3rd Year Update.
My distance vision was 20 - 20, and I had no problems reading the smallest paragraph on the reading chart. My eye pressure was 12 & 13, wonderfully low. They did digital retinal photographs of my eyes this time. First time I have ever seen the inside of my eyes. Wow! Macula in great shape, all the blood vessels looking good, and the optic nerve showing no problems. My surgeon is pleased and my next appointment is in another year.
The Trulign, the toric version of the Crystalens, has turned out to be a winner for my cataract surgery.
I have my first cataract consulation for my right eye with a top local eye surgeon next week. She is experienced in the latest IOLs including Trulign and Symfony, and they have the advanced femtolaser and ORA equipment as well.
Since my right eye has moderate stable glaucoma (VFT shows only affects one quadrant peripheral vision) its important to select an IOL that provides good contrast sensitivity, also I desire a lower risk of poor night vision effects from halos, starbursts, etc. So of course that means I am not interested in the multifocal IOLs. I also put priority on distance and intermediate vision over near/close reading vision, so my goal is glasses free for distance and intermediate (computer, smartphone) vision and reading glasses when needed for closer reading especially of fine print. In the right eye I have -2.75D cylinder, 170degree astigmatism with -0.75D spherical (spectacle plane).
Since many Symfony IOL patients here have reported night vision issues (halos, circles, etc around lights) my top IOL choices are instead: Trulign (toric) or Tecnics Monofocal Toric. The Trulign could give me the distance+intermediate range I desire but due to limited cylinder range models may require in addition LRI/AK, while the Tecnics Toric has higher cylinder models available and probably the highest contrast sensitivity of available IOLs.
I have read articles how for a good refractive result with Crystalens/Trulign IOLs an eye surgeon with lots of experience specifically with these lenses is a must. As well as to reduce the risk of the possibility of its unique "z-syndrome"
Anyone have any good questions I should ask the eye surgeon at my consultation (includes a full dilated exam) next week? I also have a second one scheduled next month with a second eye surgeon at the top eye clinic in my area of San Diego, CA.
When I had my surgery (2014) the Symfony lens wasn't an option stateside.
Hopefully you can find a surgeon experienced in both lenses so you can get recommendations based on actual patient experience, good and bad.
Good luck, and keep posting.
Your experiences with the Trulign Toric IOL over the past couple years is fascinating and your excellent night vision with little or no halos/starbursts is very promising, compared to experiences of some with other newer IOLs.
I'm considering Trulign Toric IOL as well as others (Symfony toric, or monofocal Toric) for my right eye which now has a cataract far enough along that the eye can't be corrected to better than 20/40 or so.
However I have about 2.75D cylinder astigmatism (spectacle plane) in the right eye, so perhaps that is too much for the Trulign to correct sufficiently? The monofocal toric IOLs appear to be available in higher cylinder models (4+) so I may have to go with one of those for my right eye. However in the future, my left eye has 2.50D cylinder astigmatism?
Yes-- I have had a nightmarish 2 years since cataract surgery and the placement of a Truign Toric lens in one eye. Had Lasik 10 yrs prior. Vision has been hazy and blurred off and on (distance, mid) for 2 years (to date). This lens was never going to correct for my near vision and I was prepared to wear reading glasses, but hoped for distance and mid-vision. I've had one PRK and 3 subsequent Yag posterior capsulotomies. My distance vision improved somewhat after each procedure,but significant hazing always returned. This was further complicated by a retinal tear, hemorrhage and resultant floaters (one yr ago).So now 2 specialists are involved trying to figure out if the front or back of my eye or both is causing the haze. Contacts (even the scleral ones)would not correct because of my astigmatism so progressive eyeglasses were prescribed to wear full time. Eyesight has further deteriorated and compromised (heavy hazing) with eyeglasses now not helping. Next step: a risky vitrectomy. I'm now getting 2nd and 3rd opinions, worried that the lens was actually compromised in some way by 5 rounds of lasering! I wish I had been conservative and gone with a standard lens. I cannot drive at night and struggle to read and use computer with my glasses. I'm 59 yrs. old and am pretty distraught at having to live with this result forever. My vision is far worse than with the cataract. Do your research !
