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John C Hagan III, MD, FACS, FAAO  
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Premium IOLs have a disproportionately high number of complaints:

Dec 13, 2009 - 44 comments

Patients voice concerns about cataract surgery/IOL implantation on Internet eye care forums

“Premium” IOLs have a disproportionately high number of patient complaints.
By John C. Hagan III, MD, Kansas City, Mo and Michael J. Kutryb, MD, Titusville, Fla and Michelle Stephenson.

The Internet is increasingly being used by patients to gather health information and to discuss surgical complications and outcomes. Studies suggest that Internet health forums provide a number of benefits.1-7 For example, they provide education and emotional support, and they may reduce medical costs.  They may also provide unique and important medical research data different from the usual office/hospital/ASC setting.  

One of the largest health care websites on the Internet is MedHelp (www.medhelp.org), which was founded in 1994. Its forums are viewed more than 5.5 million times each month. The site includes two eye care forums (“Ask a Doctor” and “Eye Care Medical Support Community”) that are controlled by the American Academy of Ophthalmology. The eye care forums receive approximately 260,000 viewings each month.  We are two of the four ophthalmologists who answer patient questions.

Multifocal IOL Study Results
To summarize internet patient concerns about cataract surgery/IOL implantation, we conducted a retrospective study8 of all postings between November 1, 2007 and May 1, 2008 on the two MedHelp eye care forums dealing with cataract surgery and IOL implantation, recovery, and satisfaction with results. We identified 750 postings and  reviewed the entire discussion threads. Of these, 341 could be analyzed for causes of dissatisfaction. The multifocal IOLs were almost all ReZoom, ReStor, and Crystalens presbyopia-correcting IOLs. We summarized unwanted visual aberrations (dysphotopsia), night vision problems, blurred vision, unexpected dependence on glasses, pain, retina and other problems and patients happy with their surgical result.

All 341 discussion threads began with a question about or statement of a problem, complaint, or dissatisfaction. Two patients reported being completely blind: one due to infection and one due to bleeding. Major postoperative complications included retinal detachment, swelling of the retina, epiretinal macular membranes/macular pucker, posterior capsular opacification, displaced IOLs, IOL power/residual refractive error problems, IOL exchanges or repositioning, YAG capsulotomy, retained cortex, vitrectomy and/or scleral buckle, optic neuropathy, glaucoma, and uveitis. Minor problems included foreign body sensation, watering, persistent redness, irritation, dryness, and the need for frequent lubricants. Patients also expressed dissatisfaction about the extra expense of multifocal IOLs and the failure to achieve expected outcomes.

We were startled at the number of complaints being posted from ReZoom, ReStor, and Crystalens presbyopia-correcting IOL patients, particularly with regard to dysphotopsia and blurred vision.  Although these three “premium” lenses are used in approximately 10% of patients, the volume of complaints was amazingly 6.87 times more common in presbyopia correcting IOLs (206 complaints) than all monofocal IOLs combined (30 complaints). Stated another way, each multifocal IOL was about 60 times more likely to cause an unhappy eye internet posting than a monofocal IOL.  This was a wake-up call to us that  many dissatisfied multifocal and accommodating IOL patients are using this Internet health site to search for information and support.
Follow-up Internet Survey Results

Recently, we conducted a second MedHelp.org Internet survey which we now report.  This survey retrospectively looked specifically at comments from ReZoom, ReStor, and Crystalens presbyopia-correcting IOL patients  during the entire year of 2008. (Table 1).   Using key words, we found a total of 210 presbyopia-correction IOL patients posted comments. Seventy percent reported being unhappy, usually due to glare and halos (68%), difficulty seeing at night (59%), and dependence on glasses (58%).

Sixty of the 210 patients were implanted with the ReZoom lens. Of these, 3 (5%) were happy, while 54 (90%) were unhappy. Seventy-seven patients were implanted with the ReStor lens. Of these, 18 (23%) were happy, while 55 (71%) were unhappy. Seventy-three patients were implanted with the Crystalens. Of these, 21 (29%) were happy, and 38 (52%) were unhappy. The percentages do not add to 100 because some patients did not express their satisfaction or dissatisfaction or comment about a specific problem.

Of the 3 lenses, the ReZoom lens had the highest percentage of unhappy patients. Zelichowska et al recently stated9, “Few reports describe visual performance after implantation of the ReZoom IOLS, and, to our knowledge, none discusses the optical performance of the IOL in situ.” Our studies should be considered by all surgeons, especially those who are using or considering the ReZoom Lens. Our studies suggest that ReZoom’s older technology is more prone to produce clinical problems and unhappy patients. The Crystalens had the lowest number of unhappy patients.  

2009 MedHelp postings indicate the Crystalens HD and Acrysof IQ ReStor IOL are producing happier patients and fewer complaints. The ReZoom remains problematic.

It is important to note, however, that our study protocol has some limitations. It is retrospective and has no control group. Additionally, most people with favorable outcomes probably do not visit health care forums to share their good results as often as people with unfavorable outcomes. Older patients may not have the same access to and ability to use the internet as younger patients.

Are These Lenses “Premium”?

Many of the patients expressed extreme dissatisfaction with their surgical results; particularly because they were told they were receiving a "premium lens", paid thousands of dollars out of pocket and had higher unrealized expectations. They not infrequently reported pressure to upgrade to “premium” IOLs. One patient described her surgeon telling her, “You don’t want a government issue implant in your eye do you?”  Given the much higher complication rate, greater cost and dissatisfaction among presbyopia correction IOL patients perhaps “premium” is a misnomer.  

Conclusions
Internet health forums have been used infrequently in Medicine and not at all in Ophthalmology to study patient reported complications and satisfaction/dissatisfaction with surgical procedures. Our two studies are first literature reports and offer unique and valuable insights. We believe that patients for presbyopia correcting IOLs need to be more carefully selected and educated on possible operative and post operative complications. Realistic expectations must be instilled. All patients need to know about dysphotopsia and night visual problems.  The Crystalens HD and IQ ReStor IOLs offer the highest degree of patient satisfaction.  We discourage use of the ReZoom IOL.
Given that many patients complained their surgeon didn’t listen to or ignored their complaints it’s likely that there is unrecognized and/or not reported patient dissatisfaction. This may account for the flat market share and stagnant number of surgeons using presbyopia correcting IOLs.   Surgeons may also want to create a protocol to proactively seek out and handle unhappy patients. Perhaps all these patients should complete a survey looking for unrecognized dissatisfaction 3, 6, 9 and 12 months post operatively. The lens manufacturers, as well, might want to consider having a proactive program for assisting unhappy patients. In the survey, several Crystalens patients commented on how Bausch and Lomb representatives had participated in trying to solve postoperative problems, and we believe this made a very positive impression on the patients.
  
