Crystalens - red colors now pink

[marjoryb98]

I've been searching for comments on the Crystalens, since I've had one since Dec. 2007.  In general I'm pleased with it - my doctor gave me a thorough explanation of what to expect as far as vision was concerned.  I have excellent intermediate vision, and near vision is usually good - certainly better than before.  I only use readers for closer work, smaller print, and lower light conditions - not perfect, but I don't wear glasses around my neck all the time any more.

My concern is the distortion of some colors, particularly red, that I am experiencing.  It is mostly red fabrics  - things that I know are red now appear to be a shade of fuschia, magenta or hot pink.  I did find one post here mentioning it, from 10/1/07 by Rhawk250, but nothing more anywhere online so far.  As they said, some blacks are grey, and I also find some dark green items (soft side luggage) to appear very drab and colorless.  So far my doctor has sort of brushed this off, but I want to know how common it is before it's time to have my other eye done.

I'm interested in hearing if others are finding this happening, and whether they have learned to live with it.  Thanks



This discussion is related to Disappointing cataract surgery .

[SoftwareDeveloper]

Yup, especially since some IOLs go the other way and block blue light into the visible range, which some maintain can influence color perception despite attempts to claim otherwise by some. The controversy has been going on for a while, here is an article by a prominent professor/surgeon back in 2004:

http://www.eyeworld.org/article.php?sid=2123&strict=&morphologic=&query=ophthalmology
"Perspectives in Lens and IOL Surgery Blue-blocking IOL benefits based on fallacies, not fact...

Although blue-blocking lenses do not affect the perception of other colors besides blue, the blue itself cannot be perceived normally. You cannot tell a navy from a black suit. The light blue sky turns green. ...

blocking IOL are comparing this to the vision with their cataract, not the normal 20-year-old crystalline lens. As the lens ages, it yellows. So when they compare their vision through a yellowed lens before surgery to a yellowed artificial lens after surgery, they see no significant difference. What they don't realize is that their vision would be markedly different through a clear lens, similar to looking through yellow sunglasses that block at 450 nm."

http://www.ncbi.nlm.nih.gov/pubmed/18471631
"Two patients independently reported subjective changes in color perception in the eye with the yellow IOL."

Various studies seem to show tests don't indicate a difference in color perception, but then also add that patients implanted with 1 blue blocking lens and one that didn't reported a subjective difference. It could be the tests aren't well designed given subjective reports differing from measurements. I hadn't checked into the issue in detail,  it could be that its only a small percentage that see more than a subtle difference so the studies usually miss it.

[achillea]

Wow, that's *really* interesting!  

For the small percentage of people who are extremely color discriminating (artists and craftspeople), this color shift could be very important.

Something else to think about when considering a lens implant...

[SoftwareDeveloper]

This article by a surgeon (& UCLA professor) discusses the color-shift issue:

http://crstodayeurope.com/2011/09/blue-violet-subjective-color-changes-after-crystalens-implantation
"Blue-Violet Subjective Color Changes After Crystalens Implantation
Why does tree bark have a purple tinge? Why do my black socks look deep navy blue? If you listen carefully to patients who have had the Crystalens accommodating lens (Bausch + Lomb, Rochester, New York) implanted, you will likely find a small percentage of patients who ask these types of questions....
I continue to counsel patients about the risk of changes in color perception with this lens, and I continue to have patients who report these symptoms. Within the past month, an artist who received a Crystalens AO noted that a cotton weave red sweater that had previously matched a pair of red wool pants appeared more pink/violet than preoperatively; another patient stated that a previously color-matched black cotton-weave jacket and black polished cotton pants no longer appeared to match, with the pants appearing deep navy and the jacket black. My experience has been that 3% of patients implanted with any generation of the Crystalens IOL experience this subjectively abnormal color perception. I was unable to identify other similar characteristics among these patients, although there was a tendency for them to be more discriminating about color in their day-to-day lives. Two patients showed better-than-average color discrimination with FM-100 testing.

