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Need to hear from people who know about the Nanoflex

         I am not even 30 and need cataract surgery in both eyes, so getting this right is very very important to me. I don;'t think I would be happy with any of the commonly used options, so I'm looking into lesser known ones.
        The Nanoflex IOL from STAAR supposedly gave 100% of study participants 20/20 at distance (best corrected cuz they don’t always focus it perfectly) and 20/63 at near. That’s 100%, 75% of participants could see 20/40 or better at near. Supposedly when used for monovision people have 20/20 across the board.  (instead of needed glasses for intermediate) Supposedly blended vision with this lens can be done in several different ways to supposedly give you perfect vision, no glasses, and you would not be able to tell that your eyes were not focused the same if done correctly.
        100%  of study participants could see 20/32 or better at intermediate. It certainly seems miles better than any monofocal, and pretty competetive with multifocals or crystalens with no drawbacks.  The nanoflex is approved as a monofocal, but supposedly they are trying to have that changed to accommodative for obvious reasons.  Unfortunately, this information comes from two small studies, both of which were paid for by the manufacturer. In addition, there are probably only 20 or 30 doctors in the country who offer this particular IOL. If it was as great as the study results indicate, I can’t imagine why it would not be the ONLY available choice for cataract surgery. In fact, I think everyone over 50 would be lining up to have it implanted for presbyopia correction as well. So, either it’s the best kept secret in the world, or the study results are not giving the whole picture. I want to know if doctors are seeing similar results in their patients, and I want to know if those results stay stable after YAG capsulotomy.  There is a doctor in PA I think who advertises it on his website, but he indicates that he wants to operate on the dominant eye first to ensure crisp distance vision. He then talks about the possibility of doing LASIK afterwards if there is a refractive error. It makes me wonder if the power on this lens might be a little bit more difficult to calculate than with other monofocals. (It just seems strange that someone would advertise difficulties with power calculation in the same place they are advertising why you should come to his office and get “blended vision.”) I have called ten doctors who offer this lens so far, and have written emails to two. Both emails were not replied to. Most calls were not answered. In one office the person answering the phone insisted it was a monofocal and two pairs of glasses would be necessary. In another they stated it was FDA approved as a monofocal, but when pressed she then indicated that patients could usually read around J5 (light reading glasses only, if any at all) and then politely reminded me that it was a monofocal. In one office, office staff actually called me back two days later to inform me that the doctor would not be returning my call unless I wished to travel 500 miles to come in for a consultation. Nobody permitted me to speak with a doctor who had experience with the lens, and nobody was able to answer my questions.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
Nothing is 100%.  However most physicians are near overwhelmed with patient care that they do not have time to call patients or perspective patients that call in and want to talk directly to the surgeon about surgery, IOLs etc.  The shortage of physicians will grown much worse in the next 5 years and dramatically more people have to be taken care of in the USA with much fewer physicians.

If you want to do your "due diligence" on IOLs there is a wealth of information here that you can access using the search feature and archives.

JCH MD

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Avatar universal
Dr. Hagan, I do appreciate your response. I certainly mean no disrepect to the medical community. My father is a physician and I certainly understand the overwhelming pressure from too many patients. On the other hand, I have a very important decision that I need to make and insufficient information available to me to make it with. I wrote this post after careful weeks of meticulous research including everything on this forum as well as other online resources as well. The only thing on this forum are people asking about the nanoflex, and doctors replying that they are unfamiliar with it. There was one woman who reported having one, although she mentioned it as an afterthought, she was only here with complaints about the restore IOL she had in her other eye She mentioned she needed reading glasses. Thats not a whole lot of information. Sometimes you need reading glasses, and sometimes everything closer than ten feet from you is blurry, but it doesnt really specify.  I am looking for patient reviews to describe what their vision is like, or responses from doctors who have implanted it, so that there can finally be some information about it on this forum so that I  and the others looking for info don't need to call random doctors all over the country who are too busy to speak with us. Thanks..
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233488 tn?1310693103
MEDICAL PROFESSIONAL
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Avatar universal
Hi Anomalychick,
I could have written your letter myself. Almost no information  and I searched a great deal just like you. I am in California and I met a doctor who uses the nanoflex lenses and they do sound wonderful. According to him , there will be almost no need for glasses. I spoke to an older lady who have them and she was really happy with no glasses whatsoever, plus her insurance fully covered her surgery. But like you  I need to hear from more people and doctors. The fact that they  are Standard monofocal lenses makes it difficult to search because simply doctors don't make real money on those lenses.
I will keep you posted .
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Avatar universal
Hi Anomalychick,