Thank you for your sharing your experience with the Trulign Toric lenses.I am nearsighted, farsighted, and have a very bad astigmatism and have worn glasses since I was 10 months old. I am 44 and developed an early onset cataract in my right (dominant) eye at the age of 41. I have been (un)patiently waiting for the progression to meet the insurance requirements. Vision is very cloudy in right eye, and I have now started developing a cataract in my left eye that I told my eye dr. I suspected but he didn't see. I finally went for a consult with a cataract surgeon, thinking I hadn't progressed far enough for insurance to pay I paid out of pocket for the consult only to find out it is well past the requirement and that I do indeed have the left eye cataract as well.
I went to another doctor recommended by my eye dr.( for a retinal blood vessel issue the 1st cataract surgeon suggested I have looked at prior to any surgery) This doctor is also a cataract surgeon, and covered by my insurance as the 1st one is not. I am scheduled for surgery on the 14th and 28th of July, and am going with the Trulign Toric lens. I am really nervous about surgery on my eyes, but super excited to be able to not have to wear contacts and cheaters, or my bifocal thick glasses to see and read. I was wondering if I made the right choice, but after reading your post I think I did. Thanks again.
Somewhere in FL
Congratulations and hopes for a continued recovery!
And yes, the healing process has a big effect on how quickly your vision improves, but you seem to be doing great!
I hope you can keep us informed as you go further with this process.
So far I would say your results are not only good but spectacular. You will not find any large studies on nystagmus because that condition is relatively unusual, is usually associated with poor vision and would be a condition that exempted a person from being part of FDA studies. You might be able to find one or two case reports if your search hard. You might want to discuss once more with the surgeon the choice of IOL power on the second eye. There is a lot of information the surgeon and patient get from the first eye. First is how well the predicted post-op refraction (residual refractive error) agrees with the pre-op predictions based on the formula used. Ideally there is an error of no more than plus/minus 0.25 diopters. Second and very important. What is the distance vision in the operated eye? If the person is wildly happy but would like a little more help with very small print at near sometimes the distance IOL power is reduced to leave the eye a little more myopic. If the opposite is true and the person wants better distance vision uncorrected than the IOL power may be tweeked to leave the eye with no residual refractive error (0.00 refractive error). Better these discussions occur BEFORE the surgery
Oh, I forgot to mention I am scheduled to have the Trulign lens implanted in the left eye on Tuesday, May, 24, 2016.
Re: Trulign IOL in a person with congenital nystagmus
Hi, I am a 44 year old male with relatively mild horizontal congenital nystagmus and astigmatism and I am posting this because I had a difficult time finding information concerning Trulign IOL implants in a person with nystagmus. Since the 3rd grade, I wore glasses and since the 7th grade, I have worn soft contacts, which have corrected my vision fairly well even though I played football and other sports and activities my entire life without many issues, but, contacts have not worked as well recently in terms of comfort and vision clarity. Over the years I frequented America's Best eye care chain for an annual checkup and prescription, but this year I went to an opthamologist for an opinion on other options. After the various tests, I also learned I have cataracts. The doctor told me I was not the best candidate for Lasik (which he performs), or the Visian ICL (which he performs), but that cataract surgery would be the best option for me and the Crystalens Trulign toric IOL would be the only good option for my condition should I choose to have surgery. On Tuesday, May 17, 2016, I had the Trulign Lens implanted in my right eye via the Phacoemulsification process rather than the Femtosecond Laser process and a patch was applied. Surgery was no big deal and I actually talked to the doctor while he did the surgery. I went back to the clinic for a post op the next morning, May 18, 2016, and the patch was removed. I don't know if I was still dilated, but, my near vision wasn't good, my arm's length vision was 20/30, and my distance vision is somewhat blurry, but I don't know what the visual measurement is. Near vision was not expected to be good right away. After the healing process, I will have exercises to perform in order to strengthen the ciliary muscle to take advantage of the accommodating feature of the Trulign lens. More dilating drops were administered which will keep my eye dilated for 7 days. I understand this is for eye healing and lens position purposes. Of course, I have a regimen of eye drops to continue using until my doctor says I can stop. Since I am dilated, I suppose I won't be able to know what the distance vision results are as of yet, and I do have halos around bright lights and some minor star bursts, and I am a little nervous about this, but, I am excited to say that when I wake up in the morning, my night stand clock is almost crystal clear in the right eye. I was severely nearsighted in that eye before and I couldn't even make out what time it was. I have another post op appointment today, May 20, 2016, at 2:25 p.m. and I will post more information as I experience it.
