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Crystalens Hd

I am 54 and just had surgery on 11-13-08 I had the new CrystalensHD installed in my right eye. Everything went well and I could see long distance very well immediately. I cannot read without readers and have trouble with glare but my doctor says that is due to the eyedrops I'm taking and it will improve with time. I tried wearing my old glasses for the help with the other eye but that just doesn't work, so I wear a contact lens in the non operated eye. Eventually I'll have that eye done with a Crystalenshd and then not have to deal with the contact lens which I absolutely hate wearing. I'm hopefull that in time I'll experience great vision.


This discussion is related to Crystalens HD 4th Generation Lens.
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Avatar universal
What kind of lens were placed for your IOL
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Avatar universal
I just wanted to say thank you for informing the public on your experience with the crystalens hd from the time u had surgery. I am 40 and had LASIK 4 years ago; developed last year a cataract in both eyes, but the one in my right eye was very fast progressing.  My close up vision in my right eye was crystal clear up until my surgery. I had my surgery almost 2 weeks ago and I am very frustrated with my results. My right eye was my dominant eye. I am very depressed about it and hate not seeing my 2 small children clearly. I feel atleast with the cataract I could see them well close up. It is good to know that I need to give it more time and that I am not alone; that it might improve. My doc says my vision is going to change a little but is close to what it will be...I hope not!
Not only am I a mother, I am a nurse on a pedi floor. My close-up vision is very blurry, my intermediate vision and far vision are also blurry  and am afraid my job will be in jeopardy. I have difficulty assessing my patients on occastion and I know that I would not be able to start an IV on an infant with this vision. Readers do not work well because my vision in my left eye is mildly presbyopic. After reading your comment, I feel better knowing that my vision might improve; that there may be a light at the end of my tunnel. Thanks  :)
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Avatar universal
Well, I am 70 also and am scheduled for CL 500HD in about 8 hours.  Naturally, I am nervous after reading these posts.  My right eye will be done tomorrow and the left, also CL 500HD, is scheduled for October 7th.  My objective throughout this is to achieve excellent vision at all distances and donate all my glasses to someone else.  Hopefully I will enjoy better results than recorded here.
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Avatar universal
I had surgery for a detached retina in left eye 10-06. My recovery period took about 14 Mons. with 5 eyeglass Rx changes in that eye. The slight catract in that eye steadily became worst.I am male 70 yo. April 16, 09, I chose to have a Crystalens HD implanted after considering all the alternatives. The fact that it provides a single focal point was an important point in my decission. I think I have a highly regarded surgeon and when going for my pre-surgery physical my regular MD said he is his childrens Opthalmologist.
Within a week after surgey, I tested distance at 20/30 and last week at 20/20. I can read the computer screen (arms lenght) if there is good contrast (black on white). My near vision is not very good, last week tested at J10. About a month after surgery I developed Macular Edema, I am using Nevanac & Omnipred 4x a day. the last scan three weeks ago showed it had significantly improved.
I am scheduled for right eye Crystalens surgery next Thurs.
No halos, sensitive to light, but Dr. says that could be caused by the eye drops.
Comments welcome.
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Avatar universal
Dee,
I had a Crystalens HD implanted in my right eye.in February 2009.  My initial vision was good for distance and intermediate, but no near vision.  However, it continued to fluctuate between 20/30 and 20/60.  After a few months it settled in myopic and I needed corrective eye glasses.

In the meantime, my Dr. recommended implanting the newest Restor IOL in my left eye.  After getting a 2nd opinion, this was done.  The Restor has worked out so well, that my Dr. has now replaced the CL HD with a new Restor in my right eye.

I now have good distance, intermediate vision and can read in good lighting.  I need readers for dim light.  I do not have any problems driving at night.  I get glare from both the Resor and CL HD, so I use sunglasses to drive.  I am a 62 year old male and my tennis game has also improved with the Restors.
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Avatar universal
Now that Crystalens HD has been available for almost a year, is there anyone reading this forum that has had 6 or more months of experience with the HD lens?  If you have, how long has it taken you to achieve distance vision?  What type of close-up vision have you achieved?  Is your vision still improving or getting worse? Did you chose to have the lenses set for some type of mono vision?  In hindsight, would you still chose the Crystalens HD?

I'm considering the HD lens and would appreciate all your feedback.
Dee
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Avatar universal
I read on this forum a person who had clouded vision due to PRK?
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PRK is like lasik, except that instead of cutting a flap in the cornea, they just rub away the outermost layer and let it grow back. Lasik is more popular because the recovery time is faster, but PRK is less invasive to the eye and so is preferred in some cases (like, I believe, post-IOL surgery).

