Aa
Which monofocal lens is best (after multi explant)
Can any of the doctors on this forum recommend any particular monofocal lens over another? I am looking at a bilateral explant of the hideous Restor.
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
Yes best wishes for a quick recovery from your explant.
londonbridge
londonbridge
Are the stitches in the sclera or the cornea?
The former tend to heal, albeit very slowly, sometimes it takes the eye a year or a year and half to go all the way back to the original state. (Google for "surgically induced astigmatism" and read the studies you will find.) That doesn't mean the eye will be a mess all that time, because once the astigmatism drops below a diopter or so you will probably be able to ignore it. It is my impression that stitches in the cornea do not heal nearly as well. Which makes sense structurally, since the sclera has a lot more tissue to work with, and a much better supply of nutrients. It is interesting that a sutured sclera will slowly heal returning the eye to its original shape - that implies some sort of feed back mechanism perhaps similar to whatever was operating during development. (As opposed to just forming a big scar and staying that way, like skin often does.)
The former tend to heal, albeit very slowly, sometimes it takes the eye a year or a year and half to go all the way back to the original state. (Google for "surgically induced astigmatism" and read the studies you will find.) That doesn't mean the eye will be a mess all that time, because once the astigmatism drops below a diopter or so you will probably be able to ignore it. It is my impression that stitches in the cornea do not heal nearly as well. Which makes sense structurally, since the sclera has a lot more tissue to work with, and a much better supply of nutrients. It is interesting that a sutured sclera will slowly heal returning the eye to its original shape - that implies some sort of feed back mechanism perhaps similar to whatever was operating during development. (As opposed to just forming a big scar and staying that way, like skin often does.)
Congratulations on having this behind you! I'm sure that your vision will improve in your Tecnis eye. Please continue to update us about your progress. I'm sure that many prospective ReStor recipients will be influenced by your experience.
Glad to hear things are doing well and that you have one explant behind you. It took courage, but definitely worth it.
londonbridge
londonbridge
Dear Restornomore.
We are all rooting for you! Good luck with your first explant! Don't dread the surgery.It will be over before you know it!
Disappointed no more
We are all rooting for you! Good luck with your first explant! Don't dread the surgery.It will be over before you know it!
Disappointed no more
Good luck with your first explant, Restornomore, and please keep us posted.
Dear Restornomore,
I had the dreadred Restro lens explanted and exchanged on Aug 31. The explant went very well I had the tecnis 1 lens put in. I had some blurryness at first, but after less than a week of healing I can say I am happy with it. I had had the Restorr lense put in my left eye on July 30. It was the worst decision I ever made. And my first Dr. kept telling me I had to have the 2nd eye done! Thank God to my own sense and this forum, I knew that that lens would never be put in my right eye. I too like you was ready to have a nervous breakdown. Once that Resto was removed, I was like a different person. I felt like I could breathe.
My doctor knew what I wanted to acheive and he decided on the Tecnis 1 .He also said that my experience was actually helping him. His practice had already stopped using Restor..I am 66 years old (female)and a very active independent senior, I have been wearing glasses and contacts since my late forties. I thought the multifocal lens sounded good. My first dr. did not give me enough information at all. Now I feel that the mono lens gives me more control. After what I have been through I will never complain abount wearing glasses again.
I have gotten some terrific advice from JodieJ and Londonbridge. I do not know what I would have done without them. They were so understanding and knowledgable.and gave me the courage to go ahead.
Good luck to you. When those lenses are out you will feel like that beautiful day you described. One of the best bits of advice I got was from londonbridge, "be patient" you will have the vision you deserve!
I can now sign this Disappointednomore66
I had the dreadred Restro lens explanted and exchanged on Aug 31. The explant went very well I had the tecnis 1 lens put in. I had some blurryness at first, but after less than a week of healing I can say I am happy with it. I had had the Restorr lense put in my left eye on July 30. It was the worst decision I ever made. And my first Dr. kept telling me I had to have the 2nd eye done! Thank God to my own sense and this forum, I knew that that lens would never be put in my right eye. I too like you was ready to have a nervous breakdown. Once that Resto was removed, I was like a different person. I felt like I could breathe.
My doctor knew what I wanted to acheive and he decided on the Tecnis 1 .He also said that my experience was actually helping him. His practice had already stopped using Restor..I am 66 years old (female)and a very active independent senior, I have been wearing glasses and contacts since my late forties. I thought the multifocal lens sounded good. My first dr. did not give me enough information at all. Now I feel that the mono lens gives me more control. After what I have been through I will never complain abount wearing glasses again.