I am in my 30's and was also swayed by the limited studies you see online regarding the Nanoflex. I liked the idea of the mid to distance all being in focus and not dealing with the issues people seem to have with the multifocal lenses.

I was implanted at Duke about four weeks ago and will give you some general impressions.

I have cataracts in both eyes but have only had surgery for the right eye so far. The surgeon recommended distance vision for the first eye and wants to do near vision for the left eye when the time comes.

The surgery was quick and easy (although still scary...it is a surgery after all) and I was peeking through the cheese grater metal patch right away after surgery to get a look at things. Everything was very bright and very blue tinted. The next morning I had my follow-up appointment and could read the eye chart at 20 20. For the first few days there was a diagonal glare running from top right to bottom left off of every bright light source. This lasted for about a week but near the end of the week tapered off over the course of 2-3 days and was completely gone except some localized glare around bright little LED lights and nighttime driving.

The impression that everything had a blue light shining on everything took about 2-3 weeks to fade away. Things are still notably more blue with the new implanted eye versus the still cataract afflicted eye. My brain tells me that even though the cataract is making the left eye more yellow maybe things should be a little more sepia toned than the new lens is showing me. It's more fascinating than annoying to me. I am probably seeing true color for once. I assume the issue will go away when the second eye is done.

As far as clarity - I am VERY happy with the results. I have focus from about four feet out to infinity. I feel like 4 - 12 feet is truly crystal clear and the "to infinity" part is a little lacking in crispness and clarity. I am able to drive without glasses for the first time ever and at my 3 week visit I was still 20 20.

There are some glare and halo issues around headlights and streetlamps at night but I am not sure if that is because of the already forming post capsular opacification or if I am not enough weeks post surgery for things to really settle in. I am a little worried that when the other eye is done I might not feel 100% confident driving at night, BUT, the improvement over the cataract vision when driving at night is no contest. I am much safer now.

I don't know what vision is like with any other implant brand but I am very happy with my choice. Let me know if you have any questions about my experience that I didn't cover and I'll try to give you an answer.
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1 Comments
Hello Anomalychick! Could you please provide your vision after implanted the nanoflex with blended vision? How is your vision now? Any halos at night driving? Thanks so much. Lyn
Avatar universal
How is the Nanoflex lens doing now? My Doctor mentioned three choices Acrysoft, EnVista and Nano flex. I am leaning toward the EnVista or Acrysoft but plan on seeing another Doctor for consultation and information.
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Avatar universal
I am still happy with the lens. Everything is still essentially as described above with 4 - 12 feet in crystal clear focus and further out acceptable but not a perfect 20/20. I feel the "seeing blue" issue has become much more minor and I have to actively look for it. It is like someone took the blue filter in a computer program and turned it down from 40 percent to 10 percent.