Dr. Hagan is in private practice in Kansas City, Mo., and Dr. Kutryb is in private practice in Titusville, Fla.
Financial Disclosures: None for Dr. Hagan or Dr. Kutryb

References
1. Schroder S, Zollner YF, Schaefer M. Drug related problems with antiparkinsonian agents: consumer internet reports versus published data. Pharmacoepidemiology & Drug Safety. 2007;16(10):1161-1166.
2. Guevara E, Lim HJ, Tsai HM. Issues in online forum administration among multi-ethnic cancer patients. Studies in Health Technology & Informatics. 2006;122:885.
3. Im EO, Chee W. An online forum as a qualitative research method: practical issues. Nursing Research. 2006;55(4):267-273.
4. Umefjord G, Hamberg K, Petersson G. The use of an internet-based Ask the Doctor service involving family physicians: evaluation by a web survey. Family Practice. 2006;23(2):159-166.
5. Umefjord G, Malker H, Hensjo LO, Petersson G. Primary care physicians’ experiences of carrying out consultation on the internet. Informatics in Primary Care. 2004;12(2)85-90.
6. Umefjord G, Petersson G, Hamberg K. Reasons for consulting a doctor on the internet: Web survey of users of an Ask the Doctor service. Journal of Medical Internet Research. 2003;5(4)e26.
7. Widman LE, Tong DA. Requests for medical advice from patients and families to health care providers who publish on the World Wide Web. Archives of Internal Medicine. 1997;157(2):209-212.
8. Hagan III JD, Kutryb MJ. Cataract and intraocular implant surgery concerns and comments posted at two internet Eye Care Forums.  Missouri Medicine. 2009;78-82
9. Zelichowska B, Rekas M, Stankiewicz A. et al. Apodized diffractive versus refractive multifocal intraocular lenses: Optical and visual evaluation. Journal of Cataract & Refractive Surgery. 2008;34:2036-2042

TABLE 1 HAGAN/KUTRYB ARTICLE SENT BY E MAIL TO C GLENN AND M STEPHENSON 2/24/09


Comments
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by Quixotic1, Dec 14, 2009
What an interesting view/use of the input of members of an internet forum!  Thank you.

Quix, MD

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by John C Hagan III, MD, FACS, FAAOBlank, Dec 17, 2009
You're welcome. This is actually the first time that an internet forum has been reported in the worlds eye surgery literature.

JCHMD

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by DallasCPA, Dec 20, 2009
So you have the percentages of unhappy & happy Cyrstalena HD and IQ Restor patients in 2009?  In this rapidly changing area, objective and qualified information such as this is invaluable to prospective patients.  So, with -7.25 with 3.50 astgmatism at 90 degrees, which I'd these IOLs should I consider, or would a phakic implant or Technis be a better choice for someone without cataracts, but no longer as to wear RGPs? I have 2.00 reading vision, but would consider I'd a luxury to have that eliminated without glasses...

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by theothercarl, Dec 28, 2009
Dr. Hagan,
Thanks so much for your truthful article.  I had cataract surgery Nov. 2009 on an eye that was over -8.0 diopters with significant stigmatism.  I had the ReStor lens implanted and was under the impression that I would have perfect vision for both distance and close-up.  So far this has not been the case.  My other eye is -6.0 diopters and I am wearing glasses with one lens removed.  The biggest problem is that the size of objects is quite different between the two eyes.  Additionally, neither my long distance vision not my close-up vision is as good as the eye with the lens.  #1 is there a possibility that the vision in the ReStor eye will come to be 20/20 (at last examination they said it was 20/30, but it doesn't seem that way to me)? #2 In the future, if I have to have the other eye done, should I use another ReStor lens or consider something else.  The vision doesn't seem to be sooooo bad, just fuzzy around the edges.

Carl Wright

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by NappieRed, Jan 15, 2010
I am 56 with a rapidly forming cataract on my right eye & was just informed today that I will require surgery.  of course, the topic of what kind of IOL to implant came up so I came home & started researching.  This article is very helpful, but I would really like to discuss extensively the pros, cons, my lifestyle, etc before making a decision.  Makes sense to me to spreadsheet it (can't get away from the work perspective).  I spent the majority of my work day at a computer.

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by Restorsucess, Jan 28, 2010
Well, I had Restor SN6AD1 placed in both eyes for CLE.  I'm 48 and had no cataracts.  I had slight astigmatism in one eye, and was warned I may need tweaking afterwards.  I had the surgeries done 1/5/2010, and 1/19/2010.  I went for a check up yesterday... I am 20/20 for both distance and reading.  There is one slightly "less crisp" spot at about 3 feet, but if I move forward or back a matter of a couple of inches it's clear.  So far, it hasn't affected anything I do.  I'm on the computer all day for a profession, and before as well as after I sit so my face is about 24 inches from the screen, and have no problems.  DROVE to work next day after each surgery.  I felt great.  No pain, discomfort or anything.  I think the most irritating thing was having to wear a monovision contact in one eye for 2 weeks, after the first one was fixed with the multifocal ReStor.  THAT drove me more and more nuts for those two weeks on the computer as the ReStor eye continued to improve after the surgery.  I had an "eye fight" going on and could feel the strain by early afternoons at the end of the two weeks.  No more though!

Headlights at night look like little "fuzz balls" at a distance, and as cars come closer, the halo disappears.  It's very minor.  Especially considering I had "starring" with my glasses and contacts.  No problem with night driving at all.

My vision for distance was 20/300 - 400 before surgery.  I was VERY dependent on glasses, which I wore since I was 7.  Glasses have always been a tad irritating I guess, with cleaning, fogging, having to wear Rx sunglasses, etc.  Wearing contacts for 8 hours a day was never comfortable for me either.  I never liked the idea of lasik when I was younger.... something about messing with the cornea that didn't appeal to me.  To risky I thought.  The straw breaker was when the presbyopia started kicking in.  Then my vision problems were down right annoying.  After doing research and visiting several Dr.s, I took the plunge.

The results are breathtaking daily.  No glasses for anything!  I love my ReStors, my surgeon and staff, and especially the the outcome!  

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by NatalieJay, Jan 30, 2010
Thank you so much for the information. Alas, I had cataract replacement surgery using ReStor lenses.
After each surgery I had glaucoma (one eye at one point measured 70) and much discomfort. The discomfort I could deal with because I had hoped that this expensive procedure (I borrowed the money, too boot) would provide me with a non-glasses world for the first time (wearing glasses since almost in utero).
The report so far (one month post-surgery for second eye):
- I cannot read without glasses (and with shiny paper - like "The New Yorker" - that is even difficult (and reading to me is like oxygen)
- I need glasses to see the computer (intermediate vision compromised also, at least at this point)
(I could both read and use computer with no glasses before surgery)
- I am not totally sure about my distance vision (that was my primary problem throughout my life) since my eyes get very tired very easily and there is a glare when I drive
- My doctor does not seem to believe me and says maybe "I had too high expectations".
I am waiting to see what happens and I vacillate between hope and depression.
Thank you for allowing me to vent - this has been a horrible experience.

