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?”

  • Cindi

    I’ve had repeated bouts of posterior and intermediate uveitis. I was alerted to the first one almost three years ago by the epiretinal membrane that formed over the center of my visual field. They treated me early and I didn’t lose any vision, I stayed 20/15 in both eyes. I had PVD’s in both eyes with a huge amount of stringy debris. Repeated flares clouded my vitreous. The ERM got worse and began to distort my fovea. I had a vitrectomy and membrane peel on the right eye last summer. I read the 20/20 line the next day, but a few months later the post-surgical cataract began to develop. My myopia has gotten much worse. I wear multifocal RGP contract lenses, which deliver very good vision. My doctors are all opposed to putting a multifocal IOL into my vitrectomized eye. My question is – Why can’t I have a monofocal IOL for distance and wear a RGP multifocal contact lens for close and intermediate vision? I’ve been told that doesn’t work, but I can’t understand why not. My distance would be corrected. I’d be using the multifocal contact in place of reading glasses. Why not?

  • ari

    again- crystalens, unlike restor, has no side effects, so why not try it. it may give you decent computer vision. for sure, taking care of the astigmatism is a good idea and will give you better vision.

  • I had been wearing glasses since 16 for mild Myopia in both the eyes (- 1.5 ) – needing correction for distant vision. Did not feel uncomfortable in the active 30 odd years in the army.

    I am 68 now and need cataract surgery in the dominant left eye. I searched for the best option hi and low and wide, researched the web. I find that for people like me, the best option is the “Standard” lens. It is simple,time tested, and highly accommodating with little side effects and of course – free of cost if you are insured.

    This conclusion is also supported by our family doctor Dr M.S. Srinivasan who is one of the highly experienced Cornea Surgeons anywhere ( from Aravind Eye Care System, Madurai, South India (they do maximum number of eye surgeries in the world).

    I always wanted to have vision without glasses but after this research, I am ready to compromise with Standard lens. I want to tell everyone this – I had done lot of adventurous activities in the army – including Riding, Skiing, Sky Diving etc with glasses and it is okay – no discomfort at all. I respect the opinions and choices of all of you but consider the simple thing first.

    I am going is for surgery next week. Will share my experience in this Forum later.

  • Wendy

    I am 45 and have a cogenital hearing impairment (severe). Have worn hearing aids all my life–I lip read extensively at all distances. I do lots of computer work, reading, photography and play tennis.
    Have had glasses or contacts since high school; now wearing progressives (OD -2.25, -.5 Cyl, Axis 10; OS -2.75, -1.25 cyl, Axis 10 + ADD 2.0 in Axis) which give best vision of 20/30 OD and 20/25 OS. Last July, posterior subcapsular cataracts OU were diagnosed in both eyes and right eye (dominant) is worse. Have consulted 3 doctors in the DC area — am being a nervous nellie as I really need clear vision to lipread at various distances. Have slight astigmatism in both eyes.
    Surgery for right eye is scheduled for Mar 27th — and Crystalens was selected and I’ll need to sign a consent for LeSx Femtosecond for astigmatic reduction surgery at the same time.
    I have been reading this blog and others and having second throughts about Cyrstalens — as I age my hearing impairment will worsen and my eyes are most precious. I don’t mind wearing reading glasses. What would be best for someone in my situation? Monofocal, or some other multifocal lens? Your thoughts will be greatly appreciated!

  • Trish

    I am 66, diabetic (dx 8mos ago) now in control with oral meds—but have retinopathy & DME (being treated with lucentis and lasars since Nov./12) and glaucoma treated with Azopt gtts (Pr.17 bilaterally from 20) also have bilat. cataracrs. Present Rx is -4.50 and -4.75 ( which is 3 yrs old and not adequate right now). I realize that multifocal lenses are out of the question but I wonder if anyone could suggest an appropriate adjustment to monocular lenses which would allow me to read, do computer work , paint (art) and still be able to see license plates and road signs well. I have been near sighted since high school but able to read well without glasses until a few days after I was Dx’d and 2 days after I was started on statins and other meds. Vision is now improving with treatments Also would like to know at what point in the rest of my treatment is it okay to do the cataracts ( I am on the waiting list for sometime in the fall)>

  • ari

    too late. you need to wear reading glasses when you do anything close up, whether its reading or makeup. no big deal.

