Explant of Restor

[hauptwerk1945]

My Restor IOL was implanted in June, 2009. Following the surgery, vision in that eye was and still is 20/200. A few weeks after the surgery CME was detected and when drops did not improve the situation, and OCT confirmed the presence of an epiretinal membrane. Surgery has successfully removed the membrane and the swelling has improved, but my vision is still very poor and I do not feel comfortable driving. I also find it difficult to read because my vision is impaired at all distances. Performing is also impossible (I am a musician). Is it too late to even consider an explant of the Restor which has virtually ruined my life?

[JodieJ]

I've had personal experience with an ERM, and I've done lots of reading on the topic.  Even after successful surgery to peel the ERM, the retina is never quite the same as it was before the ERM developed.  Even slight changes in the photoreceptor configuration (resulting from macular wrinkling) will cause problems with multifocal vision.  In addition, there is almost always some degree of macular edema after ERM surgery, adding to the loss of contrast sensitivity intrinsic to vision with a multifocal IOL.  Your quality of vision should be markedly improved with a monofocal IOL.  

[hauptwerk1945]

That is really good news. I am scheduled to have another OCT on April 21 to see the condition of my retina at that time and then we go from there. My retinal surgeon, who is excellent will refer me to another surgeon who does more work in the anterior of the eye rather than try to do it himself - if it is deemed possible and necessary. If my retina has improved, then it has to be either the lens prescription or vaseline vision or both, because my visual acuity has not improved at all.

[caren123]

I am sorry that I was wrong in my comment to you about how long after implant a lens can be removed.  see question Mar. 17 "Remove Rezoom Lens?"which contains doctor's answer that removal can be done even years after implant.

[londonbridge]

I had a Restor explanted right at six months and fortunately all went well. It is possible to do one later. Please look for a highly skilled surgeon who is very experienced with this. Do not agree to a Yag which will compromise the capsule which may make it impossible to do the explant. Check out my thread on the archives of this site.
Good luck.
londonbridge

[caren123]

I know it is easier to do an explant right after the implant, but after that I thought you only had 6 months to do one.  Can it be done later than that?

[Michael J Kutryb, MD]

You could consider an explantation if the visual problems are clearly related to the multifocal implant.  In this case it may be difficult to determine. An OCT scan of the macula before cataract surgery would have been very helpful.  I completely understand your situation.  We recently had a patient with a very dense cataract who had a tremor and we tried and tried and tried to get an OCT on her before her cataract surgery, but were unable to get a reading.  Lo and behold after surgery her vision is only correctable to 20/200 despite a perfect looking eye and a new OCT was able to be obtained after surgery with the clear implant instead of the cloudy cataract and she was found to have a macular hole.  DIfferent case, but it just illustrates that we like to know as much about the macula (especially) as we can before cataract surgery, if at all possible, but in some cases it can be difficult due to the cataract itself.

MJK MD

[JodieJ]

A multifocal IOL like ReStor is a terrible choice if you've had an epiretinal membrane.  Your vision in that eye may never be perfect, but it can almost certainly be improved.  Find a surgeon who is experienced doing explants.