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    Old 07-18-2007, 11:29 AM   #1
    Chanti777
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    Best option for cataract surgery?

    About 3 years ago, I had a lens replacement in my right eye. I had cataracts in both eyes but the right eye was the worst. My left eye has subsequently deteriorated to the point where I cannot see a thing if I close my right eye except for light and a bit of blurred colour. Lately I've been getting serious headaches and feel like I have vertigo. Is this the imbalance between my two eyes? I am considering surgery now for the 2nd eye but wanted to find out about the crysalens option. Has anyone got information about this and the advantages of this over the standard lens? The eye specialist here in South Africa does not use this lens and I'm wondering if it's worth going to the States to have the procedure. I used to have perfect 20/20 vision and it's been really tough trying to adjust to having eyesight problems. I believe that the cataracts may have been caused by the prednisone treatment I received over an extended period of time. HELP! I'm so confused and would prefer to be informed before I make this important decision.
    Thanks
    Chanti

     
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    Old 07-19-2007, 07:41 AM   #2
    KeelaC
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    Re: Best option for cataract surgery?

    Our expert Serious Person will tell you about Crystalens and the other newer multifocal lenses. I just wanted to point out that, if you get a multifocal IOL, you will often be using monocular vision. You shouldn't need reading glasses, but your left eye will be the one doing the reading (unless you are also wearing a reading lens for your right eye, which kinda defeats the purpose). Most right-handed people are right-eye dominant. At distances where your present IOL does not focus, you will switch your visual focus to your left eye. This is not necessarily a bad thing but would take some getting used to. I've heard that some avid golfers have one lens for far and one lens for close--permanent monovision. Once you get used to it, the switch is automatic.

    I'm no expert on the subject, just wanted to point out that if you have one permanent focus lens and one multifocus lens, your eyes won't always work together.

     
    Old 07-21-2007, 10:12 PM   #3
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    Re: Best option for cataract surgery?

    If they had a blushing smilie, I would put it here.
    I guess I'm only half an "expert" on the crystalens, since I only have one in my left eye. The other eye has the ReStor lens.
    What this means is that with the left eye I can see midrange clearly in all light. In brightest sunlight I can see most everything with that eye, except some print.
    With my right eye I can see distance well, midrange is blurry, close is fairly sharp.
    I do have access to a lot of scholarly journals and so have done a lot of reading about the crystalens, the ReStor, and the ReZoom lens too, and will be happy to tell you what I have learned through study and experience.

    It must be quite a loss to you since you had 20/20 previously. I had worn thick glasses most of my life.
    But are you a more mature person who was using reading glasses previously?
    I ask this because different lenses will measure up to different expectations.

    Regardless, if your vision is that bad right now, you should have the surgery soon. Do you have the time, money, etc. to come to the States? My health insurance covered most of the cost for me, but it is very expensive.

     
    Old 07-22-2007, 02:50 PM   #4
    Chanti777
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    Re: Best option for cataract surgery?

    Thanks for your quick response KeelaC. :-)

    Serious Person,

    I'm just over 40 years of age and developed cataracts at the tender age of 37. I was fortunate in that up until the time I took the medication (Prednisone), I never even had to use reading glasses. I really did enjoy perfect eysight. After extensive treatment with prednisone amongst other drugs for a serious medical condition (also a first for me because I'd previously enjoyed almost perfect health), I suddenly found that my eyesight became misty. I had developed bad and like I said, I had the lens replacement for my right eye (dominant eye). I have absolutely no idea what kind of lens was used as it was 3 years ago. I had limited vision in my left eye but wasn't in a big hurry to have another op. I have recently found that my eyesight has deteriorated to the point that I am struggling with various things (see previous post). Obviously, I'd like to make a choice that will offer me the best possible vision in the long term. I used to read a lot but lately I have found it a struggle even to read. My reading glasses don't seem to help much. I have fairly good distance vision but can't seem to read small print and I have to magnify everything on a computer in order to see properly. It is possible that I haven't got the right reading glasses. I'll need to check that out too.

    I really would like to know if the crysalens is the way to go or whether I should look at other options as well. Is it possible to have the lens replacement with the standard lens and then later on have crystalens inserted in both eyes? Any advice you can give me would be appreciated. I'm seeing the eye specialist on the 2nd August and would like to find out as much as I can before I book in for the op.

    One last question (sorry about this *blush*)... Do you know of any complications arising out of lens replacement that I should be aware of? I'm convinced that my vision in my right eye has deteriorated since I had the op. Is this possible or is it just taking strain because of my left eye?

    Thanks again. I do appreciate your advice immensely.

    Regards
    Chanti

     
    Old 07-22-2007, 10:45 PM   #5
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    Re: Best option for cataract surgery?

