RsStor vs Resume IOLs

[toubledeciding]

Faced wtih question of Restor or resume.   How can I compare the two, to help me decide?  Is there a web site with a comparison chart?   Thanks

[Eagle eyes]

I definitely recommend ReZoom over ReSTOR for your second eye based upon your activities. Intermediate (computer) is important to you and certainly for tennis ReZoom will give you much better distance vision than ReSTOR. Let us know!

[Bill in JAX]

I agree with your doctor and you should carefully consider his advise and recommendations. I am having my second ReZoom done tomorrow in my R/E after considering all the options in consultation with my surgeon.  Also, remember that you just had mircosurgery in you eye several days ago where they cut the side of the cornea, stuck a surgical instrument in the side of your eye, blasted the cataract away with ultrasound, irrigated the sac, sucked out all the remains of the cataract, inserted a folded lens, centered it and patched you up.  In addition, I'm sure you surgeon has you on various meds such as for pain, swelling and other things associated with cataract surgery. All of these meds also affect your close and intermediate vision. Your eye(s) will take a period of time to heal, recover and adjust.  Following is an excerpt from the ReZoom brochure."

" Q: Does the ReZoom Multifocal lens require and adjustment period?
  A:  Yes. For most people there is a period of weeks when you brain is learning to "see" up close and at a distance with the new lens. The adjustment period is usually complete within 6 to 12 weeks,  Also, like all multifocal lenses, some people report halos or glare around lights.  Again, for most people this diminishes over time.  For some, it becomes less troublesome but never completely go away.  Most people report that the ability to see near and far outweighs any and visual side effects associated with the lens."

Give it some time philz and I'm sure things will work out. I'm also your age and play golf, tennis and want the best vision possible at my station in life.  Will let all know how the next surgery goes by the end of the week.

[philz]

This is an interesting dialog as I had the Rezoom IOL installed in my left, non-dominant eye only three days ago and am scheduled to have the other eye done with a Rezoom lens in 11 days.  I see very well to drive and am typing this without reading glasses.  But I am a 64 year old high myope person in both eyes (-9 diopters left and - 10 right), and I am using a contact lens in my right eye for distance. With both I am able to read the computer screen and newspaper without reading glasses.  But if I shut my right eye, the screen blurs for a while before the eye focuses enough to read but not sharply.  This is bothersome to me and a concern.

So I am still open as to how well my left eye Rezoom is working near and intermediate because of this.  The doctor in my post-op exam 2 days ago said to give it a few days to adjust and I am.  The idea of having a Restor lens in my right eye to improve near vision is intriguing, but it seems distance suffers.  I play a lot of tennis and do a lot of hiking where I want good distance vision, and as a monovision contact lens user, I know that does not work for tennis.  So unless I hear differently, I sense that another Rezoom lens in my dominant eye, as recommended by my doctor for high myopes like me, is right.  Agree or disagree?  Stay with Rezoom on Feb. 24 or not?

[Jenta]

Wow, this is such an interesting thread.  I have Crystalens in both eyes since end of last year.  Although I have developed floaters in one eye which blur my vision alot, my distance and intermediate vision is very good.  Reading is coming along ok when the floater floats out of view.  

I can really identify with the person who mentioned the intense colors.  I also am amazed at the bright white!  I thought the entire world was sepia colored! I really had no idea that the cataract had "yellowed" my vision so much.

[bjbinfl]

Update:  My distance vision still has not shown much improvement, (but only three days).  However, my eyes are really working well together with the left Rezoom and the right Restor.  The only way I can tell that the right eye does not see distance is when I shut the left eye, otherwise, I can see distance just fine as if I were using both eyes to see.  I can see well at all distances.  I only require glasses if I want to do close intense work like sewing.  BB

I just wonder how this compares to monovision.  Anyone know?

[Bill in JAX]

Thanks for in-depth explanation posted on 2/10/06 of the various options now available.  I asked my surgeon about a ReZoom/Restor combo in my case after doing other research and and reading recent threads.  He recommended based on my lifestyle and station in life that I stay with a ReZoom/ReZoom.  He offers all three of the IOLs as options to his patients but likes the results of the ReZooms for us mature folk that are 60+. Overall, I got the impression he favors the ReZoom over ReStor. My first ReZoom in L/E was done on 1/25/2006 and my vision continues to improve at intermediate and close.  Distance vision is spectacular with clarity and color I haven't experienced in years.  The IOL was a ReZoom Model NXG1, Diopter 19.5D, SN 4109700512.  I am scheduled for surgery on the R/E (My Dominate) on 2/15/2006 where a ReZoom Diopter 19.0 will take the place of an old cloudy cataract.  Will let all know how things are going by the end of the week.

