Feedback wanted on Crystalens

[dakamala]

I am considering Crystalens and would like to hear from anyone who has had it for the purpose of vision correction not cataracts.  I am 43 and have been told that I am a good candidate since I am not a candidate for Lasik but have also been told noboby my age should have it done.  I'm confused.

[Ag-i-doc]

43 is a terrible age to have LASIK, i agree with that statement.  most people's vision changes more in their 40's than in any other time in their lives.

crystalens is probably a much better option for a person in their 40's

[Jesse Optics]

Why are you considering surgery?  What is your visual problem, failing near, poor distance, etc., near sided, or far sighted?  Are you a life long glasses of contact lens user?   Thanks JO

[Eye Guy]

I would say your pushing the envelope at 43 with Crystalens. (The reading vision is not that great anyway.)  50 is a more likely age to think about clear lens exchange.  Remember, the market is changing fast!  Now we have Restore, Rezoom, and Veriseyes.  As far as refractive procedures go, have you considered PRK or Epi-LASIK?  PRK is a slower healing, more uncomfortabe prodeure, BUT it does spare your cornea the most tissue and allows the eye to remain closer to it's original structure.  The down side to doing an intraocular surgery at such a young age, is the long term complication rates.  The patients are usually 70-80 that have surgery now.  You are doing it 30 years sooner.  No one can tell you for sure what the effects of having a lens in your eye for that many years.  That's why they make knee replacement patients wait.  Trust me, we all want everything these days, but these are our eyes, the most precious sense we have.  Please don't rush into it.  You don't see too many ophthalmologists getting these accommodative IOL's do you?

[Eye Guy]

Generally the Crystalens has limited near vision help.  Unless the doctor did the calculations to give your dad better reading power and less distance vision.  The key to the Crystalens is using the patients focusing muscles inside the eye to physically move the implant lens forward and backwards.  The doctor can choose the power of intraocular lens to get the best result for each eye.  This is similar to mono-vision (sometimes done with contact lenses).  I have to say, Crystalens is already being passed over by many doctors in favor of better things to come.

I'm glad your dad has had a good result, but I just don't want everyone to believe that they will have the same result if they make Crystalens their choice. Night vision glare is also a big issue with these types of lenses, due to the design of the lens.

[Jesse Optics]

Dear Eye Guy,

In your previous post you mentioned that the near isn't that good with crystalens.  My dad has them and see's very well at near.  What are you referring to?  JO

[Jesse Optics]

Dear Eye Guy,  Thanks for your concerns but some of your assumptions are incorrect.  My Dad was a failed monovision patient and very intolerant of the one eye short and one eye long method.  His primary requirement was good distance vision but can see without glasses at all distances.  Here in Dallas there is a lot of advertising about ReStor and crystlens.  I went to the FDA web site and compared the results.  The crystalens outperformed the ReStor at all distances.  Your comments about multifocals being bad at night are correct, the multi image design ended up with a warning for driving which the crystalens didn't have.  Jess

[steph7]

I am 52 yrs old.  Thinking of having the Crystalens surgery... should I?  Never really wore glasses, but probably should have... especially now.  Legally I am supposed to for driving.  Reading is terrible, and I use the 200 strength cheaters.  I'm nervous about the procedure--not certain if it will offer sufficient improvement.  Also... is there a period of time for adjustment?  Tell me... think I should do it? or, should I wait for a new and improved lens?  Please!!!  looking forward to opinions and experiences!

[Eye Guy]

Well, if you read Jessie Optics the choice is Crystal Clear.  Otherwise, do your homework, like you are.  Crystalens is actually the begining of the accomodative lenses, but not even close to the best yet.  There have been 3-4 since and many more in various stages of medical trials.  

You will have an adjustment phase.  You will also have to have both eyes done to balance your vision.  Yes $4,500.00 per eye is expensive, but if the calculations are done right, you should be happy.  Happy is a relative term depending on you!  The LASIK doctors have a term called, "20/Happy" vision. It may not be 20/20, but who said you have to be 20/20 to be happy.

First make sure you have a very good ophthalmologist with at least 100 eyes under their belt. Second make sure they have the IOL Master or an immersion type A-Scan or both to measeure the length of your eye. It all starts with the measurement. Then make sure you and your eye doctor get together on your visual expectaions for far and near, and trial the vision with a trial frame or contact lenses.  These are steps that most doctors won't do, because they usually think they know best.  WRONG!  you have to be looking through the lenses the rest of your life, and your paying big money out of pocket to do so.  Yes, NOW the the government will kick in a few bucks if you really have a cataract.  Take your time, and if your doctor won't explain things to your satisfaction, let you see educational videos, and offer you the opportunity to talk to patients that he/she has done surgery on already, go elsewhere.  They should also make sure you understand the risks involved.  Go to a seminar on it somewhere else to see what other doctors will tell you.