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by NatalieJay, Jan 31, 2010
Dr Hagan,
Can you recommend a specialist in ReStor lenses in New York City. I live in western MA but can easily get to NYC. My ReStor lenses are very problematic in a number of ways and I can see less well than I could before the operation.
Thanks for any help you can provide.
NatalieJay


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by Sue630, Feb 08, 2010
I am a Crystalens patient and had my surgery 4 weeks ago.  I have to say, I am disappointed.  Maybe I am being impatient?  I still cannot see up close and they told me that I would never have to wear glasses again.  I refused to have my other eye (left) done until this eye can see.  My left eye is my near sighted eye and if that one goes bad... I'm afraid I will be back to glasses again.  I'm still seeing "halos" especially with fluorescent lights.  Doctor said my brain will adjust and I won't notice it anymore.  What is the "average" healing time frame?  Am I just being too impatient?  Right now I can't even read a newspaper with my right eye.  I am in my early 40's and am an accountant, I really need my eyes for detailed seeing.  Any suggestions or advise to me would be greatly appreciated.  Thank you!

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by Jay_from_Beantown, Feb 11, 2010
Dr. Hagan...your a good man who can sleep well at night...and unlike many surgeons that keep promoting these multifocols despite repeated complaints.  As a rule the high volume medical centers don't giving proper warnings about the visual abberations and the high percentage of disatisfied patients.  The profit margins are just too good with multifocals all the way around.  Certainly at this point you would think clinics would be showing a multifocal prospect a simulation of a halo around tail lights, abberations that are there >70%.  They should also explain that whereas clear reading can be expected at 17" and 28" for example with rezoom, vision is going to be blurry inbetween these focal zones.  Many considering multifocals would choose the monofocal route after some simple web demonstrations, this if the industry wanted to be more forthcoming, more honest.  As a result of dropping sales, maybe then the Alcon's would work more quickly to resolve the multifocal issues.  Instead the industry uses deceptive studies and rigged tests, planted bloggers, to indicate excellent performance and happy patients - while at the same time they focus their Dr education efforts on "how to pick multifocal IOL patients that are unlikely to complain". If folks don't believe me here please visit the Dr section of IOL manufacturers websites.  It is unbelievable that the FDA has not stepped in to do something here - but unfortunately this organization is not there to protect the public, but rather serves the interests of the drug and device makers.  A complete survey of patients who have recieved Multifocals (this time with questions that really get to the issues) has to be conducted - but not by the device manufacturers or their affiliates.  But who will do such a survey,  who will pay for such a survey, where will they get their random mailing list?  As illustrative as your data and experience is, they will say this data is based on a small group of disatisfied patients that resort to the web to complain.  It is really sad that the only "accepted data or study" to be found is paid for and manipulated by companies that want to illustrate a certain result for their own gain.  How does one go about getting an unbiased survey done, when it is not in the best interests of the high volume installers (clinics and surgeons) and the IOL manufacturers to do so?  
I had my rezoom installed by renowned clinic in Boston that puts in thousands of these things per year.  I recently have been looking into getting a monofocol for my second eye (to avoid solidifying the hula hoop size halos around taillights). I went to an alternative Doc for an opinion on this mix/match approach - which I'm finding is is not a bad alternative to  having two multi's, particularly if the first is troublesome.  This honest (fifty something surgeon) said that she has not yet seen anyone in her office that has been happy with their multifocals.  How can this be? This comment is in sharp contrast to my symposium lecturing high volume Dr (who consults for B&L) and says that over 90% are satisfied.  Isn't it  funny that I never got a survey after recieving my multifocal.  Unfortunately there are real problems here, the public needs warning and protections...but there is no mechanism in the current  system that will stand up for the little guy in this situation.  The web, the clinics, even the best medical journals are full of lies and misrepresentations on this subject.  The real issue is the insane profit in these multifocals - there is no justifyable reason for it.!  The gravy continues B&L, Alcon and for my renowned surgeon, as well as the lobbiests and politicians they support, while the problems with multifocals are swept under the rug, quality of life diminished for the public - many too old and tired to raise the flag on it.  For 3 years I have seen nothing but bad things about multifocals on public blogs...does this public display of pain mean anything to anyone out there that can affect a change??   Thankfully their are still many honest surgeons such as Dr Hagen and my second Doc that will warn the heck out of their patients.   Sadly too many people like me end up at the high reputation, high volume clinics, get the pitch from sales doctors who will do anything to get into a larger yacht next summer.  God help America and the future of Heathcare when this much chatter can not get through the system and effect a proper warning that will spark some changes - time to throw out all the incumbents and start fresh.
Jay from Beantown

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by Fleetfoot197, Mar 03, 2010
Are there any Crystalen H.D. patients out there that want to report positive responses?

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by MortyS, Mar 18, 2010
Dear Dr. Hagan and all ophthalmologists at MedHelp forum—I have gained much reassurance and information from the MedHelp ophthalmology forum. An interesting result was to find that the surgeon of my first cataract operation had done all, it seems, right things. Several things caused me to doubt the surgeon, not least of all was the "bedside" manner, which made me feel things were being hidden from me. Thanks so much to Dr. Hagan and to ALL the doctors at MedHelp ophthalmology forum who have replied to my questions and concerns.

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by JaniceRose, Mar 22, 2010
I had crystalens implants for my cataract surgical procedure.. From Day ONE I complained to the surgeon that my vision was not 'right' . I was told that it would 'clear up'. and had the 2nd eye surgery (right eye) shortly after.. Every single visit I have complained about this ' smudging' that appears in my vision since the surgery on the left eye.. The eye surgeon seemed to just ignore my complaints, saying "nothing is wrong"  Now a couple months later... I have the same "smudging" effect appearing in the right eye vison !  
I think these lens are screwed up ! BUT my eye doctor keeps giving me same ' nothings wrong' response .
Something IS wrong, Doc !! Before the surgery I could see fine and really didnt even 'see' a problem from the cataracts, however, my eye doc insisited the catarat surgery was necessary ! Now months later I have vision problems..!!  
Dr Hagan.. What do I do ?? If eye doc insists nothing is wrong.. Do I go to another Doc ? Can they remove these
"faulty" lens and replace with something else??
HELP ! Oh and by the way .. Thank Q ! for opening our eyes to this ongoing problem ! My doc made me feel like I was crazy !

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by RogerInVero1, Mar 26, 2010
I had Crystalens implants in both eyes in Nov. 2009 to counter developing cataracts and to correct distance vision.

My surgeon recommended Crystalenses highly, told me clearly that I was a good candidate for these lenses and that less than 1% of the wearers have problems.  I was charged $2700 each in addition to the Dr and O/R charges.

My left eye distance vision is not corrected very much from prior vision (250 down to 150) but my right eye distance vision is good - almost 20/20.  My close vision is not nearly as good as it was before the implants. I still have night driving light halos and my eyes are always strong light sensitive (cloudy in bright sunlight).

I sure wish I had read your reviews before I had this work done and I believe the medical review boards ought to penalize the eye surgeons who misrepresent the potential outcomes of these lenses.