  • Janet

    Feb.4 ,I had cataract removed and monofocal lens put in now I can not see to apply makeup how do I fix this and what kind of lens should I put in my right eye now. I need enough closeup vision to apply eye makeup.

  • ari

    yes- sounds like you got very little “bang for the buck”, and that your crystalens is acting like a regular lens. thats the risk with this lens- the near vision benefit can be very modest at times.

  • Mary Currie

    I had the cataract surgery with Crystalens implanted in both eyes in November 2012. The biggest difference is how bright the world is. Colors are vivid and beautiful. My far vision is great. No glasses for driving, TV or walking around. I need readers for computer and reading. I am using 2.00 or 1.50 readers. I practiced reading without readers like the doctor suggested, but it doesn’t help. I can’t see the words at all and they don’t get clearer. I get a headache on the computer without readers. I can’t see my Ipad or very fine print even with readers. I go to the doctor on Thursday and will ask him if prescription reader glasses can correct for astigmatism so I can see the Ipad. I am grateful that the surgery went well and I can see distance. I don’t mind readers if I can find a solution for seeing my Ipad and very fine print. It seems like the standard lens would given me the results I have without the expense.

  • ari

    these multifocals definitely have drawbacks and one has to be very motivated to not wear glasses to make them worthwhile. vitreous detachments are normal and happen to everyone sooner or later

  • Debra Ann

    I had the Restor multifocal lenses put in November 2011. At first things seemed to go well, distance in right eye was perfect. Then I had my first vitreous detachment and a month later the second. The left eye was quite impaired by this web like floater. Was not informed since I was so near-sighted that this would definitely happened. By the way I did not have cataracts my specialist informed me that my vision could no longer be corrected by glasses, I now doubt this statement. 8 months later I could no longer see to drive the contrast sensitivity was so bad. The glare and reflections were unbareable in the sunlight and yet in the dark I was completely impaired. I had YAG surgery but I still had one removed 2 weeks ago thank god I had an excellent retinal specialist do this procedure. I had to have a vitrecomy as well and then had a Alcon monofocal placed in the sulcus. I could not see clearly for close to a week but the difference was immediate it was like a shroud was lifted off and I had my eyesight back. I will have to wear glasses but who cares. Will have the right eye done in about a month, can’t wait! Multifocals suck!!!! Do not risk them.

  • Joe

    I didn’t like full monovision when I tried them with contacts a number of years ago but my doc is suggesting mini-monovision with a Tecnis one piece monofocul iol. The ZCBOO. He’s talking about plano or -.025 in dominant eye and -.050 or -.075 in the non-dominant eye. He says that it will hardly notice it and that it will not interfere with depth perception which is important to me. I’m considering this or the Tecnis one piece multi focal iol. ZMBOO. Cost is not an issue in my decision. Will I notice the mini-monovision? Will it effect depth perception?


  • Susan

    I’m nearsighted (3.5 range). Discovered have cataracts – right eye, dominate, is worst. Doing contact lens experiment for monovision. Does this “partial blurriness” sensation go away after some period? I hate the feeling and prospect of always having blurriness wether looking near or far – nauseating. I also hate the thought of loosing all nearsightedness. I work on a computer 10 hrs a day at least. Read about nanoflex and they sound like my choice if I do the monovision option. Ari you spoke about making the nearvision eye slightly nearsighted which might work…. what about the problem of developing problem like “lazy eye”…. am also considering multifocal one with intermediate other with nearvision… would that work? I’d really like the sharpest, daylight contrast, no glasses option. This is just really hard to sort out.

  • I have AGONIZED over which lens to choose and have rescheduled my surgery three times due to indecision. My surgeon has been available for discussion, and I have done my research. I have decided to go with the Nanoflex monofocal; I have tried monovision with contacts and didn’t like it. My question: are there any folks out there who have the Nanoflex and would be willing to share their experience?