I have another appointment in a couple months which I might try to push up because I don't feel my night vision is very good due to the previously mentioned halos around streetlights and headlights. I am not sure if this is due to post capsular opacification or a limitation of the lens. I feel like it is the opacification because the first few days everything(including direct light sources) was so crystal clear with the exception of the glare shooting off of them. This halo issue is more of a fuzzy mess that I don't feel is part of the lens but I could be wrong. Even at four weeks out the doctor told me he could see some clouding of the capsule so I can't give a full review of my experience until they remove that at some point. My understanding (from reading this forum) is that they will probably try to make me wait a full three months for the YAG procedure to get better reimbursement rates from my insurance company.
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Avatar universal
Here we are, further down the road, and REALLY wanting an update on your nanoFLEX experience.
Thanks in advance.
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Avatar universal
They made me wait the requisite three months for the YAG. The increased cloudiness, glare and halos were definitely from Posterior Capsular Opacification. They did the laser but said the capsule was very thick so they zapped me with the laser a few more times than usual. The piece that came off decided to stick around (or part of it at least) and it now hangs around as a big goobery floater. I am learning to live with it but it really is an annoyance to an otherwise great experience. I was told that it was unlikely to go away and I just have to learn to tune it out. Other than the floater the difference immediately post YAG was as dramatic as the first few days post lens replacement. Everything was clear, crisp, contrasty and just beautiful.

Daytime vision is gorgeous. I have never had such good vision without glasses for distance vision.

Night vision is not perfect. When I first got the implant there were harsh glaring lines that came off of any bright light reflecting off metal or glass and from any streetlight or headlight. That is gone. However, even with my other eye still having a cataract I'd say my perception of stars in the night sky with my bad eye are a sharp pinpoint and they are a bit more of a messy dot with the nanoFLEX lens. Also there are halos around streetlights and headlights but they are not a deal breaker for me. I'd say if you were at a red light on a street with multiple lanes you could see a faint halo reaching more than halfway to the light next to it. By contrast, the cataract halos and distortion from my worsening left eye completely engulf and distort the other red light.

I no longer have the blue shift in the nanoFLEX eye. I think my brain must have been shocked by all the blue I was perceiving and was feeding me too much information about it at first. Now I would say the nanoFLEX has a way more natural look to it than my yellow/dust filtered cataract eye.

I am trying to have my next eye done in January or February and will post an update on what the near vision lens is like. I don't have proper stereo vision anyway and will probably opt for monovision instead of mini monovision so I can see my smartphone, books and computer without reading glasses (hopefully).
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Avatar universal
Not sure if you have been to the NanoFlex lens website, but they have a 'Find a Surgeon' link where you can select a US state and get a list of doctors who supposedly are familiar with their products.

Here's a link to the search for California - if this doesn't work, just visit the nanoflexlens.com website and use the Select a Surgeon tool.  I hope you can find someone with good experience with the lens if you pursue it.  Good luck.

http://www.nanoflexlens.com/locateasurgeon.php?state=CA&Submit=Search#search-results
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Avatar universal
Dr Ray's comment in another thread on the Nanoflex lens may be a cause of concern.  
http://www.medhelp.org/posts/Eye-Care/Staar-Collamer-Aspheric-Lens/show/1312880#post_9699591
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Avatar universal
I'm sorry but I do not have any personal knowledge of a doctor using the Nanoflex in California; I just wanted to send you the locator tool from the website.  I'm also not sure what the Nanoflex II is; I didn't see anything about this on the STAAR website.

There has been a toric version of the Nanoflex approved in Europe for a while, so perhaps they are bringing that to the US?  Or maybe the 'II' version is just an improved version of the first Nanoflex.  You could contact STAAR and ask; they are in southern California too.  

The STAAR Surgical Company customer service department in Monrovia, California, is available to assist you Monday through Friday, from 6:00 a.m. to 5:00 p.m. PST by calling 800-352-7842.

Fax Phone Number:  800-952-4923
E-mail Address:  ***@****

STAAR Surgical Company
1911 Walker Avenue
Monrovia, CA 91016 / USA
Phone:  +1 626 303 7902

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Avatar universal
In terms of your upcoming cataract procedure, please try not to freak out too much about the possibility of 'going blind' if you wait too long to have the surgery.

