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Avatar universal

Cataract and newer types of iols

Hello everyone,
I'm a young guy at my 27. For some unknown reason, this did not get in my way of developing cataracts - posterior subcapsular - on both eyes these recent years. Yep, lucky me...

I've been putting off surgery for quite a while, mostly seeing clearly indoors and away from sun or bright light - as my type of cataract mainly interferes when my pupil is constricted (being a small spot on the back of the capsule). Meanwhile i tried some nutritional/eyedrop alternatives, and i dont have to tell you how much that helped. So as reluctant as i've been to touch my eyes with surgery, I now reckon that i can't keep this up and lens replacement is inevitable. (PLEASE correct me if I'm wrong... Isn't there some laser beam that dissolves only the cataract particles on the capsule? Modern science is so disappointing.)

So as you might expect, I'm not so fond of the idea of losing focal accommodation, especially at my age. If I have to remove my natural lens to clear my vision, I'd strive to get implants that most allows me to keep a lifestyle of not putting glasses on and off, but also keep seeing the world as clear and uncompromised as possible. I don't mind glasses for prolonged reading, but good quality intermediate and far w/o glasses is important to me, with perhaps some near quick label readings as bonus. Also I probably require a topic lens for my ~2D astigmatism.

I'm aware of the common tradeoff in choosing the right iol. As I did my (borderline obsessive) homework, I've read alot of reviews about all kinds of lenses- concentrating on Monovision, Multifocals and the still experimental accommodatives- and came into reviews that were too varied and just confused me more. The problem is, most reviews I found date a few years back, and their relevance may have changed since. For instance, I found no reference to newer solutions such as Bausch & Lomb Trulign logic, or Acrysof ReStor 2.5D (which I'm guessing may have less of the gruesome multifocal side effects) These two seem like good candidates to me on paper, but I haven't come across actual patients' comments and reviews.


So I'll finally phrase my questions:

What would you advise me to do given the variety of current solutions?
Have you gotten cataract surgery in the recent years and recommend on / against something particular? (Especially monovision, multifocals or accommodatives, for the needs I specified above)
Has anyone had experience with the Trulign Logic lens and can tell if they actually work?
Has anyone experienced ReStor 2.5 (or other multifocals that don't try reaching as near as 3D) and can testify about them, including reference to distance contrast and halos?

Also, if you are aware of any new or upcoming developments of treating cataracts / accommodation that may affect my course of action, I'd love to hear of course.


Any information and comments would be very appreciated!
16 Responses
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Avatar universal
Sorry...typo there...my last  sentence should read:
It's usually the preferred way because it so much less evasive than explanting a lens...
Helpful - 0
Avatar universal
Option when you have had monovision done and are not happy, is to have a lasik touchup to either bring the undercorrected eye to mini monovision (say about -1.0 diopter) or a full correction up to 20/20...

It's usually the preferred way of explanting a lens because it is less evasive...
Helpful - 0
Avatar universal
And, of course, the Acrysof ReSTOR 2.5 and the multifocal versions of the 3.0 and 2.5 have not yet been approved by the FDA.
Maybe some time this decade, but I wouldn't count on the FDA moving faster than glacier speed.  
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233488 tn?1310693103
MEDICAL PROFESSIONAL
=  means I have read the last post and have no further comment.
JCH MD
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Avatar universal
ola1000, thanks for your valuable input... If I understand correctly, you didn't adjust to monovision? Or you DID adjust and are just unhappy with this concept? Is there anything you can do now to improve your state?
I asked a certain dr in london about Trulign for me, he checked with the supplier and said it's not yet available for my eyes.. should take a few months he said. If this may be the best long term solution, I can wait some more.


By the way, I still can't help myself from occasionally checking for other solutions. In the past few months two articles got my attention:
1. Oct 2013, Germany:
http://www.medicalnewstoday.com/articles/267835.php
2. Dec 2013, Scotland:
http://www.scotsman.com/news/health/scots-scientists-develop-laser-cure-for-cataracts-1-3242146
I know that even if any of it is true it may take a long time before it's actually out there. But, I'd like to hear you guys' opinions about these new research diretions.


One question for you Dr Hagan, if I may, what does it mean when you reply with a mere " - " or " = "? I saw it alot and didn't get it.
Helpful - 0
233488 tn?1310693103
MEDICAL PROFESSIONAL
Follow this link for Trulign information

http://www.revophth.com/content/d/technology_update/c/42257/  

Helpful - 0
Avatar universal
And who is this top ophthalmologist Trulign surgeon?  
Thanks in advance.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
=
Helpful - 0
Avatar universal
Same age I got surgery monovision on both eye using conventional lens, i would completely recommend against that. it'a not worth losing the natural accomodation, it was very depressing for me. Afterwards I got a chance to email one of the top ophthamologist in the country about the TRULIGN™ Toric Posterior Chamber Intraocular Lens. It's a surgery that totally depends on the skill of the surgeon, i would advise u to go to only the best even if you have to travel out of state. Read articles and you would see this surgeon giving advice to surgeons about the best way to perform this procedure and what to watch out for. i couldn't help sadly because i already had monofocals on both but this surgeon advised that results might differ and aren't worth the risk
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233488 tn?1310693103
MEDICAL PROFESSIONAL
-
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Avatar universal
Using the "Find A Surgeon" feature on the websites of the IOLs you find most interesting, should give you some matches, enabling you to find a nearby Dr. that has experience in both types and could make a valid recommendation.
Helpful - 0
233488 tn?1310693103
MEDICAL PROFESSIONAL
I have not experience with those two lens. You can search the medical literature using a search engine or go to  PubMed  http://www.ncbi.nlm.nih.gov/pmc/

Consider getting 2 or 3 opinions on your best options.

JCH MD
Helpful - 0
Avatar universal
Thanks, i've read the article and it was indeed very informative.

But some of my questions do remain:
I haven't yet heard experienced reviews about Trulign lens and Restor 2.5, both are the "premium" iols that take my interest most. These along with monovision seem like my leading options.
Where can I find non-commercial information of these iols?

[ And, I was of course joking with my rant about science - patients in the past probably only dreamed of today's treatments. I just wished I could fix it without cutting my eye open... But that may already count as sci-fi ]
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233488 tn?1310693103
MEDICAL PROFESSIONAL
=
Helpful - 0
Avatar universal
LOTS of valuable info in Today's Pulse.
I would also suggest a book by David Richardson, MD, titled "So You've Got A Cataract, What You Need To Know About Cataract Surgery" available for a reasonable price, and also can be purchased in a Kindle edition for easy reading.
Good starts.
Helpful - 0
233488 tn?1310693103
MEDICAL PROFESSIONAL
Your questions can be answered by going to Today's Pulse at the bottom of this page and reading the article I wrote on considerations before cataract surgery.

Modern science is so disappointing???????

JCH MD
Helpful - 0
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