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Crystalens problems

Crystalens inserted in non-dominate rt eye in early July at age 64. Left eye has small stable cataract and is 20/20. Rt eye was 20/25 previous to cataract.
Vision results were 20/20 mid Aug., but deteriated rapidly do to formation of scar tissue on nasal side of lens. Yag laser treatment eliminated tissue, but vision never improved much. Measures out to about 20/60 with poor dim light vision and somewhat distorted images. Bad flares and halos at night. Vision is unstable and changes constantly. Close vision is good but is also variable. Not a good result. Dr. offered lasik, but do to unstable lens and awful near vision forcast, I elected not to do it.
Elected to have Crystalens removed and ReZoom implanted next week. Dr. has long history of catatact surgery and is well known in this area.
Read on this forum about the difficulty of removing a crystalens. The Dr. has not discussed this potential problem with me, but I don't have any choice anyway. I am definitely worried about losing part of my eye tissue with the explant, and potential future problems because of this potential. I have been told this is not the first one he has had to remove, but mine has been in a longer time than any others he has removed. He has done all of the new lens' and likes ReZoom results the best so far.
I will not be doing my left eye until absolutely necessary. I hope the ReZoom in one eye will work ok, but after my first experience, I no longer believe the advertising and marketing hype of the cataract replacement lens industry. It doesn't always work out. Dr.and staff are very good to me.
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Avatar universal
i hope it will work as well...good luck
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Wow, I'm so sorry to hear about your problems with Crystalens.  Since both my eyes were done very recently using Crystalens, I'll be really interested to hear how this goes.  Best of luck to you.
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Avatar universal
It sure sounds like your situation is complicated. I recently (1/27)had ReZoom surgery in my non dominant eye. I researched my choice for about 8 months and am very happy with the results.

I am now a very crisp 20/20 at distance, excellent close up vision (J1 at 14 inches), and do not need glasses at all.

I am wearing a multifocal contact in my dominant eye. This combo is working very well for now. I am very aware though of the yellow tint to colors from this eye as it continues to deteriorate.

If it is any consolation, I am very pleased with my ReZoom implant. I plan on scheduling my second eye soon and will be choosing a ReZoom lens.



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Thanks for the update.  Did your surgeon measure your pupil size prior to surg.?  Also, did he make you not wear your contacts X 5 days prior to the AOL master measurements?
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Nursept; Keep us posted on your status. Choosing the right IOL for you is important. Have you decided yet or still considering?

My surgeon did not measure my pupils prior to surgery that I know of.

For the IOL measurement, I had it done twice prior to surgery but two months apart. The first time I had worn my contacts up until three days prior to the measurement. I was concerned when my surgeon suggested that seven days would have been more appropriate. It was during this visit that we discussed the different IOL brands and options that I was facing. My surgeon is extremely experienced and installs all brands of IOLs (ReZoom, ReStor, Crystal Lens, and previously the Array). He was careful to explain the different technologies and did not appear to have a bias toward any. My research was leading me to the ReZoom and he agreed that for me, ReZoom was the most appropriate.

During this first visit, the IOL Master was not getting a consistent reading as my cataract was so dense. So my doctor did an immersion reading with saline chambers and ultrasound to verify the readings. Thus I had two different methods of measurement during that visit.

For the second measurement, I avoided my contacts for 30 days prior to the measurement. During this procedure, the IOL master was able to get a clean reading that was consistent with the measurements done during the first appointment.

The following is an update:

Three weeks post op and I am thrilled with my ReZoom vision. I am still seeing 20/20 crisply at distance and have excellent close up (J1 at 14 inches) and intermediate (J2 at 25 inches) vision. I do not need any correction in the ReZoom eye and have given away my reading glasses from before the surgery as I am able to read the finest of print.

As stated in a previous post, I had rings appear when light from above and to the right (as when in a banquet hall) were present. Those have diminished dramatically and are a non issue today. I believe that these were reflections hitting the lens where the incision was made. As the incision has healed, so have the rings disappeared.

In my prior posts, I decided to postpone my second surgery as I was doing so well with one multifocal contact and one ReZoom eye. However, as my ReZoom eye settles in, the yellow cast and color degradation from the remaining cataract has become more pronounced. I have an appointment this week and I suspect that I will be scheduling the second ReZoom eye soon.

My night vision is a little different than during the day. I am seeing crisply at all distance but when outdoors I see a small ring around light sources such as streetlights and headlights. Not bothersome but noticeable only when I think about it. My left eye with the multifocal contact does not appear the same way (I just see the lights).

I am wondering from readers of this forum if this effect will diminish or will it compound when I have the second ReZoom implanted?