[steph7]

Thank ou for your feedback!  The doc I have visited with is said to be one of the best in Austin.  I am told he is the main guy training all the others.  He's done many procedures, and has been very informative.  I've actually seen two different docs for comparative consultations.  The first gave a minimal exam as compared to the guy I'm seeing.  Additionally, this guy seems to have all the latest in equipment. I asked last week to be able to speak with some patients.  I'm told they'll be given my number and if they wish to call, they will.  You hit my biggest concern right on; that is, that I imagine new and improved lenses are yet to come, as with technology, it's inevitable.  Ok, one last question.. how common is it to have dry eyes and not know it?  The doc put in temp tear duct plugs, and suggests I have more permanent ones put in.  I never noticed a dryness, but he showed me on a printout the indications of dryness... I take it this is all fairly normal?

[Eye Guy]

Your dry eyes were disovered as part of a good eye exam. The fact that you didn't notice it before doesn't mean too much.  It's a good think to try the temporary collagen plugs first, then put the silicone (permanent) plugs in if it made your eye more comfortable.  

I have a question for you though. The fact that this doctor is a big shot doesn't really impress me.  We have plenty of those here in Chicago.  But what did his exam and explanation about your concerns convince you to do?  Are you planning on doing the surgery?  I can tell you that doctors, like the one you describe, are always convincing people to do the procedure they happen to be doing at the time.  I've seen it with Array, Crystalens, Veriseyes, ReSTORE, Rezoom, etc.,.  Your goal should be a lens that gives you a good reading range, great distance vision, little, to no night vision distortion, and long term safety.  If you don't have a real cataract, one that inhibits your daily life while driving day or night, and can still see fine with your +2.00 readers, hold on a while longer.  This isn't a face lift or a Botox treatment, it's eye surgery.  Your still 20 years early compared to most cataract patients. I really want to see how many ophthalmologists would run to do this on their own eye's.  I don't mean to be negative, I'm just trying to make you think deeper.

[hmh]

Does anyone have any info on ReZoom lens.  I'm 62, have cataracts and am planning on doing ReZoom lens.  Could use any one who have experience with ReZoom.

[Jesse Optics]

HMH,  Rezoom is a second generation of the array lens by AMO.  I have just reviewed the labels of all presbyopic treating IOLs for my dad.  The link to the FDA web site is below where you can review the array data which will give you some idea of what to expect.

http://www.fda.gov/cdrh/pmasep97.html

Look at PMA 960028

Patient labeling begins on page 34

Hope this helps

JO

[steph7]

Thanks again.  I do think that the exam was very thorough.  The doc appears to have the latest in equipment.  I felt more confident for some reason with this doc. than with the first; I think, because the initial exam was so thorough.  But.. yes, he pretty much recommends surgery.  At the same time, he was clear in that it would not provide 20 20 in all areas.  He wanted to be sure that my expectations were not exaggerated.  He told me that the crystalens would improve my reading, but I may still need a light powered enhancement sometimes... but generally should be able to be reading glass free.  He told me distance would be noticeably improved, as would closer range.  He also told me that with crystalens, I'd have less chance of halos, etc. while driving at night. You're description of of what one should look for fits what he said.  None the less, I think that I am most comfortable waiting a bit.  I agree.. I have a lot of time and lens are ever changing.  It is not the surgery I question.  It's the lens.  I am feeling there are too many kinks.  I really didn't notice any change with the temp plugs.  I guess then, I'll go ahead with the permanent ones.    

I appreciate your input.  I don't think you come off negative; rather, you are simply stating facts, and givng good food for thought. I'm thinking while I wait a bit, I might try contact lenses.. for mono vision.  See how that works. out.

[Eye Guy]

That sounds like a good plan.  I commend your research on the subject. Good luck!

[hud]

I'm in Austin and it sounds like you saw a well known MD who recommends the crystalens. What is not well known that he has a sizable equity investment in the company that makes it. I have researched all the implant options, and anecdotes don't impress me. Every person is different, and there are good auto mechanics and bad auto mechanics. One doctor told me that the other crystalens surgeons here have stopped because their results were not consistent.
My goal was to avoid having a pair of glasses in every room, car, etc. The FDA data that swayed me was the percent of patients never using glasses after surgery. The crystalens was something like 20%, the Array/rezoom was 41%, but the Alcon Restor was 80%.
It has been 2 months since my surgery and I have been reading the stock charts as well as driving at night without problems (or glasses). I'm sure that the other lenses could have given me some improvement, but to eliminate glasses altogether is huge for me. you should check out the restor website.

[Jesse Optics]

HUD, For someone who doesn't like anecdotes you just accused a doctor in Austin of conflict of interest and then accused the company of selling only to people who invest in them, exactly is what wrong with the internet, If you own a keyboard you have a forum than can be abused.

I thoroughly investigated the crystalens and restor for my dads surgery, both are excellent choices. I'm glad your surgery went well and you have received the benefits you desired. My dad is extremely happy with his crystalens surgery also.

For those reading this thread that want to compare facts please see the links below.

http://www.fda.gov/cdrh/mda/docs/p030002.html
http://www.fda.gov/cdrh/MDA/DOCS/p040020.html

JO

[steph7]

Thanks for your input.  Tell me, do you have any night-time distortions?  Halos?  or, is all near perfect?