[bjbinfl]

the chart that the doctors use for reading has those numbers...J1 is the standard for normal reading.  I will keep you updated..bb

[paulb]

PS... sorry to be slow on the vocabulary, but what exactly is J1 and J2 ???

[paulb]

BB
Glad to hear your operation was a success and you're pleased with the R/R combo!!  Sounds like you are having NO problem with the "brain control" of complimentary focusing from near to intermediate (left to right eye or right to left eye).   I'm thinking of Rezoom in the Dom eye and Restore in the NonDom eye, and my ability to accomodate the "switching" at near and intermediate is the big fear.  Your results are giving me more faith / courage!!  Let us know how you're progressing!  PB

[bjbinfl]

It has been less than 24 hours since my surgery.  I had a check at the Doctor's office this morning.  With the Rezoom in the left eye I have 20/15 (brightly colored vision) and with the newly implanted Restor in my right eye, I can read J2 with the right eye alone and J1 with both eyes working together.  If I shut my left eye and look off in the distance, my vision is not that great with the right eye Restor but with both eyes open, I have no problem. I am using the computer with my flat screen monitor about two feet away and I can see the small writing with both eyes working togehter or seperately.  My Doctor feels that the Restor distance vision will improve over time but will never be as good as the eye with the Rezoom.  I am amazed that I can see close so well so fast because of the Restor.  I am curious and I ask the Doctors on this thread, how is the intermediate (1-2) feet vision with a regular lens implant?  

I would never want to give up the crisp wonderful distance vision I have with the Rezoom.  So far, I believe that I have made the right choice.  BB

[eyecu]

paulb-it looks like bjbnfl is going to give you a first hand experience on the combo.There are two theories. Put the same lens in both eyes for a stereo effect. The other theory is that if you put a lens in an eye and the patient complains of halos than if you put another one in it compounds that effect. If you put two different systems in than it offsets and you don't have the problems.One well respected surgeon says to implant the Rezoom in the first eye, if the patient likes it implant it in the second eye, if he has halos than implant a Tecnis monofocal in the second eye, if he wants better near implant a Restor. There are just so many opinions. I know a few surgeons that have Arrays themselves and they implanted alot of Array lens because they could explain and relate to the patient. But most surgeons have to go by results and listening to what patients tell them and describe to them as this board does to form opinions. It is exciting yet confusing. This is what I will say, the ReZoom is great for distance and intermediate. It can also provide good near vision. Not as good as the ReStor maybe because it has a 3.5 diopter add and the Restor a 4 diopter add. You have trade offs in life. If you want to read better, than you give up some distance acuity. The Crystalens had great distance but you give up near. Technology is advancing to try to mimic the crystalline lens and will get better. But the technology today is excellent and has brought youth back to many people. With a monofocal lens, the outcome is presbyopia. YOu will love the colors and be happier and have great distance and even some intermediate and will notice a great improvement over your vision with a cataract as you have had a gradual deterioration of vision over time until it gets to a point that it bothers you. When you have surgery, the vision is so much better you wonder why you waited so long. The retrospective quality of life studies report that patients are happier with multifocal lenses because they mimic normal vision. They are willing to deal with a few visual disturbances such as halo that diminish over time as you adjust. These are really only at night as the pupil enlarges and have to do with ligthing conditions.But they say, hey I can deal with that for what I get during the day. There are some patients who cannot seem to deal with it but it is a low percentage. They end up with lens exchange. But there are even patients who once they have had the exchange want to go back to the multifocal. It is up to the surgeon to explain and deal with that and that is why it costs more becaase they have to spend more time with you both  pre-op and post-op. It comes down to patient education prior to surgery which puts you ahead of the game because you are trying to get the answers now instead of jumping into it. I personally would opt for a multifocal lens becuase I want to have pseudo accomodating vision like when I was in my 30's and have a chance not to have to wear readers if I forgot to bring them to the restaurant. I want the freedom. But, if I was used to wearing glasses all my life, then that would not be the case. SO you can see all of the factors involved in the decision. The surgeons that have used the Array and do lasik and are refractive surgeons have more experience than the ones that just came on board. They are ahead of the game. They also might be hesitant to jump on ReZoom because they think it is about the same as Array so they try something else for a while and then realize that it is not perfect as well and then try ReZoom and find out that it is better than they thought. They then try mixing technologies and find out that works pretty good as well. The bottom line is what are you looking for, what is your occcupation and hobbies and what are you trying to obtain. If you both go in with a postive outlook and try to achieve that outcome to meet your needs, and he or she hits the refractive goals and accuracy, you will be very happy. Sorry for being so verbose. I feel you are just lucky to have more options today to find what you want.

