My Mom is scheduled to have cataract surgery next week. The Dr. is recommending the ReStor lens. I had not heard of this lens before today. Does anyone know anything about it? Any stories of it good or bad?
My Mom is scheduled to have cataract surgery next week. The Dr. is recommending the ReStor lens. I had not heard of this lens before today. Does anyone know anything about it? Any stories of it good or bad?
she has obviously opted for an 'accomodating' IOL, which attempts to lessen the need for reading glasses after surgery.
two choices that are popular now are Crystalens and Restor.
The crystalens appears to be better for distance and intermediate, while the Restor is a bit better for near, OK for distance, but not great for intermediate.
She might want to make sure her surgeon offers both so that he/she is not simply putting her into the one that he offers.
He does offer both Crystal lens and ReStor. She was planning to go with Crystal lens after talking with the tech there. The doctor recommended the Restor because her close vision is very important to her. She does use a computer, but she figures she can keep a pair of glasses by the computer if she needs to.
Her distance vision is also very important. The doctor assured her that her distance vision would be as good with ReStor as with Crystal lens but that she might have some glare with night time driving.
I am concerned that you said the ReStor gave okay distance vision. Are there problems with it other then glare with night time driving?
it appears that many people need, say, a pair of -0.50s for night driving or driving in general. as the surgeon said, the main advangtage of the restor is the better near vision.
there are other variables as well, however, including the power of the implant. the power makes a huge difference for how the crystalens performs. the higher the power, the better the reading vision.
Pupil size.....is the answer to success for any accomodating IOL as well as LASIK. It should never be under estimated in different lighting . Complaints center around problems in dim light if the pupil is larger than the diffractive zones. Another problem with glare is from certain types of haptics in IOL's
She should use a standard IOL if she wants the best possible vision.Originally Posted by Happylady
Halos at night are a real concern with the Restor IOL.
Some surgeons "over sell" these products. Get all the information you can get your hands on. Postpone the surgery until you have enough info to make an informed decision.
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
She did consider the standard IOL but she was told that she would need glasses for both close and distance. She wears progressives, but is able to remove her glasses for extra good close vision. She wouldn't be able to do this.
From what I read the problems with glare at night is about 5%. She has glare and halos from the cataracts now.
I am concerned about distance vision other then night time driving. I understand that with this lens the person is actually seeing through both the distance and near portions of the lens at the same time and "blocks" the blurry image.
I know I tried this with multifocal contacts and it blurred my distance vision. I could see 20/20 but it was ghosty and not sharp. The doctor assures me this IOL is different, but I am concerned. It is much easier to put a contact on and off then to redo a IOL.
She did consider the standard IOL but she was told that she would need glasses for both close and distance. She wears progressives, but is able to remove her glasses for extra good close vision. She wouldn't be able to do this.
That's not true. They can order an IOL that will come very close to providing the same RX that she wears now.
From what I read the problems with glare at night is about 5%. She has glare and halos from the cataracts now.
Right. The statistics are generated from test subjects who already have compromised vision. Try a multifocal IOL on a person with healthy eyes (this is being done outside of the US) and you will get lots of complaints from halos and blurred vision. Keep in mind the FDA trial subjects are risk takers to start with, hand picked, using surgeons who were extensively trained by the IOL manufacturer.
I am concerned about distance vision other then night time driving. I understand that with this lens the person is actually seeing through both the distance and near portions of the lens at the same time and "blocks" the blurry image.
Yes, it's a multiple ringed IOL.
I know I tried this with multifocal contacts and it blurred my distance vision. I could see 20/20 but it was ghosty and not sharp. The doctor assures me this IOL is different, but I am concerned. It is much easier to put a contact on and off then to redo a IOL.
All you have to do now is to convince your mother that her doctor might not be making a recommendation based on her best interests. Might be a tough nut to crack with that generation. Good luck.
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
I am one of the 5% who can't drive at night because of glare from Restor lens. Unless your mother is too old to drive at night anyway, she should give that some thought. It really makes you feel handicapped when you have to hurry & get home before it gets dark because the glare is so bad you think you might have a wreck. Other than that, I love the Restor lens. I have 20/20 reading & 20/30 to 20/35 distance. I can see the t.v. really well. I can also see the computer & I work on the computer every week day. I had to pull the monitor a little closer than I used to have it, but can see fine to do my work. My distance is the worst. He is going to do some sort of laser surgery to correct my astigmatism & that might help my distance & maybe the glare. I'm hoping so. Still, even with not being able to drive at night, I love the Restor. My eyes aren't as good as when I was young, but they're close. I think I had eagle eyes when I was younger, so it's hard to get that back.
