good surgeon will take all the time you need to explain these options so that you can make an informed choice.
Other things to consider is if you want to do a laser touch up, you need to know the health of your corneas etc.  Also you may have astigmatism that is either not corrected by your implant or made worse by the surgery. This can be corrected with various procedures. All in all while it would be nice to be glasses free, the reality is, many of us simply do not have the type of vision that will permit this even with all of the technology out there. It is far better in my opinion to go for the best, crispest, best quality vision at some focal distance(s) than to try to achieve it all and sacrafice the quality.
Good luck. ( I am happy that you found this forum before making your final choices as there are caring folks and docs here to help)
londonbridge

[val42]

Well, I've been all over this site & there are so many different places I am getting confused!  I wish it was all in one place.
Anyway, thank you for writing.  I did email the doctor's assistant & she emailed back today (I was surprised since it's Sunday) that I can take all the time I want to decide & they just want me to be satisfied.
Right now I am thinking to go with what you have (I think) with distance in the dominant & intermediate in the nondominant.  I do not care if I have to wear glasses for reading or computer --  I just don't want to have to wear a pair around my neck for everyday use.
It's kind of scary because people wrote that the implant moved or something & their vision changed, and you had a bad experience.
What gets me is this doctor I am going to charges $2100 extra per eye to do laser corrections if it does not come out right.  Oh, well....

[londonbridge]

Glad you are taking the time you need to come up with options. The forum can be difficult to navigate at times. There is both the community and the expert forum, which has only the docs, I believe. Also you can search the archives. If you do choose blended monovision, distance/intermediate, with luck, you should do fine with glasses for just reading, or a pair of progressives to sharpen up all of the distances for both eyes. Do you have any astigmatism? That can be a factor in the end result as except for torric IOL's, IOL's can't correct for astigmatism and if it is significant enough you may need a procedure like limbal relaxing incision, laser or wear glasses to correct this. As long as your surgeon is competent and willing to work with you, you should do fine. Good luck.
londonbridge

[val42]

Well, it's been decided.  I'm getting Tecnis Z2009 with one eye for distance, the other for intermediate.  I have no astigmatism.
Of course I looked it up, and an eye surgeon wrote in that he had several capsular tears with this lens because of the way the injector works.  Something else to worry about!
The surgery is not til April.
Thank you for all your help.