Crystalens post-op

[seriousperson]

moderator2, we are sorry and will behave now.
Right Marty?

Marty, Thank you for your detailed posting. I am one of those people who can never get too much information.

I'm a librarian, and so have been doing research on all the lenses out there. I decided yesterday to go with the doctor's recommendation to have the ReStor lens (6mm. diameter, thank you for your discussion of lens size!) put in my other eye at the end of the month (as was scheduled, though previously for the crystalens).

He was willing to postpone, and even encouraged it if I was uncertain, but because my other eye can only see clearly at 7" away, and everything else is an indistinct blur, I would have to either wear a contac lens in that eye and not have any better reading ability than what you so thoroughly described, or not wear one and only be able to read 12pt font at 7" and not be able to drive at night. I was able to wear my eyeglass (the other lens removed) while the crystalens eye was dilated. But after that my brain could not compute the two disparate interpretations of the same distance (my remaining natural lens with cataract has a -5.50 myopia correction).

I was upset, because I wanted to talk to the doctor about the Tecnis and ReZoom lenses, which had very favorable outcomes (though I haven't checked lens diameter on either), and my doctor's response was to postpone. But then I read that one was not so good in clinical trials, and the other had some serious, sight-threatening side effect, the exact cause of which has yet to be determined. But my interest in both was that they were supposed to work better in dim light.

Did I mention that all of your problems with the crystalens have occurred with me too? Having read so many journal articles now (online and with my fonts set REALLY LARGE), it seems that there is a very gray area where the people doing the study are not exactly paid by the company producing the lens, but they do have a relationship with the company. Watch for a legal bru-ha-ha on that one!

I told my boss today that I have the answer. I just need a coal miners light so I can read away from sunny windows. Evidentally there are similar lights for cyclists; I am going to check them out.

The real problem was lack of communication with the doctor. It says, for instance, for the Restor lens, that patients must be highly motivated to see without glasses. That was never my issue. My glasses were a part of me. On before I got out of bed, and never lost. My complaint was the halos (really big & bright) and lack of low-light vision from the cataract. Had I known that the replacement was not going to be much different, I would have waited for the technology to catch up and/or for my vision to worsen to the point where the intraocular lens would definitely be an improvement. True, I now see things with that eye that I haven't seen without glasses in 40 years. But my vision that I wanted corrected wasn't without glasses.

Okay, back to work now. I'm slow enough as it is with impaired vision.

P.S. My mom had the standard IOLs put in 10 years ago, and she has halos and shooting stars too.

[Mart21]

[QUOTE=seriousperson]Anyone who has had surgery to have a Crystalens implant, please post here.

Seriousperson- I dont think my first attempt posted, here it is again
I have had crystalens in now for 8 months. I would strongly suggest that you put off the other eye surgery for at least

6 months while you come to fully understand the results of your surgery. Here are my personal experiences.
I had my left eye lens replaced with a Cystalens in Oct of 2004, I was very excited about the prospect of focusing

in close since I read a great deal. I studied the literature and everyone seemed to have good results. I also called 3

people who had crystalens put in and they were very happy. I was somewhat concerned about the small size of the lens

(4.5mm) compared to the standard fixed lens implant (6.0mm) but no one seemed to have glare or halo problems.
I had the Crystalens put in.
I had no problems with the surgery or recovery although the eye being dialated for two weeks was a hassle. During

those two weeks my vision was blurred and I had blurry vision during the day and at night I had strong halos around

light sources and a diagonal streak of light intersecting the halo at about 35 degrees. I knew what was causing this, it

is the the light coming through the dialated iris which is larger in diameter (approx 7 to 8mm) than the Crystalens

(4.5mm). The halo is caused by by the light which passes by outside the edges of the lens and is therfore NOT focused

by the Crytalens. This light is not focused properly but much to my dismay was focused enough by the cornea (the front

of the eye) to make a strong halo around light sources like street lights and headlights. The halo diameter varies with

the distance to the source, the further away the source the larger the halo diameter around the source. Before I had

this done I had thought that this light would be too diffused to see, I was very wrong and so were the people I talked to.