I have gotten some terrific advice from JodieJ and Londonbridge. I do not know what I would have done without them. They were so understanding and knowledgable.and gave me the courage to go ahead.
Good luck to you. When those lenses are out you will feel like that beautiful day you described. One of the best bits of advice I got was from londonbridge, "be patient" you will have the vision you deserve!
I can now sign this Disappointednomore66
Many thanks Jodie.
I find your experience reassuring, as my (new) Doctor A uses Acrysof and Tecnis monos. I have been *so* worried about getting "whatever was out the back in the shed" instead of an objective assessment of what would be best given my "wish list", and of course all the other complex medical factors that may influence the doctor's decision. That is exactly what happened last time with the Restors from Hell - no alternative was even suggested.
My own General Practitioner is chasing this subject up and I'll decide within the week whether or not to go ahead with the first of the explants with Dr A. It is not an exact science dealing with a bag of jelly, and apparently I came out nearsighted for distance last time, despite measurements and lens power being correctly done. He is going to try to tweak for a better result, leave the eye to settle for a month (a whole month, groan) then assess what to do with the other one. Assuming I don't go blind or the lens won't come out etc...
When I complained about the distance vision, the awful Restor doctor told me to "forget about it, that was in the past" and was very impatient, whereas the observation was apparently valid. It's the attitudes that upset me so, not that things are not always perfect.
This whole saga has it's comic elements. Yesterday I was pegging out the washing mentally wailing and wringing my hands like Lady MacBeth. Meanwhile the sky was blue, birds were singing, people were off enjoying themselves; I burst out laughing at the absurdity of the thing. To suffer is to live in your own horrible little world, whereas the rest of the world still turns!
(Sorry - I meant that the Tecnis lens is getting a rep for being good in dim light. It is touted thus. I did see the video you mention courtesy of your link. ) You don't realise how much time we spend in "dim light", ie not *floodlit* until visual problems are experienced. I can see the floodlit eye chart well enough, but not in many everyday situations that never gave problems a scant couple of years ago pre rapid onset cataracts. If I see so badly now, what will it be like in 20 years time?
I'm taking an awful risk to hopefully have peace (with glasses) for the rest of my life. Other doctors I've spoken to have confirmed that my experiences, including the mental stress are now well known, and many will not use these lenses. In my case the mental upset is so bad that I think the risk of leaving them in is likely to lead to dire consequences, so the decision is to try for change while still possible and resolve to live with the results. Cross your fingers for me Jodie.
Regards, Restornomore
I find your experience reassuring, as my (new) Doctor A uses Acrysof and Tecnis monos. I have been *so* worried about getting "whatever was out the back in the shed" instead of an objective assessment of what would be best given my "wish list", and of course all the other complex medical factors that may influence the doctor's decision. That is exactly what happened last time with the Restors from Hell - no alternative was even suggested.
My own General Practitioner is chasing this subject up and I'll decide within the week whether or not to go ahead with the first of the explants with Dr A. It is not an exact science dealing with a bag of jelly, and apparently I came out nearsighted for distance last time, despite measurements and lens power being correctly done. He is going to try to tweak for a better result, leave the eye to settle for a month (a whole month, groan) then assess what to do with the other one. Assuming I don't go blind or the lens won't come out etc...
When I complained about the distance vision, the awful Restor doctor told me to "forget about it, that was in the past" and was very impatient, whereas the observation was apparently valid. It's the attitudes that upset me so, not that things are not always perfect.
This whole saga has it's comic elements. Yesterday I was pegging out the washing mentally wailing and wringing my hands like Lady MacBeth. Meanwhile the sky was blue, birds were singing, people were off enjoying themselves; I burst out laughing at the absurdity of the thing. To suffer is to live in your own horrible little world, whereas the rest of the world still turns!
(Sorry - I meant that the Tecnis lens is getting a rep for being good in dim light. It is touted thus. I did see the video you mention courtesy of your link. ) You don't realise how much time we spend in "dim light", ie not *floodlit* until visual problems are experienced. I can see the floodlit eye chart well enough, but not in many everyday situations that never gave problems a scant couple of years ago pre rapid onset cataracts. If I see so badly now, what will it be like in 20 years time?
