Cataract IOL Recommendation

[EyeWannaKnow]

My mother has to have cataract surgery and is unsure of whether to go with a monofocal or multifocal IOL. She doesn't care for the fact that with the monofocal she would still have to wear glasses for near vision but she's not totally comfortable going with the multifocal since they are fairly new and there is a greater chance of halos. After doing some research it seems most people are happy with the ReZoom multifocal and that the risk of halos is very small. The monofocal lenses that a few local surgeons go with are the Clariflex, the Bausch & Lomb, or the Alcon AcrySof. I've also read that some surgeons recommend going with one type of lens in one eye and a different type in the other eye such as ReZoom & ReStor. I've read a lot of negative side effects of the Crytalens.

My questions are:
Can anyone recommend which IOL my mom should go with?
Has anyone had experience with using 2 different types of IOL's?
Is it better to go with a multifocal in one eye and the Crytalens in the other - or a multifocal in one eye and a multifocal in the other  - or a multifocal in one eye and a monofocal in the other?
If my mom decides to go with a monofocal, can anyone recommend which one to go with as I haven't found much information comparing the different brands.
My mom lives in Kansas City, MO. Can anyone recommend a surgeon either in the Kansas City area or Overland Park, KS area?

I really appreciate any & all advice from anyone. Eagle Eyes - I would love to hear from you. Thanks everyone.

[hud]

sorry, but I am a ReSTOR patient and have no experience with the Alcon Toric implant. My take is that every astigmatic patient will get some level of benefit with a toric implant that does not rotate, as the history of Alcon AcrySof lenses have proven. Even if your 4.5D of cylinder is reduced by 2.0D with the implant, (and possibly more reduction with additional treatments), you would have better vision that with a standard monofocal lens.

[Eagle eyes]

It is always reassuring and comforting to hear your surgeon tell you things look fine. Could be the flickering is from the brain or just catching a glimpse of light and the edge of the lens picking it up. Most people find their brain get used to these sensations and learn to ignore it. I wouldn't worry if your doctor isn't.

Probably just the imbalance of the two eyes. Normal to have that dizzy sensation until both eyes are balanced again. The lens may move (wiggle or jiggle or seem like it is, but that is ok. It is not going anywhere and all IOLs are very stable unless there is some rare occurence usually due to trauma or surgical complication, which isn't your case.

If placing the book vertically makes things more comfortable for you, do it. You can not harm your eyes by using them computer, keyboard, distant objecs, etc. When your eyes feel tired or strained, take a break. Don't rub them or get in dirty water, perspiration in eyes, etc, but using them to see is not a problem.

Gravity is not a problem for any IOL, unless you have just had retinal detachment surgery and told to lie face down. Again, not for you to worry about.

Have a nice weekend and remember, if you just had shoulder surgery, you wouldn't be pitching a baseball game right now. Give your eye time to heal completely and know these things will pass (:>)

[Tommy2006]

Thank you so much for your reply. I visited my Doctor again.
He said the operation looks quite good, the eye looked just fine. He can't explain the flickering. He said it is probably
caused by the Brain, as the operated eye now is slightly (I think 1.5) Far-sighted while the un-operated eye is 2.00 near sighted.

Every time when I look down at a book, or the prints on a bottle
I feel dizzy, and the lower exterior (ear side) side of my right
eye(the operated eye) flicks. Seems that the lens inside is making numerous adjustments and that makes me dizzy.

( It seems better If I place the book vertically at eye level).
It is OK if I look at the computer, or the keyboard or distant objects.

Is Gravity a problem for this IOL?

Thanks for taking the time to answer my question.

[Eagle eyes]

Yes, in general I would agree. Let's see what HUD has to offer. He seems very knowledgable about Alcon products. Again, we have no experience with the Acrysof toric, so I won't comment. Perhaps you could go back to hard lenses after your IOL surgery and healing to correct just the astigmatism if you need it. That is unless there is some reason why you could not do so later. Just having cataract surgery itself, should not be a contradindication once the eye is completely healed.

Keep us posted!

[tslight]

Thanks for your comments.  I'm 56 and the right eye with the cataract has 8.75D (not sure what the tech term for nearsightedness) and my left eye is 9.0D (don't know the astigmatism of this eye.) I don't plan to do both eyes  by Sept.

I have talked with my surgeon since posting question.  He is not a fan of the Staar Toric due to the problem of "slippage" in the older version.  I have been reading that the newer Staar Toric doesn't seem to have that problem, but my doc doesn't want to use Staar.  

Yes my doc does do LASIK, but didn't want to subject me to possible multiple procedures.  I'm in excellent health generally, but I don't know how that might affect my eye recovery.

Bottom line, my doc's view is to take the conservative approach.  He feels that whether I have the standard IOL or the Toric, I will still have to wear glasses or contacts...so why not do the standard procedure. He says that the Acrysof IOL will only correct 2.0D of my 4.25D of astigmatism.  Do you have any different knowledge concerning the Acrysof Toric's performance?

I didn't mention that before the cataract, I have been a hard contact wearer for 44 years.  Boy do I miss them.  I've been in glasses for the last 6 months to allow my eyes to "unmold".

Thanks again for your perspective Eagle Eyes.

Hud - are you out there?

[Eagle eyes]

Boy.....tough one.....
Well, does your doctor do LASIK? If so, it may be possible for you to have the standard IOL then have a LASIK enhancement to tackle the astigmatism. You don't mention your age, but in general, yes, ReSTOR and ReZoom are not so good for people who will have more than 1.00 Diopter, really even more than 0.50 Diopter of astigmatism post op.

LRI...might get some (maybe half of it, but for you that really isn't going to be option either, most likely.

There are some MDs that use a standard or even premium IOL in the bag and then a STAAR toric in the sulcus with success. Perhaps Hud will comment on the Alcon toric. I have no experience with it, yet. I do have experience with the STAAR toric, again as a piggyback with multifocal and standard lenses in the bag. I would still find out if LASIK or PRK enhancement is an option for you. If so, it would be best to make the decision before surgery, so the correct power of IOL could then be selected to leave you a bit nearsighted to better correct the astigmatism with the laser. If your chosen surgeon does not do LASIK, then ask if he -co-manages with a LASIK surgeon.

Do you have that much astigmatism in both eyes and are both eyes being done in this tight time-frame you referenced?