Roger in Vero Beach FL

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by Mele20, May 08, 2010
I had a Crystalens implant three weeks ago in my right eye due to a cataract. From day one to now, it is a miracle!  I started wearing glasses at age 5 and one-half for myopia which rapidly grew worse and worse.  At age 16, I got hard contact lenses and then at age 30 was one of three patients in Hawaii who were part of an investigational study of gas permeable contact lens. Those proved to be life savers for me and I wore them for many years, but as I aged my wearing time was reduced (from 16 to 12 hours). Glasses were always very difficult for me to wear. I hated them but in recent years had to wear them several hours a day due to the reduced wearing time for the contacts. These cataracts have been growing for about 15 years (I am 67) and before this surgery, with my contact lens I had to struggle to read the top line on the eye chart with my right (non-dominant) eye. I was seeing triple traffic lights, street lights, etc. with both eyes but had reasonably good vision with my contact in my left eye (before the cataracts I saw 20/15 in both eyes with the contacts. Around age 55, I got one contact lens corrected for near vision and the other still at distance. Did the dominant eye for near which I have had several ophthalmologists say was unusual but my brain easily adapted).

I researched my options carefully and read posts here and interviewed three surgeons in Honolulu (I live on a neighbor island).  Crystalens was my choice from the beginning because it works with my body (the ciliary muscle) and I felt that was far more natural than the other choices. One surgeon, with great credentials, who trained at Wilbur Eye Institute tried to scare me about how horrible Crystalens is and he said it is never implanted at John Hopkins. He wanted me to get a toric lens for astigmatism. Another surgeon told me that I would have to go six months without my contact lenses before measurements could be made and he also said I did not qualify for Crystalens (too myopic). I challenged that and he called the Crystalens rep who said six months before measurements but that I did qualify for the original crystalens (not the newer version introduced last year).  The third surgeon I saw actually comes to my island once a month to see patients...a lot of genuine commitment there to patients on the neighbor islands. He was the first surgeon in the islands to do the crystalens procedure back almost six years ago and has done well over 300+ since then (actually a lot more than that because that was the figure he gave me three years ago when I first saw him).

One of the first things he told me was that I probably would not need "cheaters" except for very small print (phone book, maps, back of small bottles, bottom of a lipstick tube). He also told me that because of the high myopia that I was at higher risk for retinal detachment after cataract surgery. He said I might have a problem with glare at night but if I did, or if I had trouble reading books and magazines in good light, that there were ways to correct those problems. His fee included any laser enhancements I might want later. He was not at all concerned about the astigmatism that the first surgeon had said meant that I didn't qualify for Restor, Rezoom or Crystalens.

The results for the first eye, so far, have been incredible and I am told my vision will get even better. I see 20/20 at a distance now and that will improve! This is the eye that could barely read the top line on the chart with my contact lens inserted before the surgery (and my contact lens specialist had done everyI had a Crystalens implant three weeks ago in my right eye due to a cataract. From day one to now, it is a miracle!  I started wearing glasses at age 5 and one-half for myopia which rapidly grew worse and worse.  At age 16, I got hard contact lenses and then at age 30 was one of three patients in Hawaii who were part of an investigational study of gas permeable contact lens. Those proved to be life savers for me and I wore them for many years, but as I aged my wearing time was reduced (from 16 to 12 hours). Glasses were always very difficult for me to wear. I hated them but in recent years had to wear them several hours a day due to the reduced wearing time for the contacts. These cataracts have been growing for about 15 years (I am 67) and before this surgery, with my contact lens I had to struggle to read the top line on the eye chart with my right (non-dominant) eye. I was seeing triple traffic lights, street lights, etc. with both eyes but had reasonably good vision with my contact in my left eye (before the cataracts I saw 20/15 in both eyes with the contacts. Around age 55, I got one contact lens corrected for near vision and the other still at distance. Did the dominant eye for near which I have had several ophthalmologists say was unusual but my brain easily adapted).

I researched my options carefully and read posts here and interviewed three surgeons in Honolulu (I live on a neighbor island).  Crystalens was my choice from the beginning because it works with my body (the ciliary muscle) and I felt that was far more natural than the other choices. One surgeon, with great credentials, who trained at Wilbur Eye Institute tried to scare me about how horrible Crystalens is and he said it is never implanted at John Hopkins. He wanted me to get a toric lens for astigmatism. Another surgeon told me that I would have to go six months without my contact lenses before measurements could be made and he also said I did not qualify for Crystalens (too myopic). I challenged that and he called the Crystalens rep who said six months before measurements but that I did qualify for the original crystalens (not the newer version introduced last year).  The third surgeon I saw actually comes to my island once a month to see patients...a lot of genuine commitment there to patients on the neighbor islands. He was the first surgeon in the islands to do the crystalens procedure back almost six years ago and has done well over 300+ since then (actually a lot more than that because that was the figure he gave me three years ago when I first saw him).

One of the first things he told me was that I probably would not need "cheaters" except for very small print (phone book, maps, back of small bottles, bottom of a lipstick tube). He also told me that because of the high myopia that I was at higher risk for retinal detachment after cataract surgery. He said I might have a problem with glare at night but if I did, or if I had trouble reading books and magazines in good light, that there were ways to correct those problems. His fee included any laser enhancements I might want later. He was not at all concerned about the astigmatism that the first surgeon had said meant that I didn't qualify for Restor, Rezoom or Crystalens.

The results for the first eye, so far, have been incredible and I am told my vision will get even better. I see 20/20 at a distance now and that will improve! This is the eye that could barely read the top line on the thing he could to enhance the vision in that eye). I had to wear "cheaters" for all reading for the first two weeks so that the crystalens would not try to accommodate during that period as the movement could cause it to permanently displace slightly. For a week now, I have not used the "cheaters" for computer or book/magazine/etc. Computer vision is fantastic. I was using a large font (20pt Verdana on 1280x1024 19" LCD 5:4 ratio screen also with a Windows DPI of 120). I was able to lower the font size to 15pt! That means that I can now visit the websites I could not go to (like newegg.com) where I saw text on top of text and text on top of clickable buttons making them unclickable all because I had to use such a large font and the 25% larger Windows DPI. I am thrilled about this as I spend 8 or more hours a day on the computer on the web.

Reading books, magazines, the back of the toothpaste tube, etc. at first when I stopped using the "cheaters" was great, then terrible, fuzzy letters, then clear, but too small, suddenly bigger letters, etc. In other words, it was variable throughout the day. But that has rapidly gotten much better and now in good light I can read a novel at any hour with no difficulty. Off and on, during the day and evening, I can even read tiny print like the name of my lipstick on the bottom of the tube...that is very tiny!

I can see the whales now in the ocean behind my condo and when I wake up it is a miracle to be able to see clearly when I open my eyes....especially to be able to read the clock on the dresser. And this next comment has nothing specific to do with crystalens but it is the most amazing thing of all...the colors are so gorgeous now!! I had no idea I could not see blues or purples and I am reveling in the beauty of these colors. Half my clothes are a different color than what I thought LOL and white...oh, white...so pure and crystal and gorgeous now! My brain is so thrilled to have an eye that it can use that sees correctly now that it totally ignores my left eye and suppresses the yellow cast to colors from that eye entirely. This is even though my left eye is my dominant eye. If I cover my right eye then I am astounded, continually, by the change in colors ...how yellow and "dirty" looking white and colors on the red/blue side of the spectrum are in the unoperated eye.

