My Cataract Surgery with the Crystalens Trulign Toric IOL

[KayakerNC]

Cataract Surgery
At my annual eye exam June 19, 2014, my optometrist said that new glasses would not help a lot anymore, due to my cataracts.  He recommended an opthamologist who did multiple types of implants, about 30 miles away.
On July 9, 2014 I had my cataract exam.  Lots of tests. Had a nice long discussion with the Doctor about my options.  
Monofocal lenses; set for distance, with a .5 to .75 diopter difference for better reading. Cheapest, fully covered by Medicare and my BCBS insurances. But would probably need glasses for ALL distances because of astigmatism.
Multifocal lenses, Tecnis or AcrySof ReStor.  Premium lens so out-of -pocket costs of around $2000 per eye.  NOT recommended due to many patient complaints.  Astigmatism is the enemy of mutifocals.
Toric lenses, recommended for my astigmatism correction (about 1.5D in each eye).  He does not do torics with traditional surgery because the results are so much better with laser and the Optiwave Refractive Analysis (ORA) System to insure correct placement and power of the lens.  He uses Verifeye, which is the new version of ORA and says it give excellent results. But would probably need glasses for reading and intermediate (computer distance) vision.
Accommodative Toric lenses, Crystalens Trulign. Same as the Torics, but with the probability of   good vision at all distances, including reading.  May need drugstore readers for reading small print or low-light situations, such as menus in a restaurant.  Out of pocket cost of around $2500 per eye.  Laser and ORA are also included in that price.
His 1st recommendation is the Crystalens Trulign, 2nd the single vision torics.

[kingfisherbb]

Hi.  Would you be willing to share the name of your surgeon?  I had an odd experience.  After my appointment with the surgeon, whom I just met, I was again being tested by the same gal that works in the clinic who tested me in the morning (because of previous RK the doctor wanted a mid-day measurement of my eyes) and she asked what lens he had recommended and I told her it was the Trulighn Toric.  She said I should do more research.  She said he is the only physician in the entire clinic of 13 (well known eye center too) that uses those lenses or would put them in me.  I gathered from her that there has been a lot of patient dissatisfaction.    Also, from your research, what at the best lenses over seas?   thanks!

[frank4907]

Thank you.  Your postings are always helpful and I have learned much from them.  Regarding the Toric, I do understand that if it rotates, there would be a need to return for surgery.  I plan to continue learn about the Trulign and Tecnis Toric before I proceed with my surgery.

[KayakerNC]

If an ophthalmologist is recommending a Trulign, he must surely have a model of this IOL and can show you how the hinges work with the eye muscles.  If the ophthalmologist hasn't provided all the information needed for an informed decision, Insurances and Medicare (if applicable) are more than happy to pay for 2nd and 3rd opinions before cataract surgery.   Given your previous surgeries, I'm thinking that a non-accommodating Toric IOL would be easier to target your best vision power and placement.  But, I'm not a professional, so get those 2nd opinions.  As many as you need!
After cataract surgery, cells can build up behind the IOL, causing cloudy vision, sometimes called a secondary cataract, which can be easily fixed with a YAG laser making an opening behind the lens.   My understanding is that B&L thinks it is better to do the YAG sooner, to avoid acoustic shock wave and thermal conduction which can damage an IOL.

[frank4907]

Very glad to hear of your positive outcome and thanks for the informative and well-written diary. I had been considering the Tecnis monofocal for my post RK eyes but a Dr. recently recommended the Trulign.  I understand the Trulign operates on a hinge. I was told that I will be given exercises to do to help me use the Trulign effectively.   I don't really understand how this hinge works nor how long it will continue to work properly.  1. Can you pls share your thoughts about this?  2. What was the purpose of the YAG procedure? Thank you.

[shirdisai]

Thanks!!

[KayakerNC]

A week after the YAG, the halos are pretty much non-existent.  Very faint around some headlights, and getting less and less visible each day (night).  
So..not an issue, not a problem, and I expect them to be totally gone in a few weeks.