[bjbinfl]

Not Dr. S in Jax...I had surgery today.  My eyes are still dialated, so I cannot report anything right now.  Surgery went well though...more later.  bb

[paulb]

PS... I'm definately going to call the surgeon tomorrow for a list of people who have done the R/R combo!  Thanks

[paulb]

Thanks for the thoughts.... so if I understand, to get the Rezoom done first, I would have to do that in the Dominent eye. Then If I'm ok with the reading, I could do the NonDom with Rezoom, and if I wanted a better Reader, I could try the Restore?  After reading several boards, I'm "put off" a little by the Restore anecdotal stories... the mid range blurring and an occasional report of "wax film" at distance worry me, and the nightime halos are a major fear for me, since at 50 I still do quite a bit of nite driving.

But I haven't read anything pro or con about the binocular adjustment problems of using Rezoom and Restore... seriously, would that be an easy adjustment??  With Restore being Strong at 12" and not so good at 24, and vice versa for Rezoom, am I setting myself up for Frustration or should this be easy as blinking?

[Bill in JAX]

To bjbinfl - Just curious to know if your surgeon is Dr S in JAX. Just learned today when I had my final meaurements for a ReZoom that he was preforming his first ReZoom/Restor combo tomorrow.

[bjbinfl]

I will definitely let all know how the two lenses work together.  If this board is full, I will post under a new topic that will be something like: restor in one eye and rezoom in the other. BTW eyecu....thanks for the post.  I already had the rezoom implant in my left eye and was supposed to have another rezoom in my right eye.  Since I did not like my close vision with the rezoom I suggested to my doctor that he do the combo.  My brain seems to adjust to either eye for distance and/or reading.  He is an excellent surgeon....with excellent credentials and about 15000 cataract surgeries performed...(we get a lot of those here in Florida).  I will be his first patient to do a combo, he told me that immediately.  I know he would not do this if he did not feel he could or should do it.  He knows me and he implants both rezoom and restor lenses...just never on the same patient.  I have total confidence in him and he has worked with me on this whole thing all the way since day 1.  More Friday or Saturday...bb

[eyecu]

paulb-There are quite a few surgeons using the combo approach of all three lenses. They are saying that they are getting very good results.  The Rezoom in the dominant eye is the what most recommend for good distance and intermediate and the restor for reading in the non dominant. The ReZoom allows for better distance acuity, reading in low light and intermediate. The Restor for reading in bright light so you have pupil size coming into play depending on lighting to give you the benefits of both lenses. You will find happy patients with all scenarios. I would quiz the surgeon who is recommending the combo and find out how many he has done and see if you can speak with some of his patients that have had this done. The ReZoom does have 20/20, J1 plus for reading in some patients. Some think you should go ahead and have the ReZoom implanted and if you are happy for all distances and not bothered much by halo than have the other nondominant eye implanted with it and you will be fine. If you are not happy with the reading, then get the ReStor in the other eye. What is nice, is the options are available and it sounds like the one surgeon is trying to listen to you and meet your needs. That is what is most important. Trying to meet your needs.

[paulb]

Hope your procedure goes well!  Keep us posted.  Anyone else have thoughts / experience about the "2-brand" Plan?

[nursept]

I am very interested in your experience w/ 2 different lenses in each eye.  Thanks for posting.

[bjbinfl]

Paul, I do not have trouble seeing at night with my rezoom lens.  The hallow effect is very mild in my case.  I do have trouble with my intermediate vision and it has been three weeks, but my distance vision is so very good as well as the wonderful color that I do not mind.  I will be getting the Restor lens in my right eye on Th.  I will let you (and others) know how it goes.  I am really hoping that the Restor will provide the good close vision that my right eye currently gives me.  What the right eye is missing (due to the cataract) is good distance vision and colors look like they are tinted yellow.  BB

[paulb]