As of Tuesday, when my surgeon made his monthly visit to this island (not quite three weeks after the surgery), I began no longer wearing the left contact lens for one month so we can do the measurements next month, when he comes, for that eye. (He had done measurements three years ago when I first saw him. I decided then to wait awhile before doing the surgery as the cataracts were not bothering me enough and I could still drive with no problems. When we did the measurements again this time, after one month with no contact lens, the measurements were exactly the same as three years ago so he said I did not need to go six months without the contact lens for the measurements to be accurate).  Uncorrected, I am -13.5 diopters in the left eye so I am relying almost entirely on the right eye with the crystalens for this next month.  I have no problems with glare/halos at night (other than the glare I have had for ages from the vehicles that have those horrible white headlights).  

In closing, I think a major key to happiness with Crystalens is the choice of surgeons and not being told that you will never, ever need glasses (at least "cheaters") for anything especially if trying to read in non-optimal light. I knew going in that I would probably need "cheaters" for very small and tiny print and might need them for some books/magazines, but for that I could later have laser enhancement if that really bothered me. It is important that highly myopic patients understand this because it means losing that ability we have when we take out our contacts or take off our glasses to see tiny stuff up close with great precision. Even with that ability pre-surgery (and I still have it in the left eye) I had trouble threading a needle as the cataracts were interfering too much . Now I can thread a needle with a tiny eye in it on the first try!  I can polish my nails, and do a perfect job, and that is using the crystalens eye because my hand is far enough away that my left eye just sees a blur there. Oh, and I was allowed to start wearing eye makeup again on Tuesday and I can put on liquid eyeliner perfectly now on the first try (with no magnifying glass needed)!!!!

I can't emphasize enough how important the choice of surgeon is and how important it is to interview several. Mine is at the peak of his career, he has done many crystalens implants (he does not do the others except rarely but he doesn't badmouth them like one surgeon badmouthed Crystalens), he was one of the first surgeons in the nation to train with Eyeonics, he is on the medical school faculty at UH. He never tried to "sell" me on Crystalens. He answered every question I had with an assured calmness that impressed me (quality the other two surgeons lacked). I know a number of people who have gotten Crystalens from him and they are very happy. I met a woman (55) in the elevator at my hotel just after surgery and she saw my eye patch and asked if I had cataract surgery. She had Crystalens implants three months previous at Stanford University and was unhappy because she cannot read anything without glasses. I mentioned this to my surgeon the next day during the post op visit and he asked if I had her name and phone number as he said that could probably be corrected and said he would be happy to see her while they were in the islands. Another thing that is important is what other patients think of the surgeon you are considering. My surgeon has had his Lasik clinic voted the best in Hawaii by the readers of four major Honolulu newspapers for several years. He is the surgeon that other physicians come to for their eye surgery and has been voted Best Doctors in America and Hawaii for the past three years. With all the honors, my surgeon still manages a refreshing degree of humbleness which is an important quality not seen too frequently with surgeons.



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by Mele20, May 08, 2010
I don't know what happened! I proof read it several times. I think when I had to register here, after I clicked on "post", that somehow messed up the text and I stupidly did not read it again before posting. I can't see any way to edit my post. UGH! Sorry! (And I worked so hard and long on this post).

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by Cleareyed, May 17, 2010
Thanks for your post! I really enjoyed reading your almost poetic description of the colors of  the wonderful new world that your
newly improved vision has opened up for you. And all because you were able to find the perfect surgeon! You might as well call him a miracle worker!  Congratulations! Enjoy your good fortune, and good luck with the other eye!

P.S. Can you tell us who this surgeon is, and how much did you have to pay for this procedure?


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by dobbslaw, May 18, 2010
I have a quick question; does B & L have to give permission to have the Crystlens explanted?  Went for second opinion and that was the impression I was left with.  Thanks.

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by dobbslaw, May 19, 2010
Question:  I will soon be 3 months post crystalens insertion.  Dr. did not correct for slight astigmatism so I have blurred/shadow vision.  Dr. going to correct for astigmatism in June--anyone had good results with that?

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by angiedcake, Jun 02, 2010
I am from England and would like to make a comment.  I had a Technis lens in my right eye in June 2009 and a Rezoom in my left eye, one week later.  My right eye has since been nothing but trouble.  I had haloes, glares, starbursts and very, very waxy vision.  My left eye has a halo around all lights but otherwise has been no trouble.  Last month, after trying to convince my surgeon that I have a problem with my right eye, he decided to explant and replace with a Lucentis (I think) lens.  Well, this is worse than the Technis.  I am seeing him again, this afternoon, and want him to explant and put in a monofocal lens, unless he can see any reason for this awful waxy vision.  I am telling everyone NOT to have multifocal lenses fitted.  I have had a wasted year, its made me depressed, I can't drive at night nor in fact during the day during low-light conditions, and I am really really unhappy, disappointed, angry and broke.  These surgeries cost a lot of money.  I will keep everyonee posted.

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by Judy7469, Jun 25, 2010
I have had cataract surgery on both eyes, had the restor lenses implanted in both eyes, and have deeply regretted my decision to have the restor lenses implanted.  I do not have clear vision up close or in the middle.
I wake up to sharp eye pain and bloodshot eyes every morning.
I cannot shop alone anymore, can't read  the package labels in the Wallmart.  My doctor told me it would take time.  It has been 7 months, and I am back to wearing progressive lenses, and still have poor vision.
I was swayed by the thought of having 20/20 vision again.  I fell for the pretty color brochure, and the Doctor telling me I will be able to get rid of my glasses.  I trusted my Doctor completely,  and now I pay the price for doing so.
I tell everyone of the drawbacks to these lenses, I only hope they listen.

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by allmymarbles, Sep 17, 2010
I have been following the Eye Care forum for some time. It is because of your wise advise, and those of your colleagues, that I will have monofocal Tecnis lenses implanted. It would seem that "government issue" is the most reliable thing going. By the way, if the surgeon I find tries to talk me into premium lenses and I will walk out because I will know he is more interested in money than his patient. I have only one set of eyes.

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by Judy7469, Oct 27, 2010
After 9 months of distorted vision,  three different eyeglass prescriptions, and the inability to read in dim light (such as Walmart) I am having the Restor lenses ex-planted  next week.  How I wish I had not been so trusting of my Doctor.
I didn't know about medhelp website at the time, but now, I thank you sincerely for the valuable information you provide.
It has been very clear to me that these "premium" lenses are very lucrative for eye surgeons and Alcon Inc.
Because they rob seniors of their vision and their money, I have filed complaints with Medicare (they pay for the explant surgery)....My States Attorney General Office.....and the FDA...and of course my eye surgeon.
WE need to be protected from unscrupulous Doctors and Companies that say the lenses will, "Restore  your youthful vision,"  and forget to tell us of the hell we will encounter if the surgery is not successful.