This will be important later. The diagonal streak which appears to shoot out from the halo in both directions at a

diagonal is caused by the Haptic plates which are the arms of the Crystalens and contain the hinge next to the lens and

the wire like structure at the outer edges which help it embed it in the eye. The light which is passing outside the

diameter of the lens hits these two arms of the Crystalens shich are clear and is bent into two streaks giving a sort
of image of the two arms of the lens. There are also small spiky streaks around the night lights caused by edge effects

of light hitting the edge of the lens.
Are you still with me, we are almost through, but these concepts are critical to understanding later issues.
Meanwhile, the light coming through the center of the iris is focused properly by the 4.5mm Crystalens and gives the

image on the retina we want. However, your retina sends the image of ALL the light falling on it and you see both the

focused and unfocused light.
OK - This was understandable if somewhat unexpected in that I did not think the light going around the lens would be

such a problem. However with dialated eyes it is like putting a cup saucer on top of a dinner plate. Imagine that the cup

saucer is the 4.5mm Cystalens and the dinner plate the opening of the iris (7 to 8mm). You can see how much area

(light) is not going to be focused by noticing how much of the dinner plate is not covered by the saucer plate. The

unfocused area is as large as the focused area and they compete which gives the blurred vision.
After two weeks I stopped using the dialation drops and I was impressed by the the color brightness in my left eye

caused by the lens being clearer than the old lens especially in the blue range, and now I was not seeing double from

the old faulty lens.
But I was having blurred vision at night and in the morning, an even under office lighting if half the lights are off or a

slightly darkened corner. It started to annoy and frustrate me how often I would see the blurriness and and halos. I

could understand having this problem at night but it was and is happening even in moderate to low light conditions. I

took to studying my pupil size to see at what size would trigger the halos. It turns out that it is around 4.5mm which is

about the diameter of a pencil eraser. That is pretty small and under typical indoor lighting my pupils are right on the

edge of getting too large in diameter for the Crystalens to capture all of the light and focus it, leaving the remainder to

pass by outside the lens and cause blurred vision. At night when I watch TV in low light it has a halo around it and some

blurriness to the image. Driving at night would be very difficult if I had had this done to both eyes because there are

halos around all light sources (headlights,streetlights, etc) and it is very confusing.
I complained to my Eye surgeon and they claim I am the only one having such problems and it is just me. But the

physics of light are the same for everyone and I believe other people may have the same experience so I want to let you

know of the downside if you are considering this proceedure.
The big claim to fame for Crystalens is the claimed ability to focus at closer range than the standard larger non

moving implant lens. I have tried every day to make the lens focus closer and at first I thought I was having some

success. The page of the book would at times focus (under good light - 250 watts overhead) for a short period of time.

There was just one problem, it was not like your normal focus reflex. It is almost as if you have to strain some muscle

which pulls the eye in a way you have never done before. I never mastered this in a repeatable way. Over months as I

continued every day to try to strengthen the muscles as the Doctors told me I found a strange thing. The focus ability

became worse, not better. I can only conjecture, and it is conjecture, that the tissues surrounding the lens tend to get

a better grip on the lens as you heal over time and limit if not almost eliminate any potential movement. I have a

hologram in my wallet which shows how a Crystalens is supposed to flip forward and back inside the eye, remember,

reality is that the lens is inside a sack being pressed by fluids from the front and back which strongly affect its motion.
I have to go but let me summarize my personal experience
1. Halos and streaks are a fact of life every night, I am fortunate in that I only have to close my left eye, the only one

with a replacement lens, to see what proper vision looks like. I believe this is the result of the small size (4.5mm) of the

Crystalens. My friends with the standard fixed 6mm lens do not seem to have this problem.

2. Morning and evening inside the house and some office situations cause blurred vision if there is not enough light,

and enough is brighter than I would have thought.