Also Ive already had my left eye done and am not happy having a mono focus lens, will I be okay just having one accomadating lens?
How do I know if I have astigmatism post lasik, is it on the card I got after lasik from the surgeon?
Lasik should not present a problem however most people who have had lasik by an experienced surgeon do not have enough astimatism post lasik to need a toric IOL
Has anyone who has had lasik had experience with the trulign toric lens?
I would absolutely choose the Crystalens Trulign if I had to do it all over again. It is the Cadillac of IOLs available in the USA.
Of course, every wallet is different, but in my case the additional $2250 per eye was not a burden.
And every eye is different, my farsightedness and astigmatism were in the moderate range so YMMV.
Thanks for your posts KayakerNC. I've paddled the Nantahala; nice river. And thanks fort the very helpful posts. If you had to do it all over again would would still choose the Crystalens?
For what its worth I had quite bad astigmatism in both eyes
I can excellent distance and very small print but can identify with what your friend has said regarding menu in a dimly lit restaurant
I think a lot depend on your vision going in. I was moderately far-sighted with moderate astigmatism, and my results were all I could hope for.
I have a friend who had the toric lenses and he only needs glasses for very small print and dimly lit restaurants. So he's happy.
Insurance and Medicare (if applicable) does pay for 2nd and 3rd opinions before surgery, so definitely get appointments with the best professionals you can find.
Good luck and keep us advised on your journey.
Oops, hit post by accident before editing typos. I meant of course that you might reconsider whether to use the doctor you went for the surgery. View talking to another doctor as not merely getting another opinion before using the first, but as part of hunting for a new surgeon to use for the procedure.
It seems rather surprising a doctor would tell you there was no toric accommodating lens, even if they didn't personally use it. Unless it is a misunderstanding and he merely meant that *he* didn't offer a toric accommodating lens in his practice since he doesn't use the Trulign, it would tend to suggest the doctor doesn't keep up with the very basic developments within his old field. If he isn't up on the latest IOLs, I'd be curious what other very basic developments in the field he isn't up to date on. If it were me, if he truly didn't know about the lens, I would consider not merely talking to another doctor as a "second opinion", but reconsider whether to use the doctor you talked to rather than another option.
Of course since you mention accommodating lenses it seems you are aware that even with a toric monofocal you'd likely need glasses for some distances, its only a tiny minority that somehow manage to read with a monofocal lens set for distance. Monovision can provide some more near vision, but there is still a decent chance of needing glasses for near at times.
I've seen some sources suggest that odds may be somewhere around 50-50 that you'll still need reading glasses with any version of the Crystalens, but I don't have a study offhand. Even though most people get a benefit from the Crystalens, there are some where it doesn't seem to provide accommodation, i.e. it winds up being closer to a monofocal, which is why I considered other options instead. The other premium lenses available in the US are multifocals which can provide better near (and/or better intermediate) than a monofocal but have a higher risk of glare or halo issues than a monofocal or the Crystalens. (I chose to go outside the US for the newer Symfony lens which is a new type of lens, but I assume like most people you aren't considering that option).