I'm taking an awful risk to hopefully have peace (with glasses) for the rest of my life. Other doctors I've spoken to have confirmed that my experiences, including the mental stress are now well known, and many will not use these lenses. In my case the mental upset is so bad that I think the risk of leaving them in is likely to lead to dire consequences, so the decision is to try for change while still possible and resolve to live with the results. Cross your fingers for me Jodie.
Regards, Restornomore
I doubt that there is any meaningful difference among the available monofocal aspheric IOLs. Many surgeons have more experience with a particular brand, and it's probably best to go with their choice. There's an interesting "patient education video" about the benefits of aspheric IOLs at www tecnisiol com. It's great advertising for the Tecnis, but it probably applies to the other aspheric monofocals as well. I've never had even a minor problem with my AcrySof IQs, and they do seem to help with driving at night on dark roads. (Could it be the Tecnis multifocal that's associated with poor acuity in certain lighting?)
MEDICAL PROFESSIONAL
Dear Retomomore,
Each doctor prefers a different lens implant. I would recommend an aspheric lens implant. There are different manufacturers including the Tecnis, SN and Akreos lenses from AMO, Alcon and B&L. Ask your doctor about the options. It is important to know that all lenses can be associated with increased glare but the quality and contrast should be improved as compared with multifocal implants.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
Each doctor prefers a different lens implant. I would recommend an aspheric lens implant. There are different manufacturers including the Tecnis, SN and Akreos lenses from AMO, Alcon and B&L. Ask your doctor about the options. It is important to know that all lenses can be associated with increased glare but the quality and contrast should be improved as compared with multifocal implants.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
That sandpaper feeling is probably due to a dry eye. OTC lubricating drops/ointments might help.
Hi pasadena,
I have no idea where the stitches are, or were since they've been out for a week, must ask Dr. I was told before the first restor surgery that I had some astigmatism in that eye, possibly due to the cataract - certainly never had any noticeable blur when my vision was good, and perhaps the worsening cataract masked it. Post explant surgery with stitches in, the blurring and ghosting was awful. The bulk of it settled down in a couple of days post-stitches, and the remainder has been pretty consistent, ie no further improvement. I do hope you're right about it eventually self-correcting.
What I do have since getting the stitches out is surprising sharp discomfort, even worse than the stitches themselves - one eye full of barbed wire, the other of sandpaper. This has worstened over the past few days to the point of driving me nuts, esp at work. Optometrist who provided the above figures said he saw a bit of scar tissue, so maybe that's the barbed-wire culprit, can't account for the sandpaper. I see Dr in two weeks, but may be driven to distraction or a phone call to the office beforehand.
With the figures above, I certainly notice the blur. Thanks for your google hint, will have a look.
Regards, Restornomore
I have no idea where the stitches are, or were since they've been out for a week, must ask Dr. I was told before the first restor surgery that I had some astigmatism in that eye, possibly due to the cataract - certainly never had any noticeable blur when my vision was good, and perhaps the worsening cataract masked it. Post explant surgery with stitches in, the blurring and ghosting was awful. The bulk of it settled down in a couple of days post-stitches, and the remainder has been pretty consistent, ie no further improvement. I do hope you're right about it eventually self-correcting.
What I do have since getting the stitches out is surprising sharp discomfort, even worse than the stitches themselves - one eye full of barbed wire, the other of sandpaper. This has worstened over the past few days to the point of driving me nuts, esp at work. Optometrist who provided the above figures said he saw a bit of scar tissue, so maybe that's the barbed-wire culprit, can't account for the sandpaper. I see Dr in two weeks, but may be driven to distraction or a phone call to the office beforehand.
With the figures above, I certainly notice the blur. Thanks for your google hint, will have a look.
Regards, Restornomore
Your refractive error relates to how nearsighted/farsighted you are. If you want good distance vision, you want to be close to plano (i.e., zero). Something around -1.25 would give you good intermediate vision. Good near vision might be around -2.50.
Hi Thanks for the reply. I have no idea what a refraction error is. I'm thinking that it is just where my distance vision stops. I really do not know much . I assume once I know what the refraction error is in the left eye I will know what to do with the right eye. I will schedule a consultation appointment.
Thanks Jodie.
L
Thanks Jodie.
L
Be sure to get your concerns addressed before your second surgery. Schedule a consultation with your surgeon if you need to. What is your refractive error for your left eye? Make sure that your surgeon is aware of your goals for your post-surgery vision. It's very important that you both are in agreement about the targeted refraction for your right eye.