[hud]

at first there was some glaring headlights with halos. I had halos before the surgery so I was kind of used to that. but after a couple of weeks, either they went away or my brain got used to it. I have no nighttime issues now, not that I ever liked driving at night.
On my last dr visit I was talking to another Restor patient who had just got the latest restor which filters blue light. Most implants filter UV only, but now I wished it was available when I had my surgery. I asked my dr about it, and he said there are some studies that show removing the human lens also removes some of the retinal protection from light damage. My mother has macular degeneration and I want to take any precautions I can.
as for Jesse's comments, he's right that I am using the internet to pass rumors, but I know a lot of docs, and unfortunately, some do have serious conflicts of interest. crystalens works for a small set of people and the company would probably love to sell to as many surgeons that would buy. You're doing what you have to do-research.

[gigi102]

Had the crystalens implanted, and found wonderful results at the beginning, great distance vision, after the second implant, seem to lose distance but gain reading, and a film developing in first implant, may need laser surgery, anyone else having these problems?

[eyecu]

I would say that eye guy is on the money. This has been fun to read. The good news is that you have a lot of choices and more on the way. The Crystalens in the only true accomodating lens. It uses a single focus lens which will not give you the other images being defocused such as the Array, ReZoom and ReStor so you cut down on the halo effect. But with large pupils at night and a 4-4.5mm optic you could experience some. It works by moving back and forth. The problem can be, that over time with capsular changes it might not move back and forth as well and you can end up with decreased near vision. But you will have great distance and possibly intermediate. The ReStor gives you great near with a 4.0 diopter ad but no light goes to intermediate and there is a loss of light due to diffractive optics so it can cut down on contrast. The yellow lens deal is really debatable and there is no proof to the claims. In fact you can go the Federal Register and find out that they were turned down for New Technology IOL claims because it cannot be proven. There is also a feeling that yellow lenses cut down on blue light which furthers contrast loss at night. If that is the case, buy some blue blocker glasses and wear them during the day and take them off at night when you do not need them. There are also some debates on color perception and there are patients who have one in each eye and can tell the difference. Younger ones more than older ones.

At 43, you can surely wait. The Tecnis multifocal lens is under study in the US now and is one of the most preferred lenses in Europe at this point. The ReZoom is gaining in popularity as it is an improvement over the Array lens. Spectacle independance has just about doubled from the Array. This is due to a refocus of light at night to distance so the halo effect is minimized. With the Array, surgeons shot for a plus .50 correction to minimize halo. WIth the ReZoom, they are shooting closer to plano since they are not as worried about the halo effect so the near results are much better. There are some other changes which have enhanced performance.

You will get different opinions from many people but that is why you talk to more than one, research it and make your decision. You will find happy and unhappy people with all types of lenses, even monofocal lenses.

Go to www.tecnisiol.com and www.visioninfocus.com for the AMO lenses.

The bottom line is to research it and try to decipher and assimilate all of the informaion which is what you are doing. My father has the Array lenses and loves them. An eye doc in Houston has the Array lenses in his own eyes and so does one in Austin and he is a pilot as well.

Good luck.

[casn]

Had Crystalens surgery in July.  Still not happy.  Have great distance, middle and closeup vision in one eye, but have "fuzz" for distance in the second.  Had laser surgery two months ago to correct the problem.  Didn't help.  Only picked up a "floater".  Will have LASIK in a couple of months.  Two friends have had this procedure.  One uses eye drops constantly due to dryness and wears glasses.  Her vision is slowly improving.  The other friend refuses to have the second eye done since she isn't satisfied with the first.  We had different doctors but were told it might take up to a year to get 20/20.  So far, it isn't worth the money.  We don't work, but would not have been able to hold down jobs after Crystalens.  You don't wake up the next morning with perfect vision.  I'm not sure I'd do it again, but I have two friends that wouldn't.

[eyecu]

You can always look at a lens exchange. Plus, there are more treatments on the market for dry eye such as Restasis. Don't give up as you can search deeper for an answer. lasik can also cause dry eye. Besides drops there is flaxseed oil and another pill you can take. Do not go around being unhappy until you have exhausted your resources.

[Allright22]

I am 51 years old, and quickly developed catarcts in both eyes.  I have worn glasses since a teenager.  I had the ReZoom multifocal implant surgery in my left eye just before Thanksgiving.  The procedure was uneventful, and to my delight I was tested 20/20 the following day.  What a difference!  Since then, I have not been wearing glasses as I wait for my right eye surgery scheduled for early January.  My brain is still 'learning' reading distance with the lense but middle and far distance is just perfect. I experience halos during night driving, but this is very minor.  I wanted to share my positive results with the ReZoom implant, and I can't wait to get the right eye corrected as well.

[eyecu]

The ReZoom results have been very good. It is a second generation multifocal lens. The side effects from the Array which were mainly halos at night have been reduced through a redistribution of light at night plus some other changes. All multifocal lens give you halos or some visual symptoms due to defocused images. Even monofocal lenses can give you halos or edge disturbances. The technology keeps getting better. The ReZoom just has not been advertised as much but your results are becoming more of the norm which is enlightening.