Crystalens or Restor as a Multifocal IOL After Cataract Surgery?
April 1, 2010
I am 40 yrs old and in need of cataract surgery. I have taken prednisone and inhaled steroids for asthma, which may have contributed to the formation of cataracts.
I knew nothing of monofocal or multifocal IOL’s when I started to suffer degraded vision in my left eye. I received opinions from 2 optometrists. One was for Restor and one for Crystalens. It may have just been the $3000 extra per eye over a monofocal IOL, but my initial impression was that the multifocal lenses were some sort of shady up-sell.
Now after thinking about it, I really do not want to have to rely on 2-3 pair of glasses and feel the extra $$$ might be worth it. I have worn glasses or contacts since grade school and am a pretty active guy. I set my mind on getting a multifocal lense after my second opinion (better bedside manner). This second optometrist recommended Restor, while the first optometrist had recommended Crystalens.
I am all bet set to get this done next month, but I am second guessing now. Can you recommend some impartial reading on the subject? My right eye is supposedly about a year behind in needing surgery.
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146 Responses to “Crystalens or Restor as a Multifocal IOL After Cataract Surgery?”
Than you for the info and advice.
I very much appreciate your responses and clarification to my questions.
I feel much more informed now.
If I can trouble you with one more question.
As I have some astigmatism as well. Would it be advisable or a good option to have a toric IOL.
My understanding is that a toric lense is a monofocal lense that corrects astigmatism as well.
Would this be riskier? Would it be preferable to allow glasses to do the correction, the IOLs or laser?
recovery is very short- day or two. until the second eye is done, you will be in limbo with 2 very difft eyes, so it may be hard to do prolonged work. you cant hurt or strain the eyes, so feel free to go back to work asap.
Thanks again Ari,
Very encoraging. I am actually looking forward to it.
Would you happen to know the recovery time?
I do computer work. Would I be able to start working in a couple of days?
What would I need to keep in mind in regards to short term recovery and long term lifestyle?
yes- monofocal is regular
yes- plano means zero prescription for distance
as i said, considering how awful your prescription has been for most of your life (-17 is really, really bad), you will be ecstatic with regular (monofocal) implants with a prescription of -2.00, and you therefore dont need to spend money on premium lenses.
good luck!
Tank you for the respons ari.
By regular implants, do you mean monofocal?
Your advice does seem sound and does confirm my research.
Do you now if there is a cost associated with thes lenses in Canada.
By “make one eye plano” do you mean correct it perfectly? I have not heard of that term before.
Like I mentioned, wering light prescription glasses for reading and/or distance vision would not be too big of a deal considering how I have been seeing my entire life which has always been difficult. Soft contact lemses do not offer as clear as vision as hard lenses but I found hard lenses very irritating. Everything is a sacrifice I suppose.
My optometrist does agree that they will most likely opt for regular implants. Regular implants is how he put it as well. Just wondering if that means Monofocal.
He also assures me that despit needing reading glasses or distance glasses to compensate for any adjustments to my vision, that I will see better than ever befor, assuming all goes well of course.
Would this be your opinion as well with people like myself.
Thank you once again for your feedback. I just want to be as informed as possible before desisions are made on my behalf and understamd what is being done.
my feeling is that you would be happiest with regular implants, aiming for like -2.00 or so, which would give you comfortable reading vision w/o glasses, and at -2.00, your distance glasses would be normal thickness. if you are very motivated to reduce your reliance on glasses, make one eye plano and the other at -2.00. a very myopic eye that underwent laser/surgery is not the ideal eye for premium lenses.
My situation is a little unique. I am 40 years old and very mypoic (-17.5).
About 3 years ago a had a retina detachment in my left eye which was repaired via laser and a schleral buckle.
In my right eye I had laser to repair some minor tears.
For the past year, i noticed my vision getting worse. After seeing my optometrist I was diagnosed with cataracts in both eyes. The left eye being more advanced than the right. My retina surgeon did warn me that this would happen.
Now my optometrist has referred me back to my retina specialist to have the cataracts removed and have IOLs.
I am uncertain as to what type of IOLs someone in my condition should proceed in regards to what type of lenses would be right for me.
I trust my retina specialist who is well respected and a top doctor.
I am willing to sacrifice wearing reading glasses for better distance and intermediate vision.
