Lens replacements?

[groveguy]

I am in my 80th year and in great shape.  I was born cross-eyed and have worn glasses since 2 years old.  I am far-sighted and, thanks to good care, can see a good picture with both eyes open together and people don't know that I am still slightly cross-eyed.  I do not see 3D and am an alternator.  My correction is +5 both eyes, but I get along well with glasses and have played all sports fairly well.  I now have cataracts forming and have been reading about Crystalens, but after reading this forum am thinking about Restor/Rezoom.  If I could throw away glasses for reading, it would be the greatest blessing in my life!!  I do target shooting and am left eye dominant but sight with my right eye.  But now my right eye is stronger due to cataracts. Thinking about Restor in left eye for reading and Rezoom in right for mid and distance.  As an alternator, switching eyes is natural.  Cannot and never will use both eyes together.
I look forward to any helpful comments.

[John C Hagan III, MD, FACS, FAAO]

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[JodieJ]

I had vision problems prior to having cataract surgery, so I've been very biased toward IOL options with the least possibility of complications.  As a happy recipient of Tecnis MFs, your posts are extremely valuable because they provide an honest, realistic view of the advantages these lenses can offer.

It's curious that skilled cataract surgeons (like Dr. Oyakawa) report having many happy patients with all the multifocal IOLs (including ReZoom!)  It does makes me wonder how much the surgeon's skills (or lack thereof) contribute the outcome.

      

[John C Hagan III, MD, FACS, FAAO]

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[cdn_glenn]

Quote: I think there is a new "ReZoom" available now from AMO--known as the Tecnis Multifocal IOL.

Sigh.  I'm definitely not defending multifocals, but that was uncalled for.  Though, interestingly, both the ReZoom (which my surgeon advised me against -- Thank You!) and the Tecnis Multifocal are both made by AMO they are very different.  I know you've read up on various multifocal lenses and know the difference between each.

ReZoom has five separate zones for different distances and light conditions.  Only the occasional person -- I think two in the past couple of years I've been reading this board -- said they were adjusting to the ReZoom IOL.  Most everyone else had horrid experiences and reviews.  The Tecnis Multifocal has only two zones (near/far) and doesn't have issues with being unable to focus in low light.  It was only recently released on the US market.  It has been in use in Europe for the past four years.

I just wish to show a fair set of options between monofocal, multifocal and accommodative IOLs.  In each category they are all not the same.

For multifocal IOLs neuroadaptation is the greatest issue regarding satisfaction of the patient and most definitely the surgeon.  I think I was fortunate and had both a good surgeon and a good IOL (for two years ago).  I would not want to go through that neuroadaptation time again for anything.  Now that I'm past it my vision is pretty darned good -- without many of the issues attributed to other multifocal IOLs.

Now accommodative IOL technology has come of age.  Multifocal IOLs may be an alternative to those who require more range and can understand and adjust to their limitations.  As I have said in previous posts, "Had the newer technology been available when I had surgery I would have chosen an accommodative IOL."

Jodie I've read and respected your long history of good posts and good advice.  I'm just hoping you'll wait for a little more feedback on the -new to the US market- Tecnis Multifocal.

[John C Hagan III, MD, FACS, FAAO]

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[Lerbea]

FDA MAUDE data base  TRY THIS.
Do  a general search  using   FDA MAUDE  it should bring up the website that way then just click on it

[Lerbea]

Sorry I can't get this FDA website to work when I post it.
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/search/.cfm

[Lerbea]

www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/search.cfm

[JodieJ]

I think there is a new "ReZoom" available now from AMO--known as the Tecnis Multifocal IOL.  It's a very different lens than the aspheric monofocal Tecnis lens.  Actually, the Tecnis Multifocal is very similar to an aspheric ReStor.  I suspect that it's not breaking any sales records, though, due to persistent problems with neuroadaptation, night vision, and reduced contrast sensitivity (compared to a monofocal IOL or the Crystalens.)  The Crystalens HD seems to be the current winner in the competition among the "premium" lenses.  

[John C Hagan III, MD, FACS, FAAO]

For other readers would you post the web address of the FDA maude website. Due to the automatic software used by MedHelp to prevent spam you may need to include a few blank spaces within the address.

I cannot comment from personal experience on this since our practice uses only Crystalens HD but the manufacturer of the ReSTOR is trying to say that the new Aspheric ReStor +3 and +4 are much better than the old ReSTOR you received.

That's what I think ReZOOM will do, suddenly there will be a new REZOOM and they will say "yeah that old ReZOOM had a lot of problems but this new one doesn't". I think the thing for these companies to do is to acknowledge problems when they learn of them but they keep sell/hawking them until the new new thing comes along. That's why I'm making a national effort in the ophthalmology journals for eye surgeons to not upgrade everyone to a premium IOL, to educate them better about expectations, to prepare them for wearing glasses sometimes and about glare/dysphotopsia problems AND stop using the REZOOM "DOOM" (my opinion) IOL.

JCH MD

[Lerbea]

Evidently you haven't done the research on the Restor lens at this website. Most here will tell you or suggest to you not to consider the Restor at all. I too had Restor put in and the bottom dropped out of my vision. It was the biggest mistake of my life.  I had one exchange and am to schedule the second exchange of the Restor iol.

Just to be able to wear glasses and have that correct your vision is a blessing in itself. You may just end up with worse off than you currently have.

Go to the FDA Maude website and research the adverse reports on the Restor alcon lens. Currently there are over 800 adverse reports so far. More than 2 is to many for me.

[groveguy]

Thanks so much for your input.  You are correct, I was reading 2006 forum stuff.  Thanks also to Dr. Hagan. I now have a plan for success.

[JodieJ]

Dr. Hagan has given you excellent advice.  I suspect that the "many forum responses" which recommended a ReStor/ReZoom combination were written in 2006, when this was the rage.  It is certainly not the rage today.  One of the forum ophthalmologists (Dr. Oyakawa), who used to implant all the premium IOLs, no longer uses any version of the ReStor or the ReZoom--he now implants the Crystalens HD only for "premium" IOL patients.  (Check his recent posts on this subject.)  .  

[groveguy]

Have re-read your first response. Apologize for mis-reading.  Thanks for your help.

[groveguy]

Wrist slap accepted.  You don't mention Crystalens for my problem.  Many forum responses recomend Restor one eye, Rezoom other. Is this obsolete technology?  Have had bad eyes for 80 years and need best possible, practicle help.

[John C Hagan III, MD, FACS, FAAO]

You haven't read enough of this forum to get a clear picture. ReZoom (ryhmes with "DOOM") and is old, I feel bad, technology. I would never let one of my patients even consider a Re-Doom (excuse me ReZoom) IOL.

ReRead all the recent posts. I'll summarize briefly.

1. If you want the safest, best vision, lowest cost IOL and will accept wearing glasses sometimes, perhaps just for reading then get a monofocal aspheric IOL by a great surgeon.
2. If you will accept the reduced night vision, higher cost, higher complication, high dysphotopsia (glare, flare, starbursts, arcing, etc) and are prepared to wear glasses sometime then ONLY consider the new Crystalens HD or the new ReStor aspheric +3.00 or +4.00 IOL.
3. Find the best surgeon possible, one that also does cornea and refractive surgery and get a Crystalens HD in both eyes or Crystalens HD in distance eye and ReStor Aspheric +3.00 in the near/intermediate eye.

You've done so well for so long don't mess it up with a ReZoom IOL.

JCH MD