Hi
Restor I am so happy to hear of the improvement to your vision. I am scheduled for Nov 9th for my right eye. I have the distance technis monofocal in the left eye. (Thank goodness that dreaded Restor is out). I do not think I have the full distance vision. It is more like an intermediate. My surgeon plans on putting another distance in the right eye. I am a little confused. I will have to consult with him on what vision I actually have in the left eye and what he hopes will be accomplished with the right eye done. I am happy with what I have with the left eye. I do not know or understand any of the technical terms and measurements. I never knew there was so much involved. It all stems back to the first surgeon who just jumped on the bandwagon for Restor and did not inform me of any other choices or anything else. Now I am quite apprehensive.I originally started to wear glasses for presbiopia and then needed help with distance. I have been wearing multifocal eyeglasses for years. I also wore monvision contacts. I did okay with them but couldn't keep them in too long. After the left eye surgery I had the lens taken out of my glasses. I need the right eye glass to see full distance and small print reading. I am confused, but at this point seeing everything with the Tecnis left eye and half of glasses on the right eye.I am confused and not as excited about having the other eye done as I was at first. I want crisp clear vision at all distance with or with out glasses. Am I being overly concerned?
Restor I am so happy to hear of the improvement to your vision. I am scheduled for Nov 9th for my right eye. I have the distance technis monofocal in the left eye. (Thank goodness that dreaded Restor is out). I do not think I have the full distance vision. It is more like an intermediate. My surgeon plans on putting another distance in the right eye. I am a little confused. I will have to consult with him on what vision I actually have in the left eye and what he hopes will be accomplished with the right eye done. I am happy with what I have with the left eye. I do not know or understand any of the technical terms and measurements. I never knew there was so much involved. It all stems back to the first surgeon who just jumped on the bandwagon for Restor and did not inform me of any other choices or anything else. Now I am quite apprehensive.I originally started to wear glasses for presbiopia and then needed help with distance. I have been wearing multifocal eyeglasses for years. I also wore monvision contacts. I did okay with them but couldn't keep them in too long. After the left eye surgery I had the lens taken out of my glasses. I need the right eye glass to see full distance and small print reading. I am confused, but at this point seeing everything with the Tecnis left eye and half of glasses on the right eye.I am confused and not as excited about having the other eye done as I was at first. I want crisp clear vision at all distance with or with out glasses. Am I being overly concerned?
Dear All,
I'll make what is probably a concluding post on this thread, for the sake of anyone who comes along and follows it.
It is now nearly three weeks since I had a Tecnis aspheric mono in my left eye, and five weeks since having an AcrysofIQ in my right eye. The Tecnis-eye had complications from earlier Restor surgery whereby vitreous fluid leaked and the eye depressurised, and stitches were required. It was not a happy eye.
All stitches are out of both eyes, and five days after Tecnis-eye has settled down and lost the awful and worrying ghosting, though a small but irritating blur from astigmatism remains right across the whole visual spectrum. This may or may not improve, as apparently I did have a bit of pre-all-surgery astigmatism with the cataract. An earlier mild distance prescription over Tecnis-eye brought acuity almost up to perfection!
Was the bilateral explant worth doing?
Most emphatically yes, given these results. My life and sanity have been returned to me, and my quality of vision is far better than I had dared to hope for. In my opinion, the aspheric monofocals *in skilled hands* represent the best current technology can offer. There is no tommyrot about long periods of "adaption" that may never occur, just (potentially) good clear distortion-free vision from the time of surgery. Night-time abberations are negligible compared with the dreadful multifocals. Quality of life (ability to return to work and normal pursuits) is wonderful. Most importantly, clarity and crispness of vision is as unimpaired as it could possibly be - at the expense of some glasses dependency which most people experience anyway! Why anyone would want a multifocal lens in their heads is quite beyond me.
However, things could have turned out much worse, and I think it is awful the way patients who fall prey to lens-touting are placed in this quandary to begin with.
