ReZoom versus Monofocal for myopic -6.50,

[zedhawaii]

I was sing told that I cannot legally drive at night with 20/50, 20/60. I have been using Soflens Multi-focal -6.50 Add Low and High for a few years.   No vision problem during the day, seeing halos and one thunder spoke through the halos at night driving.   I am scheduled to have my surgery on April 2, 2008 for my dominate left eye with reZoom, second surgery is scheduled for April 30, 2008.   I am still ambigious about my choice to go with the surgery and using reZoom.  Hope you can help.    Much Mahalo.

[cdn_glenn]

So many thoughts come to mind when you describe your needs.  Just to review, and please correct me if I've misinterpreted:

1) this is to correct for longterm vision issues, apparently not for cataracts
2) you are currently fully corrected using multifocal contact lenses
3) you are having surgery on one eye at the beginning of April and the other at the end of the month, with ReZoom IOLs being reconsidered
4) shortly after you might leave for work in the Far East
5) you love tennis

From what I'm reading you're going ahead with the surgery on this schedule.  It's the lens choice in question.  I have multifocal implants, and really wanted ReZoom IOLs when I was ready for surgery.  I'm very relieved my surgeon directed me to a different lens.  In the months after surgery I read the many ReZoom related posts on MedHelp.  

The other multifocal IOL available in the US market is the ReSTOR.  Good near and distant vision, fuzzy in the middle.  Halos?  Definitely, but lower MedHelp-reported intensity than with ReZoom.  Some variations with different light conditions.  Also, reducing any astigmatism after surgery by either Lasik, limbal relaxing incision or implanting the IOL on the proper meridian will reduce likelihood of halos.

Crystalens is the accommodative IOL.  It has also had reasonable results with recipients.  Failing seems to be in achieving good near vision.

Oh, monovision and tennis.  You are using multifocal contacts.  If they're paired for monovision then you're used to monovision and the next comment doesn't apply:  You might want to do a search on MedHelp and see the effects of monovision and sports.  It seems any sport where depth needs to be gauged continuously, monovision doesn't help.  Two lenses focused at the same focus will give you good depth perception, but may lose a zone: near, mid, possibly far.

Lastly, you said you might be leaving for work in the Far East at the end of April.  I'm not sure if you mean it's for an interview or really heading over later in the year.  You need follow-up with your surgeon at least twice: in a week and in a month.  If all goes well after your second surgery you could travel after a week, but would still be due for further follow-up.

Maybe one more thought.  If you're heading to the Far East -- not certain where you mean -- there may be a medical facility there.  It is possible to have surgery there on a week off work, and continue working and following-up with practitioners there.  Conditions do need to be right and have good word-of-mouth.  Other possibility as a result is a greater choice of IOL.  You will be living in a market where more choice is available.  Whether a lens other that the ones currently available to you is better, I can't say.  Time for more homework if this route interests you.  I did just this and have a lens that still isn't available in the North American market, but should be a staple once it approved.

Good luck with your decision,
Glenn

[JodieJ]

Within the past couple of months (check archives), Dr. Hagan recommended aspheric monofocal lenses (he likes the Tecnis but any of the 3 aspheric options would do), with the dominant eye set for about -.25D and nondominant for -1.25D.  Since you've been successful with monovision in the past, you could probably go stronger with the monovision.  A limbal relaxing incision would eliminate your astigmatism, if necessary.  Your insurance should cover the bill.

The Crystalens is supposed to provide clear distance/intermediate vision, although most people reportedly need weak readers for close vision.  Sometimes the Crystalens is implanted with a slight monovision effect to address this issue.  The Crystalens involves a rather hefty out-of-pocket fee, and there have been several recent posts from people who have had problems with this lens.  I think it would be important to have a surgeon who was experienced with it.  If this lens appeals to you, though, you might want to ask the surgeon if s/he would recommend it to his mother/spouse/best friend over aspheric monofocals before proceeding.  You would still need limbal relaxing incisions to eliminate significant astigmatism.

