Explanting ReStor IOL

[londonbridge]

After going through three months of blurry vision at all distances with my left eye ReStor IOL., I took the advice listed on this forum and submitted an Adverse Medical Report to the FDA. Imagine my surprise to find 50 pages of reports, over 500 of them associated with this lens. Most of them were for my model lens as well. All had similar problems to mine and none were resolved by Yag laser capsulotomy or PRK lasix to fix the power. I understand once they do the Yag it is much more dangerous to explant. Three doctors have confirmed that my capsule does not look blurry and contrary to the typical events, my vision after surgery hasn't changed, verses becomming blury later like most capsule problems. My current doctor recommended a piggy back lens for the power, which he claims is off due to measurement error. This type of procedure is not recommended by the manufacturer of the lens. I sought the opinion of MASS Eye and Ear, a world renowned facility and they said that there were risks in explanting my lens.
So now I am faced with a life of blurry vision that can't be corrected with contacts or glasses. I currently wear a contact in my "good eye", which is -7.5 with a small cataract, a +2.5 in my operated eye to even out my vision so my mid distance isn't half in and half out of focus and reading glasses! My visual handicap was better before the surgery when the only thing I couldn't do was drive at night, which I did any way.
The other alternative appears to be an explant of the left eye, continuing with the right eye wearing a contact. What are the risks of an explant? Would you replace the Restor with a monofocal for far distance and get a far-intermediate contact lens for the right? Acylic verses silicone, which is better?

[londonbridge]

Glad to see you found the thread I started about Restor.
I posted a comment in the expert forum as well.
Like Lerbea, I did notice that the ghosting, double images, contrast sensitivity and large halos and glare were gone once I got rid of the Restor. The quality of vision is much improoved and feels more natural. I am planning to correct any remaining vision with glasses. Since I did not do my dominant eye at all, I need to continue to wear a contact lens in that eye, because I can no longer wear glasses without a contact lens due to the big difference in my two eyes, my original eye still very myopic, -8.0 and my new eye slightly near sighted (my choice).
Good luck. Consider all less invasive procedures carefully. Weigh the possible benefits and whether these will be sufficient to give you the quality and quantity of vision you need and deserve. Be aware of the risks of explanting and find a surgeon who will give you an honset evaluation of whether this is a reasonable option along with any risks. Good luck!

[Lerbea]

To Gina00
I had the dominate eye Restor lens replaced with the AMO astigmatic lens.  Immediately I could tell the ghosting was gone.  I still had misalignment of some images i'd guess to say but with the new glasses it is all cleared up in the new surgery eye.  My left eye still has the Restor in it.  I'm waiting to see if the dominate eye will compensate for this.  

Night driving is out of the question for me. The lights are so bright and I can't judge distance.  Still it's the restor that's giving me problems.  
If I think I can live without having to drive much at night I won't have the other lens replaced.  
I was scared for a few weeks after the replacement exchange but glasses cleared it right up.
If I'd known about the Adverse Reports with the FDA I would not have had the Multifocal used for my eyes.  My old doctor and staff told me there were none.  HA.

My vision in the dominate eye with glasses is almost perfect.

[peakhope]

I'm not a doctor, so you should definitely discuss options with yours, and probably get a second or third opinion as well.

You didn't really describe your symptoms. If your only problem is astigmatism, I would think that you should be able to wear glasses to correct it. If that works, you could get LRI's. They are a quick and relatively painless, low-risk procedure. Or you could wait a few months and get a PRK. Astigmatism could be causing or enhancing other visual effects with your lenses.

Definitely don't let yourself get pushed into a yag. And you should quickly but carefully evaluate all of your options before going with the relatively drastic explantation to switch to another lens. It may or may not be your best choice.

[JodieJ]

I'm sorry to read about your poor results.  In your place, I'd waste no time getting additional opinions from the best cataract/refractive surgeons in town, especially those who are very experienced with multifocal IOLs.  You might try calling the ophthalmology department at a major medical center and requesting an appointment with their senior staff member who specializes in cataract surgery.  If you're considering explanting your IOLs, don't agree to a yag procedure--it will make the explant more difficult and risky.

[Gina00]

I am looking for some advice from someone who has had their multifocal lenses replaced. I have a Restore in my left eye and Rezoom in right. I now have astigmatisms in both eyes I didn't have before and my left is 20/100. I feel like I'm blind, I can't work (I'm an RN) or drive. The sugeon says it's these "finicky lenses", I would like him to try to do his job with this eyesight he's left me with! How did you end up with deciding what to do?

[londonbridge]

Thanks for the update and for not saying anything too. I think it is good that they don't automatically say they can explant anything with no problem. I have talked to other practices who were willing to try anything and I did not choose those practices. I prefer someone to be conservative. Ironically I was also there yesterday at 1:00 for my second post op. I again expressed how sastisfied I was to them. I still have some blurriness due to the medications and some high eye pressure so I have a new medication. I trust Dr. Melki absolutely and I know he would be completely upfront about the risks and benefits. So it sounds good. I will keep you in my thoughts.
My vision seems to be coming in right on the money. I wanted mid distance in my nondominate, former Restor eye and leave my dominant eye for distance, with a contact for now and if needed down the road another monofocal. The blended vision gives me a nice range without glasses so I am happy with my decision. Their measurements and choice of the torric Acrysof lens for me seems to be just right. Once you have a surgeon and a practice you trust it I think it is best to express your preferences and then let them do the choosing.

My best wishes to you. Keep me posted.
londonbridge