  • ari

    whether crystalens is good or not is unrelated to the lasik.
    crystalens can be unpredictable in its ability to give you god reading vision.
    if you have astigmatism, and its not corrected, your success with crystalens will be less. some astigmatism can be irregular after lasik and may be hard to correct.
    implanting the correct implant after lasik can be tricky. i strongly suggest a second opinion from someone who has a lot of experience in these matters.

  • Mary Currie

    I had lasik which was great, but fast growing cataracts have now made me near sighted again. I wear glasses for distance and can see fine up close. I am having my left eye done this week, followed by the right eye the following week. There are a lot of people on this blog who aren’t happy with the Crystalens. My opthamologist is highly recommending it for me. I wonder what the stats are on people who do like it. My question is ……Is Crystalens a good choice after lasik? I had a special measurement test by a lasik opthamologist surgeon as a pre op and that test showed astigmatism that doesn’t show up on normal refraction tests for glasses. In other words my glasses don’t correct for astigmatism and only this one test shows it may be an issue following the cataract surgery. I guess the astigmatism found on that test is related to reshaping the cornea in lasik surgery. My doctor did not recommend the toric. He thinks Crystalens is the best option (rather than the standard) with follow-up with the lasik doctor, if needed. It is all very anxiety provoking. My neighbor had Crystalens in both eyes and loves her outcome.

  • DO

    I am 50 years old and had a vitrectomy for floaters in my right eye which quickly worsened what was probably a small cateract. My eyes are otherwise healthy. I am considering the Nanoflex IOL but was wondering if it would even accommodate for me since I don’t have any vitreous. Have you seen any research about the Nanoflex’s effectiveness in vitrectomized eyes?

    I would like to try a blended vision approach and have read that the Nanoflex works well since the Collamer material it’s made of is more flexible that acrylic and provides for a greater range of vision. My left eye is -1.25 with .33 astigmatism and my right eye prior to developing the cateract was -2.75 with .55 astigmatism. I was thinking of targeting plano or slight myopia with the IOL correction in my right eye and using my left eye as is for computer/reading. I would then get an IOL with -1.25 when I need to have the left eye cateract addressed.

    I guess my natural eyesight was like mini-monovision for near/intermediate as I could work at my computer and desk without wearing my progressive glasses, which have a 2.25 add. I find working with glasses very annoying, so do you think it would be advisable to keep my right eye more myopic like it was rather than correcting for distance? Or do you think having plano in the right and -1.25 will work for me at the laptop? I spend probably 10 hours at the day at the computer and reading for my job, which entails a lot of graphic design work and proofreading.

    One surgeon I visited recommended the Tecnis ZCBOO set for distance correction and use my left eye as is. He thinks I can work at the computer all day with this approach, but I am concerned that after I set my left eye IOL at -1.25 that I will have little accommodation with a Tecnis ZCBOO and will be stuck using readers. That’s why I’d like to investigate the Nanoflex because it seems to flex for some pseudoaccommodation.

    Thanks, in advance, for your help!

  • George

    Thanks again,
    I will be seeing my surgeon tomorow and I feel more prepared to understand my options thanks to your advice. My hope is that this will be done ASAP as tasks are becoming increasingly more difficult.

  • ari

    toric is risk-free and i strongly recommend. otherwise, you will need glasses to correct the astigmatism to see better. makes more sens to implant the astigmatic correction in your eye instead of wearing it on your nose.

  • I am 66 years old and facing cataract surgery in right eye. Have cataract starting in left eye. I wear a contact in right eye and reading glasses with computer and for some fine print. Vision good enough in left eye for distance. I often go without contact at home and can see well enough to drive without during the day ( can read license plates and street signs well). Would not pass the eye exam for driving in right eye without contact. I was going with restore multi-vision but am concerned about halo affect and depth perception. I wore multi-level contacts for a few years but got tired of the halo affect and lack of precise vision at all levels. I would take them out at night and wear glasses. I also wore mono vision contacts for years with good results. Any thoughts on best way to go.