Double-distance rig starring Tecnis and AcrysofIQ:
This may be a minority opinion and I'm not knocking the shades of mono/modified-mono vision often used - but I do find my double-distance focal points extremely satisfactory. Distance vision is by far the bulk of our visual spectrum, and I'm a very active person so I find it very intellectually satisfying to have this entire range of vision correct and balanced across both eyes, with the same power of glasses prescription needed in each eye for close/intermediate. (It may also be that I have had particularly good results, so take what follows as an observation, not a promise!). I see perfectly well "across a room", and can distinguish without stress all items on a table, on my desk, people's faces across a table etc. I absolutely need glasses for all print and computer, buttons on remote control, mobile phone, price tags - I needed them for this purpose from my mid forties prior to cataracts, so no surprises there. I can see "the hand in front of my face" quite satisfactorily for practical purposes without glasses - to see every vein and wrinkle clearly, on with the glasses, ditto for "fine" close up distinctions, such as different weaves on cotton fabrics, esp if light is a bit dim. I can read the digital clock upon awakening without glasses. I can see a kitchen benchtop to peel an apple - to see the hairs on the grub in the apple, glasses. I suppose my point is that "one" distance focal point is giving me a much better range of unassisted vision than I had been led to believe possible - surely any decent surgeon should be able to advise what a patient's eyes would most likely support based on their measurements!
My "zone" of glasses dependency is about a foot further than it used to be, and in special situations such as standing in bookshops or DVD shops, I can't quite comfortably make out all the print on spines without standing a bit far back - new glasses not yet prescribed. I have glasses permantly slung around my neck, just as I used to and regard pulling them on and off as required as a small price to pay for the beautiful clarity and quality of my vision. Wearing glasses while stationary - eg reading, or at the computer is a trifle - why sacrifice acuity across the spectrum and night vision for that?
Walking both by day and night has returned to being the pleasure it used to be. The finest outline of leaves on distant trees can be seen without the inherent blur and ghosting of multifocal technology. Strongly contrasting colours no longer have penumbral smudging and bleeding, and as for the absence of nasty halos everywhere, well, don't start me! I used to have mental competions - what annoys me most - is it the halos, the ghosting, or the bleeding of contrast?
My Restor lenses were nearsighted for distance, but even with a distance correction that improved the sharpness, all the other "special effects" continued unabated.
Tecnis/AcrysofIQ
There is a noticeable difference in the colour spectrum between these two lenses as described above. It doesn't make a huge difference to night vision, though I think a slight edge to the Tecnis. I vote for Tecnis-world, though not by a huge margin. Am quite happy to have one of each, and am not sure at this stage which set of visual input dominates with both eyes in use.
Night Vision:
I had been concerned all along about the "dimmer/darker" world of the Restor - well that's about the only thing that hasn't greatly improved. Post-cataract night vision (and dim-light acuity in general) is very definitely worse with *any* of the lenses than it was pre-cataracts just a few years ago. I used to be driven so nuts by moonlight and street lights streaming though my bedroom window that ordinary curtains were inadequate. This is no longer the case, and contrast sensitivity at night has definitely declined. I suspect I had very good night vision without knowing it & can't account for this. Dr thinks the natural lens does a lot that has not been replicated, though results are still very good (not complaining).
It is still early days with a lot of healing and settling down to do - left eye still quite sore, right one less so but not yet there. I hope my saga is of help to others - I'm very happy with my vision now and think aspheric monos are the way to go, especially for people who are very exacting and like things just right. For the technically minded here are my latest measurements - just *look* at those spheres, lol.
Right Left
Sphere -0.12 +0.12
Cylinder -1.25
Axis 157
Add +2.25 +2.25
Regards to all other helpful posters,
Restornomore
I'll make what is probably a concluding post on this thread, for the sake of anyone who comes along and follows it.
It is now nearly three weeks since I had a Tecnis aspheric mono in my left eye, and five weeks since having an AcrysofIQ in my right eye. The Tecnis-eye had complications from earlier Restor surgery whereby vitreous fluid leaked and the eye depressurised, and stitches were required. It was not a happy eye.
All stitches are out of both eyes, and five days after Tecnis-eye has settled down and lost the awful and worrying ghosting, though a small but irritating blur from astigmatism remains right across the whole visual spectrum. This may or may not improve, as apparently I did have a bit of pre-all-surgery astigmatism with the cataract. An earlier mild distance prescription over Tecnis-eye brought acuity almost up to perfection!
Was the bilateral explant worth doing?
Most emphatically yes, given these results. My life and sanity have been returned to me, and my quality of vision is far better than I had dared to hope for. In my opinion, the aspheric monofocals *in skilled hands* represent the best current technology can offer. There is no tommyrot about long periods of "adaption" that may never occur, just (potentially) good clear distortion-free vision from the time of surgery. Night-time abberations are negligible compared with the dreadful multifocals. Quality of life (ability to return to work and normal pursuits) is wonderful. Most importantly, clarity and crispness of vision is as unimpaired as it could possibly be - at the expense of some glasses dependency which most people experience anyway! Why anyone would want a multifocal lens in their heads is quite beyond me.