    First of all, anything I give as fact you should check with your doctor in case things have changed. However, the crystalens has not changed, still, my experience with it could be different than yours. I would not recommend the crystalens for anyone who hopes to read without glasses. There are percentages of people in studies who were able to read without glasses with the crystalens, but that is not my experience. It does, however, give clear vision for people standing at arm's length, and with fairly low prescription glasses you can read clearly. The Restor lens does allow me to read without glasses, although, as I said above, I almost always where glasses to read.
    What prescription of reading glasses do you currently use? Is it hard to read because of the left eye? Or is it not clear with the glasses with the right eye either?

    After having cataract surgery it is not unusual for a "posterior capsular opacity" to occur, which means the membrane holding the implanted lens has gotten cloudy. It seems doctors routinely perform a "YAG laser capsulotomy" to poke a hole in the membrane, but I just read that only 20% of cataract surgery patients need such a procedure, so perhaps it is done more often than warranted. The same article said that the odds on developing a detached retina after cataract surgery are 1%, but the odds go up to 2% following the YAG procedure. Also, something I was told by my doctor: once you have had the YAG, it is much more difficult to perform surgery to replace an implant. However, he also said that replacement of an implant almost never has gains that outweigh the risks, meaning, the surgery is not worth the tiny possible improvement. So that also answers your question about replacing your single-vision implant with the crystalens.

    It's too late tonight, but I'll try to find and read some journal scholarly abstracts for recent studies on "outcomes" for the crystalens.


    P.S. I just read an abstract about a lens implant that can be adjusted after implantation. In the abstract it's called *Acri.Tec AR-1 PC/IOL, but it probably has a catchier brand name.

    Last edited by seriousperson; 07-22-2007 at 11:13 PM.

     
    Old 07-23-2007, 08:10 AM   #6
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    Re: Best option for cataract surgery?

    SP, what about the Rezoom lens? I know you don't have any personal experience with it, but I wonder if it has any advantages that the Crystalens and Restor don't have?
    I was under the impression that double the number of implant patients eventually developed that cloudy capsule. But you have access to the scientific papers, so I take your word for it.

    Chanti, you say you don't know what kind of lens was implanted. Normally, it's a monofocal lens for distance. Since you use reading glasses, that's probably correct then.

    SP, my brother has two IOLs and does not use reading glasses. He claims he can see perfectly far away and yet read. I can't understand this at all. He doesn't know what kind of implants he got, but I'm pretty sure he wouldn't have got multifocal lenses without the doctor saying so. ???

     
    Old 07-23-2007, 10:12 PM   #7
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    Re: Best option for cataract surgery?

    Keelac, have you actually seen your brother read without glasses? If so, that's amazing, and he's very fortunate.

    About the numbers that develop cloudy capsules, you could be right. Those figures I quoted were just from the Internet.

    About the ReZoom lens: What I read several months ago was that it was not really living up to its expectations. It was developed to give better vision in low light. Post-cataract surgery I have very poor vision in dim light, and I think that's always the case. The ReZoom lens is a bit better in that respect, but it seems in good light there's a glare effect.

    Cataract surgery is at a state where the outcome is better than 35 years ago, but there's still a way to go before it will be "perfect." But cataract surgery seems to be much more advanced than hearing aids or cochlear implants for deafness, and much more affordable too. My poor dad is nearly deaf and doesn't hear very well with his hearing aids. So I guess we should be grateful that the cataract surgery techniques are so much more advanced.

     
    Old 07-24-2007, 07:37 AM   #8
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    Re: Best option for cataract surgery?

    Thanks, SP. I understand hearing aids have come a long way too, but not far enough to help your dad, I guess.

     
    Old 08-02-2007, 02:49 AM   #9
    Chanti777
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    Re: Best option for cataract surgery?

    Thanks to all who've taken the time to respond to my message. Thanks especially to SP for taking the time to answer so many of my questions and to allay some of my fears.

    I went in for my pre-op exam and will have the lens replacement in my left eye done on 5th September. I have less than half a percent vision in that eye so guess that would be classfied as legally blind. The eye specialist is going to implant the standard lens as he feels that my eyes should match. He says that I will have good long distance vision but will need glasses for reading. I can live with this. I am still worried about the loss of vision in my right eye and hope that this can be sorted out somehow...or will my left eye now take over? Sheesh this is scary albeit exciting. I can't wait to see again.

    Chanti

     
    Old 08-02-2007, 04:09 AM   #10
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    Re: Best option for cataract surgery?

    Chanti...I am in th esame boat. Much steroid use has caused a cataract in my left eye. Right eye has 20/20 but when it's covered I can only see light and shadows. Am seeing the eye surgeon this afternoon. I know nothing about nay of the different type of lenses so will ask him multiple questions. The Dr. who did my routine told me this type of cataract is most definitely caused my steroids. Good luck on the 5th.

    ICC

     
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