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by dwjeanette, Nov 03, 2010
I  had the Acrysof Toric lens implanted on 9/13/10 and 9/20/10. My eyesight was very poor before this. Right eye has the 10.5 D lens and left eye has 9.5D lens. I would have to say that it has been a dream come true for me! I can see clearly now with reading glasses used only for close up work. Not to say it's been a piece of cake cause it's not. Kinda like getting used to contacts the first time but every day is an improvement. My main problem was using a local optometrist for my after care. He started talking about  everything will get better as soon as I got my script for eyeglasses from the start. He prescribed glasses for me 2 weeks ago and I wore them all the time (bi-focals) because  he said I would be more comfortable if I wore them. Finally my husband that paid thousands of dollars for implants called my eye surgeon who wanted to see me ASAP. Thank goodness I did cause he told me my eyesight was better than his!! I think success with these implants comes with having a great doctor and lots of positive thinking.

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by jd3450, Dec 23, 2010
Oh man.....this just creates more unknowns for me.

How the heck am I supposed to know what is the best lens or who is the best doctor?  I can understand bedside manners being a good example but doctors can be snake oil salespersons too!    It's not like I can take the lens out and put in a new one to try like a pair of shoes.  Obviously the brands mentioned above are a clue and I feel for the people who are now sufferring with vision problems....like me and unless you have problems no one can look through your eyes to understand.  They can detach from the situation but for us it is 24/7....yes, it affects my dreams.

I wish there was more discussion on alternative approaches to catarcts that were successful and document by the mass of doctors.  What about nutrition or supplements?   But every new peice of information helps my awareness.  The last thing I want to do is suffer more with my vision.

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by RussM, Jan 10, 2011
I am a 57 year old male, diagnosed with cataracts in both eyes about five years ago.  It finally got to the point where I decided I had to do something about them.  I found this web site to be extremely helpful in making my decision on what to do.  In general, a lot of the available information appears biased toward unsatisfactory results (I gather most satisfied patients are out enjoying life rather than surfing the web) so I promised myself that I would post my results here so that others might benefit from it in making their decisions.

I have had excellent vision all my life, better than 20/15, but started to have issues with presbyopia in my late 40s (followed by the cataract issues).  As a result, when it came time to do the cataract surgery, I really wanted to use the Crystalens, a multifocal (such as ReStor, ReZoom, etc.) or mono-vision.

I did lots of research, using this site and others (such as the FDA MAUDE database), to understand the range of possible outcomes, risks and the probability and types of complications.  I got contact lenses from my eye doctor to try multifocals and mono-vision.  I wore them multiple days and multiple times to cover as many typical eyesight situations as possible.  My eye doctor recommended a local cataract surgery specialist, which I chose after meeting with them for a consultation.  Their experience with the Crystalens had not lived up to expectations and they no longer recommended it.  At no time did they try to push me into purchasing a premium lens (as I have seen in some posts).  In every respect, I felt that I was dealing with a high integrity organization that was most interested in having a satisfied patient when the work was complete.

Even though the cataract in my non-dominant eye was somewhat worse, I decided I to have my dominant eye done first with a monofocal lens (Tecnis acrylic aspheric IOL Z9003) and decide what to do about my non-dominant eye after more research and seeing the results on the first eye.  At that point, I had rejected multifocals (fuzzy vision and night-time driving issues) and was leaning toward either a Crystalens (set slightly near-sighted as the reported range of focus was not as advertised) or mono-vision for my non-dominant eye.

I had the surgery done on my dominant eye in late August 2010 and it went as advertised - pain-free and without complications.  I won’t bore you with the details, but based on my experience, there is no reason to delay having this done.  Although there are always risks from surgery, I compare it to going to the dentist for a filling or a crown.  Within a few hours, the visual acuity and color perception improvements were dramatic.  I could probably have lived with only my dominant eye fixed for quite some time.

After further research (esp. Dr.  Hagen’s articles and the FDA MAUDE database) and experiments (reading glasses and contacts), I rejected the Crystalens (my perception of the risk and severity of unacceptable outcomes/complications was just too great) and decided to go with mono-vision.  I decided a target of 1.75D near-sighted in my non-dominant eye would give me the ability to go about a normal day without having to pull out reading glasses every time I wanted to look at my watch, car dashboard, cell phone, etc.  My glasses/contacts experiments had led me to the conclusion that +2.0D was too much and + 1.5D was not quite enough.

I had the surgery done on my non-dominant eye in late November 2010.  It went off just as the other eye.  I was sitting at my computer ~4 hours after the surgery using my “new” near-sighted eye to check email without glasses.  Fantastic!


I just had my ~4+ month (dominant) and 1 month (non-dominant) check-ups with the following results:
Dominant eye: Sphere: -0.25D -> -0.5D (slightly far-sighted), Astigmatism (+0.5D), Axis: 140 degrees
(the astigmatism roughly compensates for the far-sightedness, so I have ~20/25 vision)
Non-Dominant eye: Sphere:~+1.75D (nearsighted), no astigmatism

Both eyes are correctable to 20/20 or better.  My doctor pretty much hit the targets on IOL lens power “spot on” for both eyes.  I have gone from needing reading glass for books, computers, etc. to hardly using them at all.  (I have had a set of custom reading glasses made for long reading/computer spells).  I have some haloing during night driving (for reasons I do not understand it happens mostly in my dominant eye).  For everyday things,I do not notice the lens power difference at all – my brain figures out which one to use and ignores input from the other.   The only time I notice a “dissonance” between my eyes is night driving in mostly dark areas with infrequent areas of bright light.  In all situations, my vision is still far superior to what I had pre-surgery.

I am physically active and like to play racquetball.  Prior to surgery I was having some issues with losing the ball in the glare from the court lights.  Since surgery, I have no such issues and am able to track the ball quite well.  I have noticed some loss of depth perception with mono-vision but it has not been a problem for racquetball.

My Learning/Recommendations

1.Be prepared, listen to your doctors and don’t’ be afraid to ask lots of questions if you don’t understand something.  After all, you’re the one that will have to live with the consequences.

2.Use glasses, contacts, etc. to try out the various options.  Get contacts that cover a range of prescriptions so you can see what you can tolerate.  Get extended wear contacts and wear them as much as possible for as long as possible.

3.If you are going to go with something other than single focal lenses set for distance in both eyes, if at all possible, have your dominant eye done first.  You can see how that turns out and try reading glasses and contacts to improve your decision for what to do for your other eye.

4.Be reasonable in your expectations.  Decide on a set of situations for where you do not want to wear glasses, tell your eye doctor what they are, and be prepared to where eyeglasses for other situations.

5.Do what to doctors tell you to do post surgery – antibiotic and anti-inflammatory drops are not optional.  Follow their instructions to the letter!  Nobody wants to be writing a blog post about infection or inflammation complications.

6.Do the work to figure out what will work for you.  Just because I am happy with mono-vision does not guarantee that you will be happy too.

I can’t complain.  Good Luck!