Would appreciate some inputs from all, including Dr. John and eyecu on my dilemma:  I've seen two very good surgeons in the Dallas area and they are recommending very different plans. Dr C is recommending the Crystalens in each eye, with a "tweak" to the non dominent eye to possibly improve a vision a little closer (not a mono vision gradient, just a tweak).  Dr T is recommending Restor in Non Dom eye, and Rezoom in Dominent eye.
I had very thorough exams at both places and feel comfortable with both guys, both said I was an excellant candidate.  I was careful to give the same visual activities and desires to both: 50 years old, active driver including night driving, I work at monitor and read most of the day. Definately "NEED" Intermediate and Distant vision for hobbies, would "Like to" get out of Glasses for Reading and closeup hobby work, but willing to concede that with 50 year old eyes, "readers" may be my destiny, and I'm ok with that.  Noticed a couple of other "threaders" had received similar info on the "different lens in each eye" plan, and was wanting feedback on that.  I think the reason DR T recommended the Rezoom in the Dominent eye was that I Needed the Intermediate on that side for sharp focusing on indoor work and outdoor hobbies that need "arms length" sharp focus.  My concerns:  1) Nite driving - neither one of the "R" lenses seem to be rated as good as crystalens for night driving... just how often do halos really cause a problem, and is it predictable by looking at my presurgical eye exams?  2) How well does the mixing of the "R" lenses work?  I understand the binocular concept, but how difficult is it in practice?  With the Rezoom strong on Midrange and weak on Near, and with the Restore Strong on Near and weak on Midrange, it would seem to be a perfect setup, if my head doesn't explode from trying to focus back and forth!!!  Any Ideas, Thoughts, Experience??  Thanks!

[Bill in JAX]

Hi All.  Had the same dilemma recently in trying to decide between the Rezoom and Restor.  I am 63 and was diagnosed several years ago with cataracts in both eyes and surgery was only a matter of time.  Well the time came in January of 2006.  I had two highly qualified surgeons here in JAX to consider, a DR. S and Dr. C. Dr. C only offered the Crystalens and Restor and Dr. S offered all three, the Crystalens, Restor and Rezoom.  I elected to go with Dr. S who had a great deal of experience and about 30K procedures behind him.  After a through evaluation he recommended the Rezoom based upon my eye condition and lifestyle.  After cataract removal on 1/25/2006, a ReZoom IOL was implanted in left eye.  After surgery, I had some problems with a cornea abrasion and some swelling.  Dr. S took care of the problem promptly with a contact lens cover for a couple of days and appropriate amounts of Cosopt, Nevanac, Pred Forte and Muro 128.  A couple days later, Walla, a miracle, a sight to behold like an eagle to infinity.  Everything out of left eye is clear and the color is so vivid I still hardly believe it.  Intermed vision is excellent and I'm still adjusting to near vision.   Estimated are 6 to 12 weeks for the adjustment period of the IOLs. I now estimate that my vision had deteriorated about 30 percent with the cataracts.  It was like looking at the world through yellow wax paper.  My next surgery is scheduled for 2/15/2006.  I am looking forward to a bright future with my new Rezooms.

[nursept]

Eyecu:  Thank you for your response.  Is there any way a non-physician can find out what the studies at your annual meeting are purporting?  I scheduled surg for the end of March but maybe I can postpone it a few weeks into April until I have more information from that meeting.

[eyecu]

Your surgeon does not use the Array because it is no longer available except for second eyes. In medical devices you can make changes or modifcations without having to go through clinicals. I believe it is called a Tier B. The Array labeling has to be used for the ReZoom due to modification so that would tecnically be a downside. The bottom line is that the ReZoom works and gives you the intermediate and distance, as well as improved near. Surgeons shot for a little hyperopic result with the Array to cut down on halos. With the redistribution of light at night which cuts down on the halo effect with the ReZoom, they can now shoot for plano and the near vision results are better. I think you will hear this from most patients on this board. Your surgeon will probably come around. Everyone likes something new and jumps on the new technology. The Array was yesterdays news and he is probably more hesitant to go to ReZoom because he is basing it on Array. He will find out as others that ReZoom is way better than Array and I think that a Dr. John on this board addresses that as well. You can also get caught up in clinicals. The only way to tell is that if both lenses were studied under the exact conditions and they were not. Plus, the Array clincials were over 7-10 years ago and the surgical procedures have improved as well as the technology to measure the eye and correct astigmatism. If you check near vision with a back lighted card with the ReStor it will perform better than the ReZoom. If you check it in lower light it is vice versa. Surgeons are compiling their data now and there will be a lot more released toward the end of March after the American Society of Cataract and Refrative Surgeons meeting this year where they all present their own studies. I also believe that Dr. John mentioned with the ReZoom, 93% are spectical independent for both distance and intermediate and 81% for near. This is published data. Intermediate vision is meal time(serving, eating), computer use, wristwatch, dashboard gauges and cell phone(caller ID, dialing). I think most surgeons agree it is best for distance and intermediate and the ReStor for near with its higher add power. There is a web site from a Dr. Harvard which has a really neat chart on it that shows the pros and cons of all three lenses which might help.