3. Focus is marginally, if at all better up close than my friends with the standard 6mm lens implant. They can read at

20 inches as well as I can.
4 Lots of light is needed for good vision.
When my other eye eventually needs a replacement lens I am going to definitely go with the standard tried and true

by millions, 6mm fixed lens. It is far cheaper, the incision to put it in is smaller, and the pupil has to open much further

to have the light passing by the outside of the lens effects. At my age of 51 my pupil will not open that far under any

conditions except extreme darkness. I am fortunate that only one eye had the crystalens and I have the ability to see

what a normal eye does under all the conditions I have mentioned. The regular eye never has halos or bluriness under

any of the previous conditions mentioned. I wish I had a standard implant in my right eye so I could give you a first hand

account of a side by side comparison, but that will come later. In the meantime, my advice is to wait until you really

understand the lens and your personal experience with it. I wanted this lens taken out but they tell me it is too

dangerous to remove. It does work as well as a standard lens if I have enough light, and the distance focus is right on.

But meantime, wait, there is no rush for this irreversible proceedure and you eyesight is for the rest of your life. Any

potential problems will be forever, but if you are happy with the lens you have only lost 6 months. Live with the

difference in glasses for 6 months, even though one will be thicker than the other. You will be happy you did. I only wish

I had a voice of experience when I was on fire to get this done telling me to slow down. Think hard and do not let

Doctors dismiss the things I have said till you prove the reality to yourself, they have an agenda and can be very

intimidating. I would suggest that everyone wait a minimum of 6 months between eyes when they are trying

something new, so they can fully understand how they react to the new technology, perhaps you will be very happy, but

you cannot know that in three weeks either way and this is irreversible. - Marty
PS: Please E-Mail me if you have any other questions or results. I would like to hear from anyone who can offer insights

based on their PERSONAL experiences. I have heard enough from Doctors who brush off my issues with claims that I

am a unique case, unique or not I live this reality every day, and I regret my decision EVERY day since I feel there is a

better, cheaper and well proven alternative. We all have different perspectives but we do live in the same world of

physics.]

[Mart21]

Seriosperson-
Sorry to have resent the posting, I didnt see it posted and need to understand the post proceedure better.
Thanks for the detailed information, especially about your mom and her problems. I see you are interested in the restore lens. I dont know much about them but I am concerned that it is a rehash of a lens that didnt work out too well in the past. These lenses use a multifocal approach where the lens is cut so that it has different focal planes that fall upon the retina at all times and your brain is supposed to pick out the properly focused one and ignore the unfocused light. This supposedly allows near and far vision, but it means that unfocused light will always be on the retina and you will have to ignore the blurred part. It is my contention that a single focal point is always best even if some glasses may be required under some conditions. I would personally stick with the standard lens which I have a couple of friends that really like the ones thay have. They can read computer screens very well and only need reading glasses for close (12" - 15" inch reading). I'll leave it at that and bear in mind it is only my opinion.
I also want to tell you about an eye drop which shrinks the pupil size, which really helps with the Crystalens and eliminates most all of the halos and glare until it wears off. It is available with your Doctors prescription and is called Alphagan. I did not want to take an eye drop every day but if I dont want the low light issues then I must. Thanks for the write back and keep me informed on your results. - Mart21

[seriousperson]

Marty, When you said that the shooting rays were reflection off the lens' haptics, was that a logical conclusion or a proven fact? Because my incision was at the top of the iris (yours may have been too, given that we're the same age), and there is just enough scarring still there to possibly account for the rays (picture the light hitting the irregularities at the top of the cornea on their way to the pupil).

Right now I am very depressed over the loss of my perfect near vision. Instead I have good intermediate vison in bright light--which I already had with glasses. There is less haze now, but I really wish I had waited for the new low-light lenses to be fully developed.
What's also really getting me down is reading that there is an "alarming" number of post-capsullary opacification with the Crystalens, which is treated by a simple YAG laser-piercing of the capsule, but which disqualifies the eye from ever having a replacement lens in the future.

[seriousperson]

I went for a second opinion today.
I'm going ahead with my second surgery Monday, which will be to place a Restor lens in my right eye.
I will try to start a new "Restor lens implant" thread before then.

For now, keeping my fingers crossed in the position of prayer (as did a main character on one of my favorite scifi shows recently).