Regardless, the results of my ReZoom implant have been truly amazing and I will make the same choice again.



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Avatar universal
Thanks again for your detailed update.  Whenever I read your posts, I lean toward REZOOM. However, the surgeon I feel has been the most accurate with measurements etc. has been the one who only feels confident with RESTORE.  (Confident w/ good results).  This has kept me alittle confused about which lens to implant.  So there I stand.  I asked to speak to patients w/ REZOOM (that had the REZOOM MD do their surg.) however, they were reluctant connect me with these patients giving  HPPA regulations etc. as a reason.  This made me alittle weary. I have surg. scheduled w/ RESTORE lens the end of March only because I was not very confident with some of the measurement techniques used by the REZOOM surgeon. (I have seen a total of 3 surgeons already and am running out of time as my vision in the worst cataract eye is 20/400 WITH correction).I was told the surgeon and placement of the lens is most important. EYECU noted that a conference will occur mid March which this  RESTORE surgeon  will be attending.  I am hoping he will hear some more data about REZOOM.  I certainly will keep you posted and will continue to check this site for your comments. I hope you will still be checking this site the end of March into April. I am so happy your lens is working well for you. Thanks again.
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Avatar universal
In my research of lens choice, I came to realize that there is much hype out there by the lens manufacturers. I tried to look past the hype and look at the technology.

I have also read a number of physician opinions in my research and clearly some are "shaped" by their own limited experience and  manufacturer's hype.

I would encourage you to seek out a surgeon (even if it is a 4th) with experience in refractive as well as cataract surgery. These are the folks who know best how to accurately correct vision while replacing the cataract. Your ideal solution would be to find a surgeon with experience in  both ReZoom and ReStor and then have him(or her) tell you why you would be a better candidate for one over the other.

One source that I used for research was this publication;

http://www.crstoday.com/

You can look at current and archived articles on ReZoom, ReStor, and Crystalens.

I wanted to have very crisp distance vision. My research helped me to understand that the ReZoom is sized in the same way as a mono-focal. The center "distance" part of the lens is  monofocal by design. I like you had low presobia (1.25 readers) and thus I felt that the ReStor may end up too strong at near. I also wanted very crisp intermediate vision for computer work, reading my watch, seeing the dashboard, and my cell phone.

Also, the diffractive design of the ReStor "splits" the available light at all distances. This was another negative for me with the ReStor. These design issues (low light reading limitations, distance crispness, intermediate vision, and the near add possibly being too strong) lead me away from ReStor.  

One article convinced me when it stated that for older patients where close up detail work (like sewing) is important then chose ReStor. Daily activities (such as I described above)are important to me and that is why I chose ReZoom.

In my case, after installing the ReZoom, I do not need correction at any distance. My thoughts prior to surgery were that if I were to need glasses at all, then occasionally reading glasses for fine print would be preferred over having to wear glasses for intermediate during daily activities.

From your previous posts, your intermediate (for your music) seems important to you. In the end you should be the one to chose your lens technology.

Best wishes with whatever you decide.
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Avatar universal
Here is a link to a series of articles that I found very useful.

Rezoom, ReStor, and Crystalens info included.

I hope this helps!

www.crstoday.com/PDF%20Articles/1005/CRST10005_supp.pdf
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Avatar universal
My research and the results reported by others from the ReZoom implant are the reason I want to have it replace the Crystalens after it is explanated.
My expectations were high when the Crystalens was originally implanted and the vision I had one month later was stunning. I was very pleased.  I still don't understand what happened to cause the lens to decenter or shift position later and cause the vision problems I am having now. My research has found that the Crystalens is potentially subject to "capsular contraction syndrome" which after several months can cause it to decenter and vault forward in the capasular bag. If this happened to mine and the Yag laser treatment did not correct the lens position, then I believe the only recourse is to remove it or live with it. I can't live with the visual aberrations and poor distance and night vision, so out it comes and in goes a Rezoom.
As long as no damage is done to the capsular bag during the explant, everything will probably work out ok.  Unfortunately, it just can't be lifted out easily after it has healed into the bag. Somehow, it needs to be separated from the capsule tissue without disturbing the surface of the bag, so there is a good stable surface to mount the ReZoom on.  To say that I am concerned is an understatment.  
If any eyecare professionals monitoring this forum can offer any insight into this procedure, it would be appreciated and might alleviate my concern. The clinic has not discussed it with me, so they may consider it not to be a problem due to the expertise and experience of their Dr. and did not want to cause unnecessary concern or maybe I'm just magnifying the issue.
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Avatar universal
I have empathy for your situation as an ophthalmologist. The technology is first generation, it is good but not a substitute for being twenty or thirty. I listen to my patients when it comes to choosing an IOL since I have no bias on the lens I implant. It makes no difference to me as long as I feel the results will be the best possible. As long as the patients expectation is set properly not one person has results unhappy with results.