Accommodating Lenses!!!
Check out http://AccommodatingIOL.com
Has some decent info about the topic
I made the mistake of my life going with Restore lens. I had one cataract and had both the lens in my eyes. Theproblem started when after the first one was inserted . A day before the second one was to be surgically placed my Physician says OOPS I didnt know that ALCON did not make a lens in the strength that my eye required! He said that he would have to perform Lasik to bring my eye up to the tight prescription. So now I have to go under the knife(laser) again. How in the world can a professional goof up like this on the second patient in his practice to have this new lens. Where are the office protocols? I would have thought that there would be a check list that would be checked at least twice to make sure everything is in place. I am not sure if it is because I do not have the right strength lens in but my vision stinks. I cannot read a newspaper unless I have a high powered light shing on me and my intermediate vision is horrible. This product has been way over sold and patients need to step back and really make a conscious decision and decise if they want to go with this new technology. I honestly now think it is all about the money. I read all the clinical trials and how 90+% of the patients loved this lens. I would like to meet these so-called happy people and ask them some questions. BTW I am only 53
I am sorry you are having problems with this lens. My Mom had her left eye done with it 8 days ago. At first her vision was blurry, but now she says the distance is sharp. The near is getting sharper, but is still not perfect. The doctor told her it could take a couple of weeks for the near vision to clear up.
She goes back in 5 days to have it checked and if all is well will have the right eye done the next day.
[QUOTE=jmbeam]I made the mistake of my life going with Restore lens. I had one cataract and had both the lens in my eyes. Theproblem started when after the first one was inserted . A day before the second one was to be surgically placed my Physician says OOPS I didnt know that ALCON did not make a lens in the strength that my eye required!
I'm not exactly understanding what you're saying. It sounds as if you had the first Restor IOL implanted in one eye and that went OK. Then you needed it in the second eye and they did not have a lens available in that power? If you don't mind my asking; what is your prescription? Unless you have an extremely long or short eye the Restor lens should be available. I am, therefore, assuming that you must have an extreme prescription for which Restor is not available. If that's the case then I agree that they should have known that before. However, I have a feeling that you will be very satisfied after the Lasik. We are beginning to realize that a good percentage of Restor patients may need to be supplemented with Lasik to get the really perfect results. Most Restor surgeons (such as myself) are mentioning this upfront and offering a sharp discount in the Lasik if it is absolutely neccessary postop. I am hoping that most of my patients will be perfectly happy without the neccessity of additional Lasik; however, it is only fair to warn them upfront.
By the way: Restor is not about the money. Even though there is more money involved it is mainly about offering multifocal vision to patients. I have seen the look on patient's faces when they can see distance and near without glasses after 50 years of dependence. I think that's it's the next evolution in the IOL.
After reading all these posts I have some doubts. If the MD would answer some questions for me. I am having surgery in about two weeks on my left eye. My night vision is scary!! My right eye with my glasses on is just great. I think the Dr. said I had a +.75-2.00 in this right eye. He wants to wait a week after the first to do a second cataract surgery on the right. He says I have a small cataract on it as well. My question is if it is not ready yet why do it?
As far as the IOL standard my parents had theirs done in their 60's. They are both very happy with this plan. They still wear eyeglasses for reading. Only one problem my dad had was after awhile I do not remember the time frame he had to have a lazer on one eye because he saw cloudy. They fixed that. Of course they did not have the MF implants then. I was looking at a article on the web and it said that some patients wanted the MF removed and the standard put in because of multiple images at night. So why are the doctors pushing a lens that would cause problems when the standard is okay? I for one like to wear glasses. My MD told me I would have to wear sunglasses anyway!
What is the cost difference for a standard implant vs. the MF implant?