However, things could have turned out much worse, and I think it is awful the way patients who fall prey to lens-touting are placed in this quandary to begin with.
Double-distance rig starring Tecnis and AcrysofIQ:
This may be a minority opinion and I'm not knocking the shades of mono/modified-mono vision often used - but I do find my double-distance focal points extremely satisfactory. Distance vision is by far the bulk of our visual spectrum, and I'm a very active person so I find it very intellectually satisfying to have this entire range of vision correct and balanced across both eyes, with the same power of glasses prescription needed in each eye for close/intermediate. (It may also be that I have had particularly good results, so take what follows as an observation, not a promise!). I see perfectly well "across a room", and can distinguish without stress all items on a table, on my desk, people's faces across a table etc. I absolutely need glasses for all print and computer, buttons on remote control, mobile phone, price tags - I needed them for this purpose from my mid forties prior to cataracts, so no surprises there. I can see "the hand in front of my face" quite satisfactorily for practical purposes without glasses - to see every vein and wrinkle clearly, on with the glasses, ditto for "fine" close up distinctions, such as different weaves on cotton fabrics, esp if light is a bit dim. I can read the digital clock upon awakening without glasses. I can see a kitchen benchtop to peel an apple - to see the hairs on the grub in the apple, glasses. I suppose my point is that "one" distance focal point is giving me a much better range of unassisted vision than I had been led to believe possible - surely any decent surgeon should be able to advise what a patient's eyes would most likely support based on their measurements!
My "zone" of glasses dependency is about a foot further than it used to be, and in special situations such as standing in bookshops or DVD shops, I can't quite comfortably make out all the print on spines without standing a bit far back - new glasses not yet prescribed. I have glasses permantly slung around my neck, just as I used to and regard pulling them on and off as required as a small price to pay for the beautiful clarity and quality of my vision. Wearing glasses while stationary - eg reading, or at the computer is a trifle - why sacrifice acuity across the spectrum and night vision for that?
Walking both by day and night has returned to being the pleasure it used to be. The finest outline of leaves on distant trees can be seen without the inherent blur and ghosting of multifocal technology. Strongly contrasting colours no longer have penumbral smudging and bleeding, and as for the absence of nasty halos everywhere, well, don't start me! I used to have mental competions - what annoys me most - is it the halos, the ghosting, or the bleeding of contrast?
My Restor lenses were nearsighted for distance, but even with a distance correction that improved the sharpness, all the other "special effects" continued unabated.
Tecnis/AcrysofIQ
There is a noticeable difference in the colour spectrum between these two lenses as described above. It doesn't make a huge difference to night vision, though I think a slight edge to the Tecnis. I vote for Tecnis-world, though not by a huge margin. Am quite happy to have one of each, and am not sure at this stage which set of visual input dominates with both eyes in use.
Night Vision:
I had been concerned all along about the "dimmer/darker" world of the Restor - well that's about the only thing that hasn't greatly improved. Post-cataract night vision (and dim-light acuity in general) is very definitely worse with *any* of the lenses than it was pre-cataracts just a few years ago. I used to be driven so nuts by moonlight and street lights streaming though my bedroom window that ordinary curtains were inadequate. This is no longer the case, and contrast sensitivity at night has definitely declined. I suspect I had very good night vision without knowing it & can't account for this. Dr thinks the natural lens does a lot that has not been replicated, though results are still very good (not complaining).
It is still early days with a lot of healing and settling down to do - left eye still quite sore, right one less so but not yet there. I hope my saga is of help to others - I'm very happy with my vision now and think aspheric monos are the way to go, especially for people who are very exacting and like things just right. For the technically minded here are my latest measurements - just *look* at those spheres, lol.
Right Left
Sphere -0.12 +0.12
Cylinder -1.25
Axis 157
Add +2.25 +2.25
Regards to all other helpful posters,
Restornomore
Dear Restornomore
Again that dreaded Restor is out!. It will probabaly take a while for the vision to clear up. It took me a week. I went to dr. this week. My left techis lens eye is doing well, I can see at 20/30I but eye is still not fully healed and it has been a month. The cornea is swollen and there is an inflamation on the spot where the incision was made The doc said it will heal in time. The good part with me is that it is not in my field of vision
I"m sure yoou tecnics eye will imrove You are on your way without the Restor!.
