Crystalens caused farsighted and starlight glare

[7150tim]

I had cataract surgery 8 months ago, and elected to have the premium Crystalens lens put in.  The problem is the lens replacement caused extreme farsightedness and I see a starlight glare.  I am not sure if the lens was faulty (or the wrong size was put in) or my eye seated the lens too close to the cornea.

My Doctor's soultion is to put in a corrective lens in front of the Crystalens to correct the vision.  However, the starlight glare is pretty extreme, The rays are pretty big, when driving at night and looking at oncomming headlights, the star spikes are across the whole windshield.   My vision is correctable with contacts, but it is single focus and the glare is still there.  I'm afraid that I am stuck with fhe glare problem.

My question is this the only or best solution?  Can Crystalens be taken out after so much time?  

[JohnHaganMD]

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[CBCT]

I too had problems with Crystalens -- serious glare and minimal accommodation.  After a year for one eye, and a year and a half for the other, I had the lenses exchanged with monofocal lenses.  I am happy with the results and have good vision at all distances with progressive lenses. If you are considering a lens exchange, dont have a YAG, as this complicates the exchange.  Best wishes.

[CBCT]

I too had problems with Crystalens -- serious glare and minimal accommodation.  After a year for one eye, and a year and a half for the other, I had the lenses exchanged with monofocal lenses.  I am happy with the results and have good vision at all distances with progressive lenses. If you are considering a lens exchange, dont have a YAG, as this complicates the exchange.  Best wishes.

[Anomalychick]

Crystalens in particular can cause peripheral rays of light. You may still have these issues if you switched the lens to a monofocal, but there is a decent chance they would go away. Nothing other than an IOL exchange will help with your dysphotopsia.
All the other options mentioned can fix the farsightedness, and are safer than an IOL exchange. Could you deal with the light rays if you did not need the contact or are youc ompletely unable to deal with them to the point where you are willing to risk further complications? If you can't deal with them, you need to have an IOL exchange which will probably help but not for certain. if you can i'd recommend one of the other options.

[JohnHaganMD]

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[SoftwareDeveloper]

Although the Crystalens can likely be replaced, since it is a single focus lens the question is whether you might have the same trouble even with a monofocal replacement.  Unfortunately there is no IOL out there that is perfect, even people with monofocals can have issues with halos or glare. The difficulty of replacing the lens   depends partly on whether you have had a YAG treatment, which may lead the replacement lens to need to go outside the capsule.

In terms of farsightedness, that can be corrected either by exchanging the lens for one of a different power, or by a laser enhancement, or by a 2nd piggyback lens as the doctor suggested. A piggyback lens   is one of the commonly suggested treatments for dysphotopsia (an unwanted visual artifact, though usually I don't think they use the term for this, rather than just saying "glare"). I am guessing the hope is that using a 2nd lens rather than replacing the existing lens is more likely to get rid of the glare. I don't know if this is necessarily the case, and unfortunately I suspect no one can know for sure. There are experts in dysphotopsias so if you are concerned about getting another opinion, you could search the net for articles on dysphotopsias and contact the surgeon's mentioned,  e.g. Samuel Masket.

http://www.eyeworld.org/article-understanding-positive-dysphotopsia

[JohnHaganMD]

I would suggest you get some independent opinions from cataract/refractive surgeons about your options. Yes the Crystalens can be removed and likely replaced with a monofocal IOL.   JCH MD