[Michael J Kutryb, MD]

FIrst of all, I think some of you are being a little too hard on the rezoom implant.  It's all about proper patient selection and counseling.  One of the main weaknesses of rezoom is the halos and rings at night.  But for someone who doesn't want to drive at night - it can be a viable option - again in properly selected and counseled patients.  There is no perfect multifocal or accomodating implant - and each have strenghts and weaknesses.  I just caution anyone who is a health professional to make such broad, sweeping statements because.  If you are a patient interested in one of these type of implants it  is important to do you own research, talk to patients that have had themm implanted, and get the opinion or one or two very qualified, board-certified ophthalmologist cataract surgeons.

Because you wear bifocal contact lenses, I gather that you probably don't want to wear glasses.  Personally, I'm concerned that you might have diffuculty driving at night with Rezoom due to halos.  If you don't mind wearing reading glasses after surgery then your decison is easy - just pick a monofocal aspheric lens like tecnis, sofport AO, or Acrysof IQ.  Now if you strongly desire to be able to read without glasses and drive without glasses after surgery then you could consider a restor or crystallens.  THe restor would give stronger reading vision but possible more glare and halos particularly with night driving.  The crystallens would in theory have less glare and halos at night but weaker near vision.  If you really want to drive a lot at night I wouldn't recommend restor or rezoom,for you.  Your decision would then come down to aspheric monofocal or crystallens (which may not give you the reading vision you want.)  SUggest you might want to get a second opinion from another surgeon.

Michael Kutryb, MD

[JodieJ]

ReZoom is reputed to be the worst of the multifocal/accommodating lenses.  If you enter "ReZoom" in the search feature of this website, you can read all about the many problems associated with this lens.  It's significant that few (probably virtually no) cataract surgeons would want this lens implanted in their own eye.  It's been stated that the technology of ReZoom will soon be obsolete (if it isn't already).  Frankly, I'd have a hard time trusting a surgeon who is still recommending it.  

[zedhawaii]

Thank you for your info.  I am so glad that you have great result with your choice.   Warmest Aloha, Zed.

[cdn_glenn]

I have Tecnis ZM900 Multifocal IOLs.  They're not yet approved in North America, but are approved in Europe and Asia.  I had mine implanted in Thailand.  I'm very happy with them.  They might not be exactly what you're looking for.

I'm certain Singapore has very advanced medical care.  I just plugged "singapore cataract surgery" into Google.  Many, many results:

http://www.google.ca/search?hl=en&q=singapore+cataract+surgery

At least now you can take time to do more research.

Cheers,
Glenn

[zedhawaii]

Much Mahalo for your time and comment.   I got a second opinion about the condition of my cataracts and was told they are fairly minor and he does not recommend surgery for removal unless I wish to rid of my glasses.  I hope my condition will stablize and I am sure with the advent of technology, a better, more suitable lenses may be available then.
My job offer in Singapore or Manillar is only for 6 to 8 months, I will re-evaluate my situation upon my return. If I do decide to accept the job, it will be lovely to know there are more options available in Asia.
To cdn_glenn, do you mind telling me which lens you have?  Thank you.

[zedhawaii]

I have spent a good deal of time on this website and learnt a lot about different options.  I wanted to thank you for your contributions helping us making an informed decision.   My rushed decision to sign for reZoom was due to the fact that I may take a job in Far East sometime in late April, and was told it was best to have the surgery prior to my leaving.

I am 54 years old, female, good health and an avid tennis player (about 2 hours per day).  I have been using contact lenses since I was 16 years old. Left eye -7.50. right eye -.6.75 both eyes have slight astigmatism.  I use Proclear -7.0 and -6.5 for tennis and love the clarity, except it annoys me that I cannot read my cell phone or any labels in store.
For every day, I use Bausch & Lomb Multi-focal Loflens -6.50 low and high with good result - reading is good, far vision a bit compromise especially at night - slightly double vision and starburst.   I wear my progressive glasses when I am at home.
Since I live on an small island and there are only two eye surgeons, I opted to seek another opinion as suggested by  Dr. Kutryb -  My former off-island optometrist suggested that I opt for monofocal lens under corrected for .5 on left, -2 for right.   I have an appointment with a local optometrist tomorrow.   Thus far, I think having the surgery will help to rid of my glasses and contact lens for most tasks and it is a freedom I have not known since childhood, I am excited about that. I do not mind using a reading glasses but I do desire a clear, crisp distance vision and an ability to read labels in store and my cell phone.

Do you have any suggestions?  Monofocal or Crystalens?

Much Mahalo for your help.