Keep in touch.
Again that dreaded Restor is out!. It will probabaly take a while for the vision to clear up. It took me a week. I went to dr. this week. My left techis lens eye is doing well, I can see at 20/30I but eye is still not fully healed and it has been a month. The cornea is swollen and there is an inflamation on the spot where the incision was made The doc said it will heal in time. The good part with me is that it is not in my field of vision
I"m sure yoou tecnics eye will imrove You are on your way without the Restor!.
Keep in touch.
Dear All,
It is 3 days after my second explant. I now sport one AcrysofIQ and one Tecnis! The surgery itself was uncomplicated and went well. The eye however is in an unhappy state due to previous complications and stitches (don't ask), and so vision is terribly blurred and (very) worryingly ghosted. Dr counsels patience and waiting for more healing to take place; this eye was always going to be more prone to trouble.
First IQ eye wonderful though. Sitting in a first floor cafe tonight with friends, I could see far down the aisle in the dept store across the street, and read the time on a distant clock. Friends could barely make out the clock, with or without glasses. Therefore Eye1 a very hard act to follow. The (potential) quality of vision with the aspheric monofocals is really stunning, and *so* worth the minor inconvenience of glasses to bring up the close/close-intermediate vision to the same standard. I honestly stand by my contention that anyone with multi lenses is being shortchanged, though others will no doubt differ. My point is that monos + glasses *if properly done* will release *all* of the potential vision that is available in a person's head, with minimal compromise and mimimal distressing visual abberations. I was fortunate in having good pre-cataract eyesight, and this technology has given much of that back to me, in one eye.
I do notice a difference in the colour spectrum between AcrysofIQ/Tecnis. On day one it was *very* noticable, and oddly, seems to have become a little less so. The AcrysofIQ world is a slightly "darker" place - particularly noticeable in the reds, less so in blues. In Tecnis-world I am wearing a shocking pink dressing gown, in Acrysof-world, a bit less shocking. Acrysof greens, esp vegetation seem deeper and more vivid than the Tecnis. All very interesting, and effects seem to vary with time of day, quality of light etc. Also I'm seeing so poorly with the Tecnis eye comparisons not yet very fair - vision too poor to make proper comparisons at night, but suspect an edge to Tecnis if vision was sharp.
I do not regret having taken the risk of a second explant, even with the current uncertainty and worry (my goodness, the worry!!). This awful situation would never have occurred if the recognised gold standard of responsible medical treatment had been offered in the first place, rather than what amounts to being used-car salesmanship. If any doctor denigrates the monofocal solution, tells you you "won't see the hand in front of your face, won't see across a room" etc be very cautious indeed, as the soon-to-be touted "premium" lenses also have significant problems that can't be fully appreciated until the devices are in your head!
If uncompromised quality and acuity (at whatever focal point) is your desire, then skillfully placed monos + glasses are the way to go. If you "don't want to wear glasses" then be aware that, with multi lenses you will experience deterioration in the *potential* quality of your vision, often to an awful extent at night, though there may be a depth of focus that allows less, or no glasses dependency.
Therefore, I have an anxious time ahead, wondering whether or not poor Tecnis-eye will come good, and to what extent. I would not wish this ordeal on anyone, and write in the hope that others may at least find my hard-won experience helpful in making their own decisions.
Regards,
now truly, Restornomore
It is 3 days after my second explant. I now sport one AcrysofIQ and one Tecnis! The surgery itself was uncomplicated and went well. The eye however is in an unhappy state due to previous complications and stitches (don't ask), and so vision is terribly blurred and (very) worryingly ghosted. Dr counsels patience and waiting for more healing to take place; this eye was always going to be more prone to trouble.
First IQ eye wonderful though. Sitting in a first floor cafe tonight with friends, I could see far down the aisle in the dept store across the street, and read the time on a distant clock. Friends could barely make out the clock, with or without glasses. Therefore Eye1 a very hard act to follow. The (potential) quality of vision with the aspheric monofocals is really stunning, and *so* worth the minor inconvenience of glasses to bring up the close/close-intermediate vision to the same standard. I honestly stand by my contention that anyone with multi lenses is being shortchanged, though others will no doubt differ. My point is that monos + glasses *if properly done* will release *all* of the potential vision that is available in a person's head, with minimal compromise and mimimal distressing visual abberations. I was fortunate in having good pre-cataract eyesight, and this technology has given much of that back to me, in one eye.