:)
I think this is very similar to the contact lens options. Robert Martarello made some excellent points concerning the use of clinical trials to support Restor and other multifocal IOLs. You have to look at the patients in the trial. Many have other pathology such as macular degeneration. Also, many have reduced demands. For a 75 year old with a less demanding lifestyle, they may be ok. But, my observation, based on feedback from real patients is that they may be able to perform relatively well on Snellen acuity tests, they are not very happy. Again, just like the multifocal contacts, Snellen doesn't fully measure quality of vision. I see lots of patients read 20/25 or 20/20, but state "it just doesn't look clear". When I ask them if they would go that route again, they generally say no. "I would rather just use reading glasses".
I'm a very active 51 year old myope. I've tried the various contact lens options and there is no way I could live with the compromises of the multifocal lenses.
The bottom line is that this technology just isn't ready for widespread use. With carefully selected patients and adequate pre-op discussion there is a place for them, but the technology is far from mature.
For now, conventional implants are the best bet for a more active, demanding patient in my opinion.
The trials only include patients without pathology. this is why sometimes they may be BETTER than what the clinicals find
[QUOTE=ilanh;113889]It's attitude's like these regarding the issue of eyewear *dependence* that are our worst enemy.
I have seen him. I have met him. And it is us!
Must surgeons should have some training about their own prejudices regarding eyewear and the *best* vision possible.
B
After a cataract procedure I was told that at times a capsule forms on the eye that creats havoc with ones sight. This condition can be easily taken care of with a Yag laser. Is this true and if this occurs in my eye is it a condition that a Physician really has to look for to see it or is obvious? I am concerned for a couple of reasons. Thanks for any input on the subject.
Usually the patient notices the vision going South, similar to cataract development (sometimes misnomered as a "secondary cataract). If no the practioner will catch same during routine follow-up or yearly exams. This occurs in 50% of cataract patients. And be not dismayed the laser zaping takes about 5 min, no recovery time and you walk out of the office seeing again.
Chip
Does the patient need to have his/her eyes dilated for the MD to be able to see this?
I doubt dilation is needed but it would give the doctor a much clearer view of what he was looking at. What difference does it make if the doctor needs to dilate him or not, dilation is not major invasive surgery.
Chip
Does anyone know how much a cataract surgery costs? I have no insurance and I am too young for medicare!
:)
They changed the ReStor after she had the implant... the add was too strong, so they dropped the number of rings to bring it down to an effective +2.50. I personally would rather be left at a -2.00 monofocal.
If you get the night glare from a Restor, try a drop of Alphagan ~30mins before going out at night. The manufacturer also recommends turning on the dome light in your car :)
Even though it's an old thread I'll throw in my two cents worth. As a surgeon who does a lot of implants I'm still not 100% sold on the multifocal implants ie: Restor, Rezoom, Crystalens, Technis MF. I offer them to patients who are VERY motivated to be completely spectacle independent and I thoroughly explain the potential downsides. The Restor lens is probably the most popular lens out now and has been greatly improved by the +3 add rather than the +4 add that it used to have. Patients are reporting that the distance is the same but intermediate vision is much better. Reading is as good as it always was but you can move the print a little further away. Due to the nature of its apodized surface and its rings, reading is difficult in low light and there are some halos at distance at night. Overall, however, the apodized lenses all involve somewhat of a compromise ie: the total available light entering the lens is split into the component focused at near and the one focused at distance. This means that your vision is always using less light that the total available and that may affect contrast, sharpness, brightness etc. Even though patients are happy to be spectacle independent I don't get quite the WOW factor that I expected. I suspect that it's secondary to the above mentioned compromise. I do get quite a WOW factor with my monovision monofocal IOL strategy which is vaguely similar to Contact lens monovision but much better in every way. It too involves a compromise but I feel that the compromise is less and is also physiologically easier.
About ten years ago, I remember reading about a lens that was either in or just about to go to clinicals. If memory serves, it was a gel based implant that was supposed to completely fill the capsule. Being gel, it was also soft, and therefore was thought to afford some of a patients natural accommodation back. The doc would take the standard A's and K's, and then order the lens power needed. It would ship to the surgeon in a rod form, roughly 1 X 10 MM, something akin to a clear pencil lead was the image I seem to recall. As it was inserted into the eye and capsule, the patient's body heat would soften the lens, and it would regain it's lenticular form in about 20-30 seconds or so.
I never hear about it now, so I'm guessing the design was a failure. But the concept - a lens as close to a natural human lens as possible - seemed a very cool thing. Anyone know if this just flopped or what might have happened? I can't remember who was manufacturing it, or it's name at the time unfortunately.
Bri~
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