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by Meeper, Jan 21, 2011
I do not know what brand lens I had transplanted with  my cataract surgery. Since surgery,  I have had double vision to the right side impairing my driving and balance.  My surgeon sent me to a muscle specialist and he recommended I have prisms cut into my glasses. My right eye is distance and the left is for reading.  My left eye is slightly droopy on the bottom so my eyes now do not match visually. Could this be corrected by making both lens the same strength or could this be corrected by a simple muscle surgery? I also am slightly crossed eyed now and never have been before.

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by rajambuj, Feb 16, 2011
doctor
my mother aged 74 has undergone cataract surgery for left eye a week back. now she complains that what she sees is twisted and distorted on on side. we got in touch with the surgeon and he says that it is ARMD which he was not aware of before surgery due to the advanced cataract which did not allow him the view of retina.
could this distortion be due to some other factor during or after surgery as she had never complained of the distortion previously.

rajeev sood

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by chrissie48, Feb 28, 2011
Dr. Hagan,
My cataract surgeries were done on Jan. 21, 2010 & Jan. 24, 2010, with ReStor Lens' put it both eyes.  February 4, 2010, I had corrective surgery on both eyes for astigmatism. Still I complained about constant burning, redness, and continual tearing.  Feb. 18, 2010 another corrective surgery on right eye for astigmatism.  Temporary plugs in tear ducts on March 2010. Symptoms persisted.  Prescribed Restasis drops on April 16, 2010.  Following appointments were to tell me to give it time and wait.  December 8, 2010, I was prescribed Arasite (off label) plus another brand of over-the-counter eye drops.  January 5, 2011, permanent punctal plugs were put in upper right tear duct and lower left tear duct.  I was given a bottle of FML (steroid) to use.

At the time this saga was unfolding, my eyes seemed to get worse with the redness, burning, and continual overflow of tears.
Then on January 27, 2011, the doctor suggested I make an appointment with yet another doctor for a consult for serum drops made from my own tears, which I was told is very expensive.  Of course, realizing everything they were doing was not working, the doctor came up with the possibility of "conjunctival chalasis".  The runaround has been unbelievable.  And still I suffer every day with red, burning eyes and constant overflowing tears.  Dr. Hagan, any advice you can share would be greatly appreciated.

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by calamity22, Mar 03, 2011
On Nov 4 I had cataract surgery done on right eye with just single lens. My surgeon was a very "breeze in, breeze out" type of guy. The first exam in Oct(which took about 3 min) he breezed in, said you have cataracts, it's an elective surgery, you don't have to do it, then as he breezed out turned around and said "that astigmatism can be taken care of with corrective lenses" and he was gone. The assistant who was in the room said "corrective lenses are $1,100 extra per eye and insurance doesn't pay for it." Well, in my mind I'm thinking, I've been told I have had a little astigmatism all my life and I saw just fine (till my 40's when I went into walmart readers lying around the house) so no big deal I'll get single lens and wear readers. Ha, Ha, and HA! I paid $1,065 out of pocket for the right eye and the next week I was to do the left eye for under $250. Three days after first surgery, I went back still blurry, my surgeon breezed in, glanced at me, said "You're 20/20, it doesn't get better than that and walked out leaving me with the assistant and me going, BUT I'M BLURRY! The poor assistant kept trying to tell me I'd be fine after the other eye was done to balance everything out. Well there was no way I was doing the other eye while walking around in a fish bowl and I missed my window for the insurance to pick up for 2010......... after several more days of walking around in the twilight zone and crying my eyes out, I got to see an OD in the same office. (My surgeon, thank God) wasn't in that day.  The OD gave me a really complete exam and said I had corneal swelling at the point of contact and that it would go away in a couple of weeks. It actually took 6 weeks. But I had to get glasses because that simple astigmatism I've always had now makes me blurry after putting in the IOL ......But now my problem is this. I'm getting ready to do the other eye by a different surgeon, but in the same group. This eye apparently has a little worse astigmatism. This good doctor did a very thorough job of explaining everything. He, of course, wants to put in the toric lens and a little later "fix" the astigmatism in the other eye. I'm not sure how that will be done. My husband is totally against the toric lens just to keep from wearing glasses; his basis being he has astigmatism and has worn glasses for 30 years and whats the big deal. After reading all this stuff about problems people have had with corrective lenses I'm leaning toward the single lens again, wait 3 weeks, fix up both eyes with glasses I can see out of and GET USED TO WEARING GLASSES for heavens sake!  I feel I suffered enough from 1st cataract surgery. And there were no underlying problems to cause the swelling. It was the worst time of my life (and I'm 58) I was blurry all through Thanksgiving when family came in that I hadn't seen for 15 years. If my breezy surgeon was at fault I will never know...... From the online research I've been doing the toric lens will take care of the astigmatism, but I will still need glasses for intermediate and reading. Then why the bleep, bleep, bleep am I paying for over priced lens and still paying for glasses the rest of my life.  Thank you. It felt good to vent.

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by mc7982, May 13, 2011
With regard to ReZoom IOLs, my surgery was February of 2007.  I'm 58 years old and always had perfect vision.  Quite frankly, I feel embarrassed to have paid more for a product that causes extensive glare, haloing and arcing.  I'm no physics expert, but I'm convinced that virtually 100% of the ReZoom implant recipients would honestly complain of this problem. I think this is a mechanical design problem with the implant.  My night vision is terribile, but I drive anyway. I would be okay driving at night on a lonely country road with no external light sources.  Yes, try to find that perfect night driving condition in America!  

My father in law, with Medicare Insurance, just had the standard monofocal lenses implanted.  No problem with glare!

The good news.......................when shining a spotlight in a field at night, I can pick out the smallest metalic pieces of metal.  Maybe I'll get lucky one day and find a precious metal.  Sometimes you just have to laugh and deal with it.  

Good luck and hopefully one day a remedy will be found.  Where is the FDA?  Hip implants are being recalled, why not multifocal implants.  mc7982



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by Deedee8711, May 24, 2011
In November and December 2010, I had cataracts removed and Restor lens implanted in both eyes.  What a nightmare it has been.  I developed "secondary" cataracts and had them removed by laser.  I can only see clearly in very bright light--which means most of my day's activities are spent in a blurry state.  I have taken Restasis, artificial tears, and countless other drops for dry eye to no avail; and I also have taken Doxycycline in an effort to thin the oil gland secretions--since my doctor says my vision problems stem from dry eye and a granular film from the oil glands.  Everything seems to have a side effect.  The anxiety and depression over the loss of good vision and the loss of about $6,000 in out-of-pocket costs are overwhelming.  Do you have any suggestions?  Can I be fixed?  Can the Restor people offer any recourse?  Should I see another doctor?  Can you recommend one in the Portland, Oregon, area?  Thank you for your help.

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by barney712, Sep 28, 2011
Hi ,one week ago I had the m plus lens fitted to my left eye ,my vision is very good ,however I have a flickering /shimmering in the left corner of the eye and is constant and driving me nuts ,its goes away when there is no light coming from anywhere and is much better when wearing sunglasses ,my surgeon says it will go away ,but Im not convinced as I am to believe that it is the light reflecting off the edge of the lens and therefore I cannot see this changing ,I had done lots of research on these lenses and did not read anything about this problem ,its a shame as the improvement in my sight is very good for only a week post op ,the only solution I can think at present is to have it removed if it continues ,has anyone else had this problem and does it go away ?