Explants are tough when the capsular bag has fibrosed the IOL in place. I explant them within the first few weeks for optimal results. It is hard if not impossible to predict who will fibrose and have problems. I am sorry to hear about your problems and your anxiety. Good luck to you.
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Avatar universal
Thanks for the article references.  I read them.  It is perplexing to me how AMO doesn't have a U.S. clinical with rezoom.  The AMO rep never showed my surgeon any clinicals when he was trying to sell him REZOOM just 3 weeks ago.  WHY?  That doesn't even make good business sense. Having been a former pharm rep I know,  you need proof sources to sell. Trust me, I am trying so hard to get over this fact because I get sad when I  think of losing my intermed. vision as young as I am.
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Avatar universal
By any stretch, I am no expert. I will try to express my reasoning but others on this site (surgeons and those who work for surgeons) seem to have much broader first hand experience.

My understanding is that AMO used the Array clinicals treating the ReZoom as an upgrade. Thus they did not need to go through costly FDA trials on an already approved product. This to me did make good business sense and did not effect my decision at all.

In the end it was my desired results and the technology itself of each lens (ReZoom vs ReStor) that helped me decide. I listed my decision factors in the post above. That does not mean that my choice is the best choice for you.

I tend to look past the brochures and advertisements and look deeper at a product, how it works, and why one product may be better for me than another.

I am fortunate to have a very experienced, world class, and nationally regarded refractive surgeon. His practice takes a brand neutral approach and he allowed me to work through the decision process in my own time frame(8 months, starting my research shortly after FDA approval of ReZoom/ReStor).  

These lens' are still new for many surgeons and so experience and actual results rather than clinical trial results are only now emerging.

Sensing the struggle you have, I do wish you well.






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Avatar universal
Had the crystalens removed yesterday and a 24 hour follow-up today. Surgeon reported all went well during the explant. He evidently removed the lens, but left the stablizing posts of the lens in, as removing them would be expose my eye to more potential capsule damage. They did not interfere will the ReZoom implant or function. This a very short discussion while I was on the table and under the influence of a relaxant, so I think thats what happened.
Today, I was seeing 20/25 distance and 20/30 close already. Need some more time obviousily to assess the longer term results and the dim light and night driving results. My eye needs to clear some more too.  So far the ReZoom results are good.
I am relieved this experience is over.  From the number of surgery tools he was asking for and the time it took, I know it was not a matter of fact eye surgery.
It's nice to be able to see well again even if it's only been one day.
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Avatar universal
I know you must be exhausted with the contemplation of your decision. Cataract49 is right about his comments about the FDA approval without US clinical trials. There is data out there prior to FDA approval in the US last March, from Europe. Much more data has been gathered since FDA approval. The ReZoom is better than Array and it just needed to be as good as the Array to get approved. If you are a musician, intermediate vision is a definite priority for you. That is the strength of the ReZoom. Obviously you must have confidence in your surgeon and this one prefers ReSTOR. Only because he hasn't done anything else. I think Cataract49 is right on with his comments and think back as to how long and tedious his decision was. I wish you the best. Get as many opinions as you need until the majority rules, but go to someone who does them all, else how they be an expert or comment from personal experience, which is the greatest teacher. Best of Luck to you...keep us posted. More amd more of our ReSTOR patients are saying the reading is too close, too strong, the distance is muddy or like looking thru Vaseline, and there is no intermediate. The ReZoom gives you comfortable, good reading, good intermediate for those arm length tasks, and excellent distance vision.
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Avatar universal
Good for you and your 1st surgery! As for your question/concern about things being better or worse after the 2nd eye....better is most always the case. Once the cataract is out of the 2nd eye and the brain now once again has 2 eyes to use that are balanced, the brain suppresses those unwanted halos, images, aberrations, funky things you see. Again as stated on this thread, noticeable not bothersome. Let us know how you do. Best of Luck for round 2.
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Avatar universal
Great news for you. Glad it went well. It should get even better, but remain stable and not fluctuate like Crystalens vision does. Keep us posted.
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Avatar universal
Rezoom lens replaced Crystalens on 2/22. On 26th starting seeing ghost image which is slightly above real image. Part of it is overlaying and part is above real image.  Lights at night also starting exhibiting this aberration.  Did not have this for first three days. Lights were pinpoint and all images were crisp with no aberrations.  This image gets larger and higher as objects move from arms length out to distance.
Is this what others have referred to as halos?  Since it is a faint image partially overlaying the real image, it makes it difficult to see crisply even though distance vision appears to be still good for real image.
I was reading with a little difficulty without glasses until this appeared.  Now I had to go back  to reading glasses.
Have others experienced this and did it correct itself after awhile?  I will not see doc for another checkup until 3/1.  Day after surgery, I was 20/25 dist. and 20/30 close.
Sight in low light and at night is also is not equal to that in my left eye.  Rooms and nightime vision are dimmer when using my rt eye only.
I normally do moderate workouts 3 times a week to keep in shape. Will the increased blood pressure and pulse rate from fast walking and weight lifting have adverse effect on implant settling in?
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Avatar universal
Exhausting is the right word.  I am totally spent on this decision.  I lost confidence in the Rezoom surgeon because he did not do my measurements w/ my contacts off for at least 5 days. He also pushed lasik as a way to "fix" any discrepancies.  This made me not feel confident w/ him. I understand the measurements are not exact at times. I need a surgeon in the L.A., South. Calif. area - I know there must be a surgeon that I  can feel confident with. I had a surg date set up at Jules Stein, cancelled it because I got scared and I didn't like the fact I couldn't meet the surgeon until 2 weeks before the surgery.  you saw a different eye MD to verify you even need cat. surg first.  Then they bring you back 2 weeks prior to surg and you meet the surgeon  and go through all the testing.  Jules Stein is at least a one hour drive one way and since I can't drive distances anymore, the whole thing felt overwhelming to me. I  am scheduled to have surg with the RESTORE lens the end of March out of desperation.  I figured some vision is better than no vision. It worries me that you say   patients are not seeing good distance w/ Restore. It worries me that there are some pt's who say they feel like they are looking through vasoline.  That would totally annoy me.
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Avatar universal
I do not know California well.

