Remove Rezoom Lens?

[Lanco]

     Is it too risky to have a Rezoom lens explanted after it has been in
     for almost three years?

The sight in my right eye, with the Rezoom IOL, has deteriorated over the last
several months.  The vision has become blurry, like looking through a glass
covered in Vaseline.  The eye can no longer focus at any distance.

     Is this likely due to a “clouding of the posterior capsule?”  If not,
     what else could have caused it this long after the operation?

The Rezoom lens was off a bit when implanted.  This was corrected by Lasik.
However, I could only focus for distance, not for near or medium sight.  It also
produced a great deal of ghosting on a dark object against a light background.

The other complication from my surgeries was I see two different sized images.
A ReStor lens was put in my left eye and the Rezoom in my right--a bad idea.
The images in my left eye are larger than those in my right eye.  Sometimes
things would float or double because of this.

Since my left eye is weaker and has a small retinal tear, the right eye was
dominant.  I was able to ignore the doubling effect much of the time.  However,
with the loss of vision in the right eye, there is a battle over dominance and
seeing clearly is much harder.  Especially in the morning, it can take a while
before I can focus well enough to read.  Sometimes I have to close my right eye
to get a focus.  (I have some near sight through the ReStor lens, although I use
reading glasses most of the time.)

     With my vision already compromised, do I dare have any further
     operations?

[Lanco]

Thank you for the response and the list of things that could have gone wrong.

I was quite dissatisfied with the results of my operations from the beginning, largely because of the difference in size of the images from the two lenses.  The ReStor image is distinctly larger than that of the Rezoom.  This problem is worse now that the dominance of the right eye has declined.  I should have had the Rezoom explanted within three months of the operation.  I kept hoping things would get better on their own.

A comment on another part of this forum also seems to indicate that I shouldn't have a posterior capsulotomy first to see how that works.  It would damage the capsule, making explantation more difficult..

Thanks again for the advise.

[Michael J Kutryb, MD]

First, almost any implant can be removed if necessary but it takes skill and the proper instruments.  Usually if a multifocal IOL is going to be a problems it will bother the patient from the very first day. The fact that you were A-OK for several years tells me that perhaps explantation is not the right course here and there is most likely some other problem such as a posterior capsule opacification or epiretinal membrane or new refractive error or corneal dystrophy.  IOL's can be mixed and matched from different manufacturers and sometimes the results are good, other times not so good.  I'm not really going to get into that issue.  I'm trying to tell you to see your ophthalmologist and try to rule out every other possible cause of visual problems.

MJK MD