the best solution for me?!

hello! I am back and i want tell you that i want to do this operation with any risks but please  tell me  what IOL is the best new for me and if a IOL in stage of aprouvement exist on the market!! thank's you
ps:sorry but i dont know verry well english:)


This discussion is related to replace monofocal crystallin implants  with multifocal lens.

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

We cannot tell you those things. You should discuss it with your surgeon.

My personal preference if I was having cataract IOL surgery would be a MONOFOCAL, ASPHERIC INTRAOCULAR LENS such as made by Tecnis and Alcon.

I WOULD AVOID A MULTIFOCAL IOL.

jch md

[mada_drs]

ok thank's you but like dentistry student is verry hard with monofocal IOL   my vision for near is not good!:(

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

Wear glasses or progressive bifocals or custom made loupes like I use for eyelid surgery.

JCH MD

[mike230]

I would go with the crystalens HD 500 accommodating lens.  If you have any astigmatism, they can do an astigmatism correction at the same time (LRI procedure)
After 4 months, I am still maintaining 20/20 distance, 20/20 intermediate and J1 reading.
Hope this info helps

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

-

[mada_drs]

yes I have astigmatism but the question is if this crystalens HD 500 are good for me if. the capsules are badly damaged and cannot be used to support a new implant thank's you!

[JodieJ]

I'm not an eye care professional, but if you have badly damaged capsules then I'd assume that you would not be a candidate for the Crystalens.  An experienced surgeon can advise you which IOL would be best for you after examining your eyes.  This is not the type of information best received on a community eye care forum.

[mada_drs]

hello!  i have recently heard from an ophtalmologist about the possibility of implanting a multifocal crystallin on top of a monofocal one. There is no need for the removal of the multifocal crystallin. Do you think this could be a solution in my case? thank's you

[mada_drs]

.........?

[mada_drs]

nobody nothing?

[JodieJ]

I really think that your question requires an in-person examination of your eye by an experienced surgeon.  I'm not an eye care professional, but I've never heard of a Crystalens being implanted on top of a monofocal IOL (although I've heard of the opposite)  I would imagine that this would severely limit any accommodation benefit that the Crystalens might offer.  Surely there are experienced cataract surgeons in Romania who can advise you.

[mada_drs]

http://www.ncbi.nlm.nih.gov/pubmed/17081900?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

the authors of this article have already performed such a procedure
they report a visual accuity similar to patients with a single multifocal iol
Since the procedure is new, I have not found any Romanian cataract surgeons who have performed it.
If you want more details, I can e-mail you the full text of the article

[JodieJ]

You previously mentioned that your capsules are damaged and cannot support a new implant.  You don't sound like a great candidate for the procedure you mentioned, especially if it were performed by a surgeon who was not experienced with it.  But I don't think that anyone can tell you what might work in your case without examining your eyes.  Please get recommendations from the best surgeons in your location.  Best of luck.

[mada_drs]

the monofocal lens stays in its place, the multifocal one is not inserted into the capsule
Studies show that
piggyback IOL implantation is a safe, efficient procedure
and that the technique has gained acceptance among surgeons
because implanting these IOLs is easier and more
predictable than IOL exchange. The piggyback technique,
originally developed to provide adequate power in highly
ametropic eyes and for postoperative correction of pseudophakic
refractive errors, has been extended to secondary
cases in which a multifocal IOL is implanted to provide
high-quality visual acuity at distance and near.

[mada_drs]

I would like to ask your opinion on my case! thank you

[JodieJ]

I read the abstract of the article you suggested.  It involved placing an Acri.Twin bifocal IOL in the ciliary sulcus over a monofocal IOL.  I don't believe that the Acri.Twin IOL is available here in the USA.  I've heard that a new version of ReStor to be used as a piggyback IOL is going to be introduced here in the near future.

Are you saying that you currently have monofocal IOLs and you want multifocals?  You've previously stated that you have astigmatism and damaged capsules.  What have the surgeons you've consulted recommended for you?  Are multifocal IOLs used often in Romania?

If you would like Dr. Oyakawa's opinion, start a new thread tomorrow marked for his attention.  Give him all the details about your case.

[mada_drs]

Two weeks ago I had my monofocal crystallins removed and replaced with 3 –piece- Rezoom IOLs. Now the diopters are the following:
VD=12.0 mm
Right eye:
SPH CYL AXS
-1.75 -1.00 89
-2.00 -1.25 97
*-1.75 0.00
-1.50 -0.50 97
Left eye:

SPH CYL AXS
-2.25 -3.50 7
-2.25 -3.25 8
*-2.25 -3.50 7
-2.00 -3.75 6

The right IOL was a little displaced during the procedure.
The left eye had divergent strabismus before the surgery.
Now I have ghosting at both eyes, like in this image:
http://www.visionsimulations.com/index.php?option=com_content&task=view&id=52&Itemid=145
http://www.visionsimulations.com/index.php?option=com_content&task=view&id=67&Itemid=160
What could be the causes of ghosting? Will it disapper in time or will I need another surgery?
Thank you.

[mada_drs]

what is the difference between diplopia and ghosting?

[mada_drs]

why no one wants to answer? :(

[JodieJ]

I'm not sure that I understand your situation.  Are you saying that you had your monofocal IOLs explanted and replaced by ReZooms?  Many people with ReZoom IOLs have a ghosting problem.  I've read that the ghosting is related to the design of the ReZoom.

What do the numbers you posted relate to?  (Is this your precription with your ReZooms?)

This is an old thread.  If you would like a response from one of the forum doctors, please repost your questions as a new thread.  It might help if you could clarify the issues I mentioned.

[mada_drs]

yes, is true my monofocal iol was explanted and replaced by 3 piece rezoom ( the surgeon decided to put rezoom because in my case was the optimal solution) and the numbers is my prescription with rezoom, now ai have miopia with astigmatis and I will do laser in 6 monts to reduce them! I want to know if what i see is duble vision or ghosting....if disapper in time.....:(
ps: sorry for my english:) thank you!

[JodieJ]

A ghost is like a partial shadow of an image; double vision involves 2 separated images.

I'm not an eye care professional, but based on the numbers you posted you are indeed nearsighted with significant astigmatism in your left eye.  It is hard to tell what your ReZoom vision will be like after you have laser vision correction.  I hope that you are temporarily wearing glasses for distance vision.

Your English is quite good.

[mada_drs]

I don"t wearing glasses for distance vision I HATE him!

[JodieJ]

I hope you won't be driving a car before you have laser vision correction.

I know that you've been through a lot of difficulties with your eyes, including unnecessary cataract surgery.  Most of what I know about health care in Romania comes from watching the wonderful movie "The Death of Mr. Lazarescu," and I assume that you don't have too many choices.  To the extent that you can, please try to find a surgeon who is experienced doing laser vision correction before you agree to have it.  An unskilled surgeon can do terrible things to your vision.  It might be best to do each eye on a different date.  There are much worse things than needing glasses to see.

Best of luck to you.  Six months from now, I hope to learn that your laser vision correction went well, and you are happy with your ReZooms.