Crystelens in right eye, Restor in the left

[ace399]

I have a Crystalens in my right eye and after 1 week, I could not read the close up eye chart.  My Dr. recommends a Restor lens for my left eye.  My right eye is NOT the dominant eye.  Also, my Dr. says that I will need a laser procedure to clear the right eye, which is starting cloud.

1.  How do you know that the eye muscles just aren't working?  How long do you use the eye exercises (word games) to begin noticing an improvement?

2.  What are the negatives about Crystalens in one eye and Restor in the other?  My Dr. says you will see rings around headlights at night with the Restor.  Except for not seeing the computer screen or reading, the Crystalens is perfect.


rystalens in my left eye and exercise my eyes to try an achieve some close up vision?

[ace399]

Thanks for replying.

According to the card I believe I have a Crystalens HD450 (or is it HD550?).  It's at home and I'm at work, so can't check.

It was implanted 1/20/09.  I can see objects clearly starting about 2-1/2 feet away, just can't read the words on magazine or books or small words on a monitor at that distance.

My far vision is good, but not as good as the left eye (no surgery yet) and eye glasses.  They measured my right vision 20/30, but far objects are not that sharp.  My vision in the house, acorss the table, TV, etc. is excellent.  In the car, I can read almost all of the words on the dash board (stereo, heater, etc.), except for the very small words.

After being myopic my whole life (I'm 62) and being able to read close up without glasses, I feel that another Crystalens in the left eye will leave me with no near vision at all, unless I use reading glasses.  The Crystalens / Restor combo seems like a good compromise.  My Dr. says that his patients that have both have mentioned the halos around headlights, but they don't complain about them and that over time they get used to it.  Anyway, I've postponed my left eye syrgery to get a 2nd opinion tomorrow.

[peakhope]

How long ago was your right eye done? Was it an HD? Before taking any serious action (like Lasik or yag) I would get a second opinion.

Vision at 3 feet is about 1D, which would mean that if your eye is at plano (worth testing), you are only getting 1D of accommodation. I believe that would be at the poor end of normal for an older Crystalens, and surprisingly poor for an HD.

If you are in the mood to self-diagnose, you could borrow a pair of +1 readers and see what happens to your vision at 20 feet, 6 feet, 3 feet, and 18 inches.

I think I read that people do get a small amount of accommodation with a monofocal lens...up to about 1D, I think. In that case, it is possible that you have ended up with essentially a monofocal lens. However, I'm not sure you should give up on your near vision yet, depending on how long it has been since your surgery.

Before you choose Crystalens or something else for your left eye, you should understand what has happened with your right eye.

[ace399]

The distance vision in my right eye is good up to about 3 feet and it is not as sharp as my left eye with glasses.  My Dr. says that this can be corrected with the Yag and maybe Lasik

I took the astigmatism test and there are some lines that seem darker than the others, but well distributed around the circle and they are all straight.

If my near vision with the Crystalens does not improve, does it mean that essentially I've got a fixed focal point lens?  If this is true, why should I implant another Crystalens in my left eye?

[Ray T Oyakawa, MD]

Some points:

1) Unusual for the need of a yag for vision this early.  It does happen occasionally.

2)  Yag will usually make you less near sighted.  It will make your near vision worse if your distance vision is good.  It sounds like you are slightly farsighted--good distance(?) and no near.  This eyes should be rechecked with a cycloplegic refraction.  

3)  I would not have surgery in the left eye until the problem with the right is determined.

[JodieJ]

I'm not an eye care professional, but I've read reports about people who had difficulty using both eyes together with different IOLs in each eye.  In your place, I'd probably choose another Crystalens HD.

[peakhope]

I assume the laser procedure is a "yag" capsulectomy. Beware that after you do that, it would be much more difficult to remove that IOL to replace it with another. It sounds like you are only disappointed (so far) with the Cyrstalens, rather than hating it and wanting to replace it with something else. So it probably won't be an issue for you. But a yag is a significant irreversible procedure, so don't rush into it.

If you can wait a few more weeks before having your  left eye done, I would recommend it. Give your right eye a chance to settle in. Did you get a Crystalens Five-0 or the newer HD model? How clear is your vision at specific distances (1 foot, 2 feet, 3 feet)? Do you have any astigmatism that might be preventing clear vision? (There is a simple online test here: http://www.acuvue.com/thinking-whocanwear-test.htm)

Many people with Restor lenses are happy, but some have been so unhappy that they have been willing to undergo a tricky explant/exchange procedure. The glare/halos/starbursts can range from a minor irritation to a huge problem. I'm not sure there is any way to predict what your experience would be.

If you drive at night, you might have to close the Restor eye, and/or take medicated drops to keep your pupil smaller to reduce the effects.