You can search for a ReZoom doctor at http://visioninfocus.com/040.rezoom.asp

or take a look at the third article in the documents at;

www.crstoday.com/PDF%20Articles/1005/CRST10005_supp.pdf

It is by a Dr. Kerry Assil in Santa Monica. I don't know how far that is from you.  His contact info is in the article.

Good luck!



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Avatar universal
I was curious and ran a mapquest from LA to Santa Monica.

A quick 20 minutes for an additional opinion would be worthwhile. I have no personal reference but from the article (see post above) this Dr. seems to have vast ReZoom experience.

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You are so kind.  I appreciate your concern and effort in this matter.  S. Monica is about 1 hour drive w/ traffic-- not really that bad.  Thanks for the info.  THe drive is doable.
I can't tell you have valuable chatting in this forum is/has been for me.  Nobody really understands these issues or concerns like someone who has gone/going through them. Thank you so much. I will keep you all posted.
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Avatar universal
Had appt with Doc this afternoon to checkout ReZoom results at 7 days out from insertion to replace Crystalens.  Had great initial results for first 3 days and then developed an additional transparent image above the real image plus some nightime halos.

When he explanted the Crystalens, the capsule was no longer able to solidly hold the ReZoom so he positioned it in front of the capsule. I don't understand exactly what is holding it in place.

According to him, and I hope I got this right, there was some change or movement in the vitreous which caused the lens to slightly decenter. He wants to wait a couple of weeks until the eye settles down and then go back in and recenter the lens and hold it in final position with a "stitch". There was also a reference to the zonules when he talked about the stitch. I don't know if he used a stitch in last weeks op, and if not, why.

Not pleased about the requirement for another eye surgery session, but optimistic about getting back the excellent 20/20 vivid vision the ReZoom gave me for a few days even if it was not able to be placed in the optimum postion initially. This is a great lens and should be at the top of anyones list who is considering a multi-focal IOL.  It's not responsible for my current problem.

He gave me some eye drops called Alphagart P to use until next weeks appt. They're suppose to lower eye pressure and change the pupil size.

I'm really looking forward to getting this experience which started last July over with and enjoying a consistant visual outcome.  Wish the ReZoom lens had been available to me back then.  My left dominate eye has a small stable cataract and is still 20/20.  Hopefully, it will stay stable and will allow me to avoid anymore eye surgeries in the forseeable future.


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Avatar universal
Hi..Yes go to Kerry Assil. He is awesome. He has a very kind and compassionate way of explaining things. He has experience with ReSTOR and ReZoom. You will be in good hands there.
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Avatar universal
I am probably late for the question about your physical activity. It shouldn't affect your eye, but you should check with your surgeon, if you did not already. As for the Alphagan, yes it will lower the IOP (intra-ocular pressure) which will help with the healing and bring your pupil down just a bit, which will help with the halo/glare/aberrations you may be seeing at night. Glad things are going better for you. Should continue to improve.
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