All implant lenses have some degree of ultraviolet (UV) block, and the Crystalens has less than most (to about 355 nm). My initial theory that the level of UV block was the cause of the symptoms led me to offer a lens exchange or a piggyback option to resolve the symptoms. A blueblocking IOL relieved the color symptoms in all patients in whom this option was elected. "

A comment posted on an article about the UV visible with the Crystalens  mentions that the commenter's lens has less UV than the Crystlans but it still appears to change colors:

http://www.extremetech.com/computing/118557-the-eyes-have-it-seeing-ultraviolet-exploring-color
"I  checked in the manufacturers website and my lens transmits some light below 400nm down to 375nm. So yes is am seeing a small part of the ultra violet.

More annoyingly are some fabrics which must contain some type of dyes that look really different colours to my two eyes. Mostly a pinky type hue in the new eye and a more natural brown in my left for example."

This page shows a transmittance curve for wavelengths of light for the Crystalens compared to a natural 53 year old lens:

http://www.dpreview.com/forums/post/39500867

Checking the manufacturer's website for the lens I have:
http://www.tecnisiol.com/eu/tecnis-symfony-iol/files/symfony-dfu.pdf
it appears the Symfony and therefore I suspect other Tecnis lenses (since they use the same material) blocks UV below about 375-380 nm (depending on lens power/thickness), and they give a light transmittance curve for a "53 year-old phakic eye" (i.e. someone with a natural lens) which shows the natural lens blocks almost all below 400nm. It looks like it isn't until perhaps 410nm or so (quick guess from  a graph) that even 10% gets through and perhaps 450nm before 50% gets through.

[SoftwareDeveloper]

Someone I know here with the Crystalens did some testing about his ability to see some in the UV spectrum. He has a page describing his surgery and Crystalens experience in general where he has some comments on the issue, including images simulating part of what he sees, search on it for ultraviolet or UV. He notes for instance:

http://www.komar.org/faq/colorado-cataract-surgery-crystalens/
"There's more pictures/analysis on the Ultra Violet page but in summary, I was able to see down to 340/350nm ... whereas similar aged people cut-out between 410-430nm. So this seems to conclusively prove that I'm able to see into the Ultraviolet spectrum."

He created a separate page where he goes into the issue in detail with more simulated images and results from lab testing:

http://www.komar.org/faq/colorado-cataract-surgery-crystalens/ultra-violet-color-glow/
"Ultra Violet Color Glow after Cataract Surgery with Crystalens
Numerous people who have also had their natural lens removed have written me saying they see similar to what I describe below."

Some IOLs block UV and even blue light, others block part of the UV spectrum. The Symfony blocks some UV but not all, I hadn't checked to see whether its possible to see any effects from the parts it doesn't block.

[Anomalychick]

Crystalens has higher UV transmissability than the natural lens. I believe you can see an extra 100 nm of light wavelengths. I found some guy online who did a lot of testing with his own vision, and determined that if he looked at a rainbow, he actually saw a wider field and shift of colors than people who had not had cataract surgery. In WW2 they used people who were aphakic (no lens) to recieve messages by shining a light in a wavelength that they could see but normal peple couldnt.  If you are sensitive to colors (some people are more than others) you will notice a difference. Its not because you are missing colors that are there, its because you can see extra wavelengths of blue light, which will shift the spectrum somewhat. I've noticed that two objects that used to appear the same color, now look like two similiar but different colors. They were always different colors, I just couldn't see it before.

[janets25]

I had one eye done and when I look through that eye everything looks fuschia

Did you ever have your other eye done? If so what has happened with the color change.  It is rather disconcerting because I am not sure what the color really is.  

[John C Hagan III, MD, FACS, FAAO]

Optical abberations from the Crystalens could cause desaturation of colors oryou could have a different problem like macular disease.

If the former problem glasses over the crystalens should help. Optic nerve disease also can affect color vision. Why not get a second opinon from another eye MD.

JCH MD