The wikipedia article on PRK (Photorefractive keratectomy) looks reasonable now, although it was a mess a few days ago.
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I just wanted to clarify.  My experience with diminished vision in the right eye in low light with the CL HD, was only after exercising that eye (eye patch over the left eye), doing the word puzzles my Dr. gave me to practice accomondation.  After a few minutes, my right vision returns to normal.

I wonder if the close up eye exercises may cause the CL to be stuck temporarily in the forward position.  I don't feel like it is and it is never permanent.  Also, I've never experienced getting an "unstuck" sensation.

Can you explain what PRK is?
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Avatar universal
I'm no expert. I just did a lot of research before (and after) choosing the HD lenses. I haven't replied to Ace's last question because I have no idea whether it is normal. (For myself, I do sometimes need more light than I wish I would need).

My understanding is that it is difficult to hit the target refraction exactly with Crystalens (CL). Also, there seems to be a high variability of how much accommodation each patient might achieve (1D-4D). Finally I suspect some doctors are having a hard time un-learning their non-HD CL experiences where some of the best outcomes were with mini-monovision settings.

So in a perfect world, both HD's would be at -0.25, and you would get at least 2D accommodation. That would allow you to see roughly 20/20 at distance, and to see clearly as close as about 4/9 of a meter (16").

In the real world, you might end up at -0.75, giving you 20/40 distance, and difficulty focusing farther than 4/3 of a meter (4 feet). Or you might end up at 0.0 but only get 1.5D of accommodation, leaving you without near vision inside 2/3 meter (26").

Obviously you can (and perhaps should) get a second opinion. But from what you are describing, it doesn't sound like you got the wrong power lens. It sounds like it was within the expected margin for outcomes. It sounds like your lenses are more near-oriented than mine, as I have no trouble reading text on the TV.

As I mentioned, I have found some tricks with my eye to improve distant vision. They are far easier to learn with one eye closed. I'm going to talk to my doctor this week to make sure doing this trick won't risk dislodging the lens. Until then, try them at your own risk.

After your eye has healed, I would think you could undergo a PRK procedure to eliminate your residual myopia. My doctor offered a discount on laser surgery if you had an IOL done by him. In my case it would have been for my astigmatism, but the LRI's seem to have worked well enough that I don't expect to need a PRK. And my distance vision is "good enough" for my needs.
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Avatar universal
You appear to be quite knowledgable regarding the Crystalens HD and have had a similar result to mine. I had Cl Hd implanted in both eyes in Sept.2008 and Oct.2008 by a renowned surgeon. I expected to have very good distance vision and probably need glasses for reading. That did not happen. I can read most print without glasses and work on the computer as well but cannot read the print on the T V at 8-10 feet away and would not be able to pass the eye test to drive without glasses although I can drive O.K. with or without an old pair of weak distance glasses. I told my doc that I wanted my right dominant eye to give me better distance vision after my left eye was done first and was able to read immediately. I am now of the opinion that I had the wrong power lens implanted in the right eye since it has now been over 3 months and my distance vision has not improved.On my last visit in Dec., he gave me a new r/x for bi-focals.Any suggestions? I am not a happy camper. Blackwell69
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Avatar universal
This problem after prolonged exercises to practice accommodation.  The feeling is as if a flash light bulb went off in front of the right eye.
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Avatar universal
I noticed that when the light is very dim, like a dark corner of the basement, my right eye with the Crystalens HD is extremely dim, like a fog in front of the eye.  I could still see with my left eye, which still has the cataract.  Is this one of those drawbacks of the Crystalens?
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Avatar universal
10 meters is effectively infinity, so count that as 0D. 2/3 meter would be 3/2D, or 1.5D. So 1.5-0 = 1.5D of accommodation.

I believe most doctors target -0.25 for Crystalens, because you really don't want to accidentally end up on the plus side. If they hit -0.25 you would have distant (20+ foot) vision in the 20/20 to 20/30 range.

I found this page to be very helpful (hopefully this link won't be eaten by the forum software):
http://www.mdsupport.org/library/acuity.html
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Avatar universal
My vision seems excellent from 2/3 meter to ~10 meters and possibly further.  How much accommodation is this?

There is another issue, my right eye is not my dominant eye and according to my medical file, my Dr. says that it has never achieved better than 20/30.

I don't know what my Dr. was targeting for my Crystalens.  My guess is he was targeting 20/20 far vision and hoped I could accommodate for near vision.
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Avatar universal
My understanding is that a monofocal lens would have, on average, only 1D of accommodation, with some people having as little as .25, and a few lucky people getting 2-3.

In my case, let's assume each eye landed at -0.5, and that I can focus clearly from 2 meters to 2/5 of a meter (I think it actually is and/or will be better than that). That would mean that I have 2D of accommodation (from -0.5 to -2.5).