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by astaylor, Mar 21, 2012
Most interesting site. My thanks to Dr. Hagan for starting it. My cataract resulted was a result of retinal detachment- it was expected. My surgeon placed in 2007 an acrysof IQ monovision lens set for distance. Have developed odd things which no one can explain. My color detection has decreased, sunlight  shining on side of face blanks out much of vision and I need lots more light to see in this eye. My other eye (nearsighted) is fine. Otherwise, all is fine and I am so glad he refused to use one of those expensive lens. Still, why has this developed over time- first noted after a year.

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by 4445, Mar 26, 2012
Hi, do eny of you have catarats surgery and cristalens "AO" premium - implants?

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by Kloecat, Apr 10, 2012
I  am 60 years old and am considering having the AcrySol IQ ReStor Multifocal Toric lenses implanted so I don't have to wear bifocals any more.  Now that it is 2012, have the satidfaction levels for these lenses increased since their inception?  Have there been any improvements to the lenses so that the blurring, halo effects, and other negative outcomes have been reduced?

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by Hopefull_with_Tecnis, Apr 30, 2012
It's now been 6 months since I had the Tecnis multifocal lenses put in both eyes.  My doctor keeps telling me that things will get better but I don't see much improvement.  If you do a standard eye test I come out at 20/20 but the halos are terrible and I have no intermediate distance focus from about 1.5 to to 6 feet under indoor lighting.  Also, everything has halos using inside lighting or sunlight, no matter how good the lighting.  Is this really going to get better or should I insist on an explant for mono focals?  My doctor insists it will get better and shows himself to be losing patience with me.  I can see fine print under good lighting and I can read reflective signs from a distance with no problems - but the halos and the poor intermediate distance vision is very frustrating. I would rather wear glasses and see clearly again.

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by Geneva64, Jun 18, 2012
I paid $4,000 out of pocket for the Acrysof Toric Restor IOL lenses,as this is not covered by health care in Alberta.  The response to the left eye was immediately clear vision.  However, I cannot focus with the right eye at all after 2 months from the date of the last surgery.  I am very disappointed and if I knew then what know now I would have gone this route!

Hopes dashed.

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by jj1958WB, Aug 07, 2012
I wish I had found this site sooner. Back in March I had catarac surgery in my right eye. At first the doctor had talked about a multifocal lens but after the exam I was told that I couldn't have a multifocal lens because of the astigmatism in the eye. I was offered a choice of either a lens for close up or one for distance. I had asked what the focal length would be for each lens but all the dr. said was I don't know. Most people go for the distance lens so they don't have to have corrective lensess marked on there drivers licence. I also asked if she could give me a temporary contact lens to try so I could get a feel for each lens and she told me that wasn't possible. Well anyway, I went for the distance lens and it totally screwed up my closeup vision. It also didn't improve my distance vision much due to the nasty astigmatism I have.
My right eye is also my dominant eye and was my good eye for closeup stuff. So anyway...... after seeking out advice form another dr. I was told that I should have had much better results than what I ended up with. They askked me if I was ever offerd a Toric IOl which would correct some of the astigmatism. I told the dr, I never heard of one and it was never mentioned to me. Well anyway after the exam they told me what they could do for me and made me up a contact lens that will closley simulate the results I will get from the new IOL. It's been great, my closeup vision is at least as good as it was before I had the catarac done and it cleared up most of the astigmatism. My distance vision isn't perfect but I'm comfortable with it. So by the time anyone reads my post I will have had the IOL replaced. Wish me luck

Joe.........

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by forme2, Aug 31, 2012
I also had the Restor lens put in and I HATE ,THEM!!!!!!!!!!!! ok people how would you like to pay out of pocket $5,000 and you were told you will never need glasses to read or see . I read where everyone says go get another opinion or do this or that ,IT'S CALLED MONEY! I HAD SPENT THAT MUCH MONEY I SHOULD HAVE GOTTEN THE RESULTS AS PROMISED RIGHT? I THINK IT IS STUPID TO GO AND PAY MORE TO GET THIS CORRECTED!  SOMEONE NEEDS TO BE HELD RESPONSIBLE FOR THIS ,DON'T YOU THINK SO LIKE LAW SUITE!GETTING OUR MONEY BACK!!!AND FOR DAMAGES .i AM LOOKING FOR SOMEONE TO TAKE MY CASE ,ANYONE KNOW SOMEONE?BEFORE I GO BLIND.I CAN SEE JUST ENOUGH TO GET BY ON MY GOOD DAYS.THANKS ,NANCY

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by jaynelittle, Oct 30, 2012
by Hopefull_with_Tecnis, Apr 30, 2012 <<< i am having the same problem as you i think my lenses were also Tecnis .... can you up date me on your vision please.


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by michael1949571, Dec 18, 2012
i was talked into getting acrisoft torric iol in left eye , was not told it would cause extreme glistening even though most surgeons know this can be a problem caused because of the material it is made of , most people can see it in certain lighting conditions been told many times by someone i have something in my eye making me very selfconcios told my surgean about , he just laughed and told me to just tell people i had eye surgery , my night vision is horrible because of all the reflections i do not drive at night because of it starting to deal with depression because of it no longer have a social life thank you for letting me post this if i would of known about this site before surgery i would have not had this lense put in by michael l dec12, 2012

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by bookquilt, Sep 23, 2013
I am trying to come to a decision over lenses for cataract surgery. I have severe dry eye plus blepharitis and use restasis semi successfully for nearly two years. My vision is no longer correctable with glasses. I have had severe myopia since ten (over fifty years) am astigmatic, and suffer greatly from glare. I do little driving after dark the past year. I need good vision on computers for work. My quilting and sewing require good vision for fine objects. The Acrysof Toric and the Acrysof Restor are both highly recommended by my dr. I never wore contacts. I am not obsessed with being free of glasses. Would be happy to have lenses cheaper and lighter than my long time Coke bottles. The Restor lenses are very appealing, very tempting, as glasses are so expensive. I am willing to spend the money above my insurance plan to get a good outcome.

Problem: While I am told the newer versions of Restor have a 94% success rate, I truly fear being one of the people who ends up with uncontrollable glare. I would go absolutely nuts!!!
So here I lean towards the Toric. Do they avoid the glare? Do they work better with the blepharitis and dry eye issues?

On a different note, what happened to having the cataract removed and just wearing regular glasses like Mom?
Barb

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by John C Hagan III, MD, FACS, FAAOBlank, Sep 23, 2013
Go to eye forums. Look at bottom of page under "Today's Pulse"  scroll through the blue dots upper right corner till you come to the article I wrote on the things you must consider before having surgery.

As long as the surgery isn't done like it was on mom (Big incision and stitches) getting a monofocal IOL and wearing regular glasses is a good plan, the least expensive and has the lowest complication rate.

JC MD

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