problems with restor

[Zuzanca]

I am living in France, and I  got a multi-focal restor implanted in my left eye 3 years ago, it was recommended by my eye surgeon although I am astigmate which is in fact a contra-indication for this lense, but I only found out later. The result is really bad, and does not at all come up to what I was promissed before surgery. Astigmatism couldn’t be corrected with the lense, and I still have to wear glasses to correct astigmatism. I am not quite sure whether the same correction criteria is used in US, in France my correction is (only in left eye : sphère +0,50 cylindre –1,00 axe 10). But glasses do not really help since vision is about 30% smaller with the restor than with the healthy eye, everything seems to be vaulted and wavy and I see in double when the light is not perfect. This is getting even worse when I wear the glasses, causing me head-aches and dizziness, so I don’t wear them. And I cannot read with the restor, so I only read with the healthy eye. I changed surgeon, and last time when I saw him, he obviously had forgotten about the restor in my eye. He told me, that indeed, my vision was very bad and I needed new glasses that would enable me to read. He gave me the following prescription: right  +0,25 (-0,75 à 165°), left +2,75 (-1,75 à 10°) and with the glasses he gave me to try, I could read with each eye seperately. I went to several opticians, and I tried to read with those glasses with both eyes together. Impossible, I cannot see anything. I have consulted quite a bunch of surgeons in Paris to try to find someone who could adapt my glasses to this very bad lense in my eye. All of them seem to tell me that my vision was perfect, and I could not obtain any better results. I am really wondering whether all these surgeons in France are supported by the laboratory which produces the relevant lense...and I am happy to have found this forum and can be assured now that I am not the only one who is not at all satisfied with the restor lense. Halos and glare is really bad at night, but honestly, I would be very happy already to obtain an acceptable vision during day time. I am thinking of replacing the restor, but I have already had the yag-treatment. (Cataract could not be extracted completely during first surgery). Do you think there could be a solution for me ? Thank you very much in advance for your help.

[Joan M Pernoud, MD]

It would help me to know why the left lens measurement is so different the two times you mentioned it in you question. Please recheck those numbers...they are too different from each other to make sense to me.

[Flavius G Pernoud III, MD]

The original recommendation from Alcon, the manufacturer of Restore was that there should be no more than 1.00 diopter of astigmatism to obtain a good visual result. The company has since reduced that to 0.50. If the lens is implanted with more astigmatism, that will have to be addressed at the time of surgery with limbal relaxing incisions or later with a laser treatment like lasik.  Removing these (or any implant) is not easy and should only be done by someone with experience especially in view of the fact that you have a disrupted posterior capsule (YAG laser). My advice would be so seek a surgeon well versed in laser treatments for astigmatism and treat it that way first. At a minimum, this will reduce the anisometropia (the power difference between the two eyes) which makes spectacles so difficult to wear. And, the risk of causing more damage will be minimized. Due to the diffractive nature of Restore, you may not achieve a perfect result but you will still be at no more risk to have the lens removed later.

[Zuzanca]

thank you very much for your reply. The first prescription was given to me by the surgeon some weeks after the first surgery in 2005. I think she wanted to obtain a kind of compromise knowing that it would not be possible to correct all problems. But as I had said before, I have never felt comfortable with those glasses, cannot read at all and cannot walk properly outside. I have tried several times to make her understand that I am not happy with my vision, but she did not believe me and insisted on the numbers which were obtained when doing these reading tests in perfect light conditions which you never have in real life (4/10 without glasses, 7/10 with glasses on the left eye). It is like looking through the bottom of a glass bottle, and as long as you can read letters through it, you are told that your vision is perfect. So finally, three years later, another surgeon gave me this prescription with the corrections that would perfectly fit my eyes and I could actually read with those glasses on, but with each eye separately. And I cannot see anything when wearing those glasses on both eyes. Maybe, it is only possible to correct either astigmatism or farsightedness with the restor, but not both at the same time...I don't know....

[Zuzanca]

Thank you very much for this explanation which really makes sense to me. I have already thought about the Lasik treatment, but the French surgeons did not think it was necessary, they always told me that my brain should get used to and accept this vision after a while (I had about 50 sessions with an orthoptist, he finally abandoned, telling me there was a serious optical problem that he could not resolve). I think I will try to find an American or English-speaking eye surgeon who should be more updated on the topic. Thank you once more for your help.