In your case, if your accommodation goes from (let's say) -0.25 (4 meters) to about 2/3 of a meter (1.5D), then you are only getting 1.25D of accommodation. That is less than I would expect for an HD, although still better than an average monofocal lens. Do you know whether your far vision is plano, -0.25, or whatever? Supposedly Crystalens users continue to improve their vision for months or years, so it may get better.

[In case you're wondering about the math, 1/meters = diopters, and 1/diopters = meters]

Oh, and I'm learning how to get better distant vision with less effort. It feels kind of like I'm pulling on a string that runs from the back of my eyeball to the front. I don't know what I'm physically doing, but it seems to be the opposite of accommodation, presumably flattening my lens. So far, I can only do it for one eye at a time, but I think with time it will become second nature for both eyes simultaneously.
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Avatar universal
It seems that your HD has settled in where it gives you good near (1 to 2 feet) vision, but sacrifices some far vision.  My HD seems to have settled in where I get really good vision in the 2 to ~20 feet zone but is not good at < 2 feet and only 20/30 to 20/ 40 far.

If what I just said is correct, then wouldn't we have been better off with the standard fixed IOL, or does the Crystalens HD still offer a wider range than a fixed?
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Avatar universal
20/20 vision is not perfect vision. In fact, it's not even great. It's somewhat mediocre. So any IOL or contacts or glasses that only correct to 20/20 would be slightly blurry. With my vision ranging from 20/20 to 20/50 (so far), it can be a bit blurry.

I haven't tried correcting my distance vision with glasses, and probably won't. As long as I can pass my drivers license test, I'm ok with how I can see. I don't want to overstate the blurriness. I have functional vision.

My understanding is that most people have excellent distance vision with Crystalens. In my case, my best guess (not confirmed) is that my eyes ended up at -0.5 or -0.75 instead of the targeted -0.25, plus maybe some residual astigmatism in my worse eye. I'll find out more next week when I go back for a checkup.

I hope that's clearer (hee hee).
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Avatar universal
Hello Peakhope,

i noticed you mentioned that your distance vision is not great, but is it correctible better with glasses? You also mentioned vision with the crystalens HD is blurry - i was wondering if you knew whether most people with a crystalens implant experience this ?

"and even if you get 20/20 vision, things will appear a bit blurry." - or did you mean all IOLs here?
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Avatar universal
I'm really sorry to hear you have had so many problems. It sounds like you were the unlucky "one in a thousand" or "one in a million" where more than one thing went wrong. The rest of this post is not specifically about your case, as only you know the full details. It's a reminder to people considering any procedure that there are risks.

Any lens can be great or terrible for any given person. Even the Array and Rezoom lenses, hated by many, worked well for some people. I think it is a combination of the skill of the surgeon, your expectations, and some luck.

Especially with the Crystalens, you want a doctor who knows exactly how to place the lens, as well as one who can correct any astigmatism that remains, and who can do a good yag if it is needed (and who won't rush to do a yag if it's not needed!). The doctor needs to pick the right lenses for the individual, taking into account the other eye, and needs to be able to handle whatever unexpected events come along.

Patients who expect perfect vision at any or all distances are likely to be at least somewhat disappointed. The target may not be hit, and even if you get 20/20 vision, things will appear a bit blurry. IOL's today can be better than the alternatives (cataracts, presbyopia), but are not perfect. If you choose Crystalens, you are betting that the advantages (sight at multiple distances unlike monofocals with less glare than multifocals) will outweigh the drawbacks and risks.

Finally, luck. Will you need a yag? Will the yag work well? Will your retina be fine? Will your brain adapt well to the lens? Will any glare or halos be annoying or debilitating? Will you get full accommodation with the Crystalens or not? Will your eye hit the target or be off by .5D one way or the other? Will you get an infection?

For many issues like that, there really is no way to know in advance. Medicine is like that. The best you can hope for is to fully understand the risks and benefits, find a great doctor, and then make your choice and take your chances.

I had HD's installed a month ago. So far, the procedure has been a success, but I realize that things could still go wrong (yag, rd). I still don't have great distance vision., which was a surprise, since most CL HD patients have great distance vision immediately. Mine seems to be about 20/40-50 in one eye, and (after a few weeks) 20/20-30 in the other.

So distant vision is disappointing (at least so far), but I'm still happy with my lens choice, because my intermediate and near vision are excellent. And I realize now (more than before the surgery) that near and intermediate are much more important to me than distance. What I have, while imperfect, is preferable to me than either monovision or the risk of glare with Restor lenses.

Informed decision + good doctor + modest expectations + luck.
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Avatar universal
I'm sorry to hear about your bad experience with the Crystalens HD.