Cataract surgery is one of the most commonly performed procedures in the US and the safety of the surgery is quite high.  Best results can be obtained by complying with your doctor's instructions about pre-and post-surgical medications and care, and by disclosing all your supplements, vitamins, meds and related health conditions so anything affecting the surgical outcome can be managed by the cataract surgeon.

That said, it is true there is an optimal window of time for a cataract procedure; when it interferes with your vision but not when the cataract has become so dark/clouded/hard that removing it is difficult.  If you wait a long time before surgery, a larger incision may be required to extract the cataract, which isn't necessarily a problem but the smaller incisions heal faster and may not even require a stitch to close.  More mature cataracts can also be a bit harder to separate from the capsular bag, but finding an experienced surgeon should help minimize any problems.

A matured cataract can also be more difficult for doctors to examine your retina and to gauge accurately the strength of replacement IOL you need (if the cataract is so opaque that viewing the rear of the eye accurately is difficult).  And having a retina exam before cataract surgery just to check for any tears or areas of thinning or peripheral detachment is another safety measure; this is harder to do accurately as the cataract gets cloudier and impedes the doctor's view of the retina.

In addition to determining the best IOL for you and the right doctor who will handle your case the way you want, you should also evaluate whether to have traditional (manual cataract chopping/extraction) or the laser-based cataract procedure (where laser energy is used to break up the cataract and prepare it for removal) will be better for you.  There are pros and cons to both, and there is a lot of info on the web now about the use of femtosecond lasers to assist in cataract surgery so you can research it yourself.  

A doctor who performs the surgery with or without the laser can let you know whether your specific case is better suited to one approach or the other.

BTW the system automatically hid the STAAR Surgical email address.  Here it is again - just replace the AT and DOT in the address below and you'll be set if you want to email them.  customerserviceATstaarDOTcom
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Avatar universal
If a surgeon no longer uses the Nanoflex IOL, you might want to inquire further.  Bad results?  Quality issues?
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Avatar universal
I had my right eye done with Staar Nanoflex in April of 2012. I did not have cataract - this was for treating bad vision due to presbyopia. I had successful LASIK on the left eye returning me to 20/20 on the left side. Due to irregular and thin cornea on the right side, LASIK was risky, so we opted for the IOL with the Nanoflex.

After surgery, and a year on, my vision had not returned to 20/20. I had clear mid range vision between 3 and 4 feet, distance vision improved some, but not near what I had hoped for. This was not the fault of the lens, but the prescription chosen by the surgeon. Again, there was improvement, but it was not the home run I was looking for.

20 months post surgery, my right eye's vision started degrading rapidly. After another exam, I was diagnosed with Posterior Capsule Opacity. So yet another visit to the laser for YAG Laser Posterior Capsulotomy.

After visiting an eye clinic in San Francisco, the surgeon there believes my original problem could have been resolved with PRK, and once the capsulotomy is completed, I'll do PRK.

Bottom line, I should not have done the original IOL as was suggested by the original surgeon. Still, in the end, all the players (multiple eye surgeons I have consulted) tell me it is a slam dunk and I will get to 20/20 on the right side... just a long saga to get there.
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Avatar universal
Date correction, the IOL was done in early 2013, so the cloudiness started at 1 year post op.
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Avatar universal
Sorry for my late response, as I haven't been visiting the site.
Dr Samir Shah in Huntington Beach, in orange county seemed like very good doctor . He loved the NanoFlex lenses and he thought I was perfect candidate  but I chickened out. You can give him a try and consult with him.
He should answer your questions. I am still considering the procedures for my presbyopia. Good luck and let me know
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Avatar universal
I looked up Nanoflex on their web site and it is just a mono focal IOL. If you don't have a requirement for a premium multifocal IOL, then there are plenty of mono focal IOLs on the market and your surgeon is most likely to recommend an aspheric type.  You should expect good results from any well known aspheric lens manufacturer. I don't see that Nano flex offers anything unique. Most people go for power optimised for distance vision and will most likely need reading glasses.  Some people who do a lot of close up work opt for near focal point in which case they may need to wear glasses for distance.
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Avatar universal
I also meant to say your surgeon can achieve blended mono vision with any mono focal lens. You should discuss this option with your surgeon as not every one can tolerate the effect of one eye set for distance and the other for near. Generally though most people achieve good outcome for far, intermediate, and near vision, but may need readers for sustained reading of small print or in low light conditions.
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Avatar universal
Hi OneEyedJill