I have been wearing high prescription glasses and contact lenses my entire life so wearing reading glasses would be a very small price to not have to wear what I have been since 4 years old.
mixing implants typically not a problem, esp with crystalens.
if then problem is the edge, you need to choose an implant with a difft edge design. the astig only causes blur- not halos/starburst/double/ghost vision.
i would go ahead with the second eye with a standard lens with difft edge design, (if you have astig, get toric lens) then see if you might be satisfied with that
Ari,
The position of the lens is correct. Four Dr.s have looked at it. The one who has done the most explants said that perhaps due to the square edge of the Crystalens, it catches the most light. I don’t know if my astigmatism has something to do with it or not. He wanted to correct this eye before putting a standard lens in my left eye but now after consulting with the other 2 docs it seems that they want me to do the left eye first to see how my brain sorts it all out. I really hope that I can handle a standard lens as I certainly do no want two bad eyes. I am waiting a call from him to see what changed his mind and to ask more questions.
Do you know how people fair with one standard and one Crystalens?
as i mentioned before, im not sure why you are having so many side effects from the crystalens- unless the position of the implant is poor. ordinarily, one does not see these side effects from crystalens. the poor intermediate/near vision is a more common problem/complaint.
replacing an implant can be tricky and can tear the capsule due to adhesions between the capsule and implant, which can lead to blurred vision or difficulty placing a new implant. ask your surgeon if he has some experience with this, and if not, would he mind referring you to someone who does more of these kinds of cases to reduce your risk. its not a common operation, so it may be hard to find another surgeon in your area.
Ari,
What do you know of the risks of removing the Crystalens and replacing it with a standard lens? It’s been 6 months and I want to have this done in the next month or two. I am very scared about it being worse. I have read that the sac could tear. Would this cause blindness?
Susan,
I would not reccomend the Crystalens. I have one in my right eye and I am on the verge of having it removed. It does not fit my eye and causes all sorts of star bursts and halos of light especally at night. I do feel that they do not give all 3 stages of vision (upclose – mid -distance). My vision has no up close which means I can’t see my face in the mirror or read a book. My mid and distance vision had gotten worse. All of this has been with in 6 months. It’s very upsetting to say the least. I would go with the standard lens.
monofocal simply means clarity at 1 distance- either near or far. all lenses give good far. the q is near. crystalens gives you some intermediate, but it can be unpredictable. it all depends on how motivated you are to be free of glasses.
Thanks for your response. Restor has not been offered to me as an option. I live in Canada – does that make a difference? I have only been told about Crystalens and was given a brochure to read about it. When you say that it would be a better option for me, does that mean that with monofocal lenses, I would have trouble seeing long distance? I certainly don’t want any dependency on glasses at all, if possible. However, I would prefer not to pay $3000.00 extra for both eyes, if possible.
crystalens, when it works, will give you greater range, so you can have some intermediate vision as well as distance. but its not so predictable as restor. i am not aware of reduced effect over time.
again, it all depends on how motivated you are not to wear reading glasses.
One more thing I wanted to mention is that I use an e-reader and can read without glasses with an increased font.
I’m due for cataract surgery and on a waiting list so it could be anytime soon. My concern (like several people here) is whether to go for Crystalens or mono focal lenses. My doctor suggests getting the Crystalens for both eyes as he says I’m still young (I’m 57 yrs. old) but I’m extremely myopic -10 and -11. What would you suggest I do? I’ve worn monofocal contact lenses since 16 and done very well with them. I’m ok with reading glasses but want to be able to watch TV and drive without issues during the day and night. My gut says to go with the standard monofocal lenses but am looking for some advice. My ophthalmologist cousin in India says not to go with the Crystalens since they lose their accommodating flexibility and hinging after some time. Is this true? She feels it’s simply a moneymaker.
Thanks in advance.
so…if the operated eye feels fine, and the symptoms are in the eye with cataract, and your eye doctor says nothing else is going on besides the cataract, what is the issue here?
The main problem is that I had one eye operated and other eye is suffering still from cataract.. Sometimes I feel there are black spots in front of eye. But when I am comparing the vision of both the eyes it feels that my right eye (implanted with restor lens) doesnot have much problem and left eye can see more black dots in front of the eye. Can you please elaborate the reason behind this. My doctor is saying that your eye is 100% perfect. Is the reason is coz of left eye which is not yet operated as of now.