I had a Crystalens HD implanted in my right eye 3 weeks ago.  My Dr. had recommended this because I am an active tennis player.  My far vision is between 20/30 and 20/40.  I've not had a Yag Laser yet, but my Dr. is seeing the start of clouding in the capsule.  He said this is common in youger patients.  I took this as a complement becasue I'm 62.

I cannot see well at all closer than 2 feet, but I've been exercising my right eye by doing the Crystalens word puzzles (1 per day) to improve accommodation.  I see flares and sometimes the edge of the lens, especially in low light, but they don't bother me.  I recognize that there is no perfect solution and afterall, this is a piece of plastic in your eye.

My Dr. recommended implanting a Restor lens in my left eye.  He says he has a lot of patients who did this and are very happy.  I got a 2nd opinion and have decided to agree with him.  This will be done next week.  Member "bstaggs" did this and he is extremely happy with the results.  It seems this combination is very complementary.

My Dr. did say that the new Restor, which has improved near vision is gaining on Crystalens and there are a number of Dr's in my area who prefer to implant the Restor lens.  Have you considered replacing the Crystalens with the Restor?  Restor does produce halos around bright lights, etc., so you will have to put up with them.
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Avatar universal
I had the Crystalens HD put in end of July 2008 when it first came out. I have it in my left eye. It's been 6 months of misery. No near vision, no intermediate vision, nausea w/ reading glasses. Timeline: July 2008 Crystalens implanted, August 2008 YAG laser, October 2008 "piggyback" lens implant to improve far vision, November 2008 'piggyback" lens removed due to high eye fluid pressure, February 2009 still waiting for vision to stabilize as it is different, both far and near everytime I go in. My vision is actually getting worse. Glare, flares, moving light at the bottom of my eye, burning, redness, floaters, you name it. I've been checked for everything, like retina detachment. My eye is otherwise "healthy" it's this horrible Crystalens. I have one of the top surgeons in the country and he is as frustrated as I am.  Next visit is in a few weeks. I still need my right eye done. I'm a 42 yr old, female. I am very active in motorsports and I have been able to do nothing now for 6 months. This lens should not be on the market. The "HD" is "Highly Defective".  
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Avatar universal
I think the main thing is that you really won't know your Crystalens HD results for at least 2-3 weeks, and probably more like 4-6. So if you can't wait that long before your second procedure. you'll have to make a decision without all the information. My eyes were done 1/7 and 1/15. I'm a 45ish male with lifetime significant myopia and astigmatism. Each eye was ballpark -4 sphere and -4 cylinder.

Both of my eyes got HD's targeted at -0.25. I don't yet know if that was hit or not. Each eye can focus to about 16 inches, but reading with both eyes at that distance is not yet comfortable.  My vision and reading at 20-24 inches is so good that I actually reduced the system font size on my laptop about a week ago, to 9 points. In good light, I can read the tiny print on the back of a credit card, which is a pleasant surprise.

I can see great out to about 6-8 feet. Beyond that, it sort of comes and goes. I think I may have some residual astigmatism in my left eye that is causing some ghosting. I find that my distance vision improves as I take a deep breath, and just totally relax into it. I feel completely safe driving. It is possible that my eyes landed at -0.75 (for example), but I won't know that until my next exam in the middle of February. I believe my near and far vision will continue to improve over the next weeks and even months as my brain learns how to use these lenses.

My goal was to be free of glasses, and assuming I can pass a driver's license visual test, I will have achieved that. I work on computers for a living, and that vision is excellent. I have no trouble reading the newspaper or a phone book (in good light). My distance vision is "good enough", so I'm already a satisified HD customer, even with distance vision that is worse-than-expected so far.
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Avatar universal
Dee,
A Crystalens HD was implanted in my right eye on 1/20/09.  After 3 days I was still dilated.  At the 1 week post op exam, I still could not read the close up chart.  My far vision was 20/30 but still not totally clear.  My vision from about 2-1/2 feet and further is really good.  I cannot read the computer monitor with my right eye.

Please review the question I posed about "Crystalens in the right eye, Restor lens in the left eye."  There are a lot of good comments.  Bstaggs raved about this combo.  I am also myopic and can read with no glasses close up.  I would hate to lose that ability.

So, I am now seriously considering getting a Restor lens in my left eye, so I can see close up.  This was suggested by my Dr., since I had no accommodation after 1 week.  I am getting a 2nd opinion tomorrow.  In the mean time, I will continue to exercise my right eye to see if I can get more accommodation.  peakhope, also a Crystalens wearer (both eyes) wrote that his eye muscle did not return to normal until after 3 weeks because of the atropine.  My next surgery is now scheduled for 2/17, so I'll see if the Crystalens will accommodate more by then.  If it does, then I might consider another Crystalens in the left eye, otherwise it will probably be the Restor.

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