No I am not a medical professional, but a potential cataract patient like yourself. Actually I just have the beginnings of cataracts and may not need surgery for many years to come but decided to go ahead with surgery anyway to address my presbyopia as I now need 3 different prescriptions for near, intermediate, and distance.

Regarding monovision,  both surgeons may have given you the right answer from their perspective. I did a lot of research online and talked to my surgeon about it. The dominant eye is normally adjusted for distance and the non-dominant eye for near. The degree of myopia they introduce in the non-dominant eye determines the final outcome with regards to intermediate (computer) versus reading fine print text.  The majority opinion out there seems to indicate no more than -1.25 Diopters of myopia in the non dominant eye.  This should give you very good intermediate results but you may need readers for sustained reading or for very small text. You can of course introduce more than -1.25D in the non-dominant eye (e.g. -2.0D) to improve near vision for reading but this may impact your intermediate vision and will also have other side effects for your distance vision (loss of stereo vision). Here is a useful online link for you to read:

http://bmctoday.net/crstoday/pdfs/crst0613_F_Barrett.pdf

I was initially going to opt for monovision but I tried it with contact lenses first. I found that my distance vision was good and also computer and close reading was OK for short time but I preferred my spectacles for continued use.   Maybe the result is much better with cataract/laser surgery than contact lens trial. I have several friends who have had the procedure done with laser and are delighted with it.

Regarding the specific material that the Nanoflex lens is made of in order to prevent PCO (posterior capsule opacification) I can't comment. This is also one of my concerns but all the reference materials I have seen dismiss it as a non-serious complication and say a simple YAG laser procedure fixes it. I tried to find what percentage of cataract procedures do result in PCO and solid figures are hard to come by, but I have seen 20% mentioned and this seems to have come down over many years - I read in the early days it was as high as 50%.  I would personally not go with the hype on a manufacturer's web site, and prefer to choose an excellent/experienced surgeon close to my home. There seems to be many factors affecting PCO (including how good a job the surgeon does to remove all the natural lens material during surgery) so the lens material may be just one element that may or may not have a significant contribution to the final outcome.

Anyhow good luck in your quest to get some answers regarding Nanoflex lens.
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Avatar universal
According to my surgeon, B&L (among others) is now recommending YAG be done as a preventive measure at 3 - 6 months.  This supposedly eliminates the problem of IOL damage (pitting, cracking, etc) which happens when the laser beam has to be more powerful because of the clouding.
And, contrary to the ads, the NanoFlex is just as susceptible to PCO as silicon lenses.
When I tried to find more information on the NanoFlex while looking at lens options last year, I was told by 3 different ophthalmologists that they no longer implanted this lens.  And these were ophthalmologists from the NanoFlex "Find A Surgeon" link on their website.
So, agreeing with joojeh, I would be very careful about believing the manufacturer's hype.
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Avatar universal
Nope.
But, reading between the lines, if an IOL was truly wonderful, why would they stop offering it?
Other than patient dissatisfaction.
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Avatar universal
LOL - I have done that a lot, not just toys; I have bought stuff from supermarket shelf when I didn't have my glasses and only found out when I got home.
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Avatar universal
I am sure I had my glasses  on when I wrote the last post - perhaps I am really going blind too!

Anyhow what I meant to say was:

LOL - I have done that a lot, not just typos; I have bought stuff from supermarket shelf when I didn't have my glasses and only found out when I got home I have bought the wrong thing.
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