Crystalens replacement

[LynnVet11]

If I had Crystalens inserted 10 months ago and have had a YAG procedure...is it too risky at this point to have it replaced ?  I've had double vision since day one up close and intermediate and two specialists (I'm headed to a third) can't seem to give me an explanation.

[LynnVet11]

I'm glad you reposted on the wrong forum as I am having the same problem with Crystalens.  Vision is worse, had Yag and am also out of pocket for a lens that now requires stronger glasses than before.  All I can do now is let people know and hopefully spare someone else from making the same mistake. I contacted Baush and Lomb Customer service and have told them of my issue.  Just go to their website.  Its easy and if nothing else, they will know I'm not the only one wiht a problem.   Best of luck to you !!!  

[tnhelen]

I apologize for posting this in the wrong area.  I reposted in the main forum and will try to delete this if possible.

[tnhelen]

I had cataract surgery 15 months ago with crystalens replacements.  My vision has been a form of monovision ever since.  The left eye reads close and the right eye reads distance.  Neither eye is 'stellar' at either.  Therefore, I have trouble seeing road signs until I get right up on them so night driving is a nightmare than I cannot attempt anymore..  I have had two Yags in my right eye and one in my left.  

I complained about this throughout my followup period but I was told it would get better and since I had RK surgery 25 years previously it would take me longer to see well.  Not happening.  I know my vision won't be like it was when I was 20 but I was hoping the crystalens would give me the vision I had with my glasses.  My question is can I be fitted with glasses so I can drive without worrying?  I am out of pocket over $10,000 for these lens which seems quite expensive.  Is it unreasonable to ask for some of my money back?  Thank you.

[LynnVet11]

  Unfortunately, I was told by a Retina Specialist that he would not recommend Lasik for me. Numerous tests and specialists have given me no positive results.   I'm so discouraged at this point and resigned that I'll have to live with double vision.  All I can do now is to hopefully keep others from making the same mistake that I did in their choice of lens.

Thank you for your time and response.

[Timothy D McGarity, M.D.]

PRK is photorefractive keratectomy...it's very similar to LASIK...same laser, just no flap. I good test to see if PRK or even iLASIK would be helpful, would be to have a trial gas perm contact fit. This is not easy to do (extra visits), but if the gas perm lens helps improve your vision, then PRK or iLASIK may help, too, though it's difficult to beat the quality of a gas perm lens (just inconvenient).
Best wishes,
Timothy D. McGarity, Medical Doctor, Ophthalmologist

[LynnVet11]

A recent visit to see a Cornea Specialist resulted in him reporting that he is not sure what is causing the moncular diplopia.  The IOL doesn't seem to be off kilter, endotheial cell count is normal with rare guttata in both eyes and topography is more regular in the eye (R) with the lens.  He does NOT recommend replacement but staying with glasses or considering PRK of refraction proves to be stable.  Could you please tell me what PRK is ?  

[William Goldstein, MD]

I agree with Dr. McGarity's comments thus far.
Double vision after any lens implant surgery is most often caused by astigmatism, less often by lens tilt. Dry eye can also cause some shadowing or doubling in the vision. Restasis is a long-term treatment for dry eye that may be helpful.

If astigmatism is present, without lens tilt, then other surgeries, such as Astigmatic Keratotomy will reduce it and improve your doubling. The YAG procedure that Dr. McGarity mentioned is very successful for lens tilt, if the surgeon knows the right way to apply it.

Your first step needs to be finding out WHY you have the double vision. Then the treatment can be determined.

Good Luck!

[LynnVet11]

I do have an astigmatism and dry eye.  I have had 2 sets of permenant lower plugs and 3 month temporary upper plugs.  It's not really helping much.  Has not made any difference in the double vision.  Is there another option for helping dry eye ?  Your information has been most helpful.  

Thank you again for your help

[Timothy D McGarity, M.D.]

The best way to tell is:
1. Detailed refraction. This will reveal either induced nearsightedness and/or astigmatism opposite the tilt
2. Full, Dilated Examination: having the pupil fully dilated will allow the surgeon to "see" the CL even better. After dilation, further testing such as anterior segment OCT, photos, or UBM may be performed, though not all ophthalmologists own this equipment.
I wish you the best,

Sincerely,
Timothy D. McGarity, M.D.

[LynnVet11]

Do you know what test could be performed to determine if the lens is tilted ?  My surgeon has mentioned that he could go back in and reposition the lens...though has never done this.  I am seeing a cornea specialist in another week  and would like to find out if this is the problem.  Thank you for your help.

[Timothy D McGarity, M.D.]

Yag capsulotomy will make it more complicated, though not impossible. Please ask the specialists if the CrystaLens (CL) is tilted or if there is any type of "Z syndrome." If any of these issues are occurring with the CL, then replacement may be a good option. Sometimes a YAG procedure is recommended to "relieve" these symptoms, but I've heard reports where this doesn't work. I wish you the best.

Sincerely,
Timothy D. McGarity, Medical Doctor, Ophthalmologist