I do notice a difference in the colour spectrum between AcrysofIQ/Tecnis. On day one it was *very* noticable, and oddly, seems to have become a little less so. The AcrysofIQ world is a slightly "darker" place - particularly noticeable in the reds, less so in blues. In Tecnis-world I am wearing a shocking pink dressing gown, in Acrysof-world, a bit less shocking. Acrysof greens, esp vegetation seem deeper and more vivid than the Tecnis. All very interesting, and effects seem to vary with time of day, quality of light etc. Also I'm seeing so poorly with the Tecnis eye comparisons not yet very fair - vision too poor to make proper comparisons at night, but suspect an edge to Tecnis if vision was sharp.
I do not regret having taken the risk of a second explant, even with the current uncertainty and worry (my goodness, the worry!!). This awful situation would never have occurred if the recognised gold standard of responsible medical treatment had been offered in the first place, rather than what amounts to being used-car salesmanship. If any doctor denigrates the monofocal solution, tells you you "won't see the hand in front of your face, won't see across a room" etc be very cautious indeed, as the soon-to-be touted "premium" lenses also have significant problems that can't be fully appreciated until the devices are in your head!
If uncompromised quality and acuity (at whatever focal point) is your desire, then skillfully placed monos + glasses are the way to go. If you "don't want to wear glasses" then be aware that, with multi lenses you will experience deterioration in the *potential* quality of your vision, often to an awful extent at night, though there may be a depth of focus that allows less, or no glasses dependency.
Therefore, I have an anxious time ahead, wondering whether or not poor Tecnis-eye will come good, and to what extent. I would not wish this ordeal on anyone, and write in the hope that others may at least find my hard-won experience helpful in making their own decisions.
Regards,
now truly, Restornomore
I have an Alcon torric lens and have not experienced dimness with that. My night vision is definitely improved over where it was with the cataract,I also dreaded driving at night, the reason why my first physician recommended Restor, can you believe that, LOL
I also think you are still improving and your cornea is healing too.
londonbridge
I also think you are still improving and your cornea is healing too.
londonbridge
I think that you will see (literally) continued improvement in your vision.
Re dim light vision: My left eye did not have a cataract, so it provides a good test of vision with an aspheric IOL. I actually prefer my vision with an IOL to my best-corrected vision before surgery. I could read the 20/15 line with either. The progressive glasses with plano tops that I used to wear over my contacts before surgery worked just fine after surgery, i.e., everything within arm's length was blurry to the same extent. However, for at least 10 years before cataract surgery, I had dreaded driving to my sister's house at night because it involved stretches of unlit, winding suburban roads. I really think that my dim-light vision has improved (as the patient education video at www tecnisiol com claims), because I no longer feel the same anxiety driving those roads at night. (This benefit should apply to all aspheric IOLs, not just the Tecnis.)
Re dim light vision: My left eye did not have a cataract, so it provides a good test of vision with an aspheric IOL. I actually prefer my vision with an IOL to my best-corrected vision before surgery. I could read the 20/15 line with either. The progressive glasses with plano tops that I used to wear over my contacts before surgery worked just fine after surgery, i.e., everything within arm's length was blurry to the same extent. However, for at least 10 years before cataract surgery, I had dreaded driving to my sister's house at night because it involved stretches of unlit, winding suburban roads. I really think that my dim-light vision has improved (as the patient education video at www tecnisiol com claims), because I no longer feel the same anxiety driving those roads at night. (This benefit should apply to all aspheric IOLs, not just the Tecnis.)
Dear All,
I've been waiting a bit before posting more about explant no 1 as I wanted a bit more technical info first, which I still don't have. It went well, and after nearly a week the eye has settled down a bit. Dr told me I had come out of the Restor surgery significantly nearsighted for distance, which didn't help at all! Lens power correct by the measurements, but not correct "in the wild" in my head! Even with a distance glasses correction though, the Restor eye cannot hold a candle to the mono eye for clarity and acuity. The distance correction cut the blur, but did absolutely nothing for the other horrible effects, ghosting, bleeding of colours, haloing etc.
Right across the visual spectrum, till just before the proverbial "arms length" things are nicely sharp and clear without glasses. Unaided close up / close-intermediate vision blurred, but not nearly as bad as I'd been led to believe. My old reading glasses bring up the computer/print etc beautifully and predictably, though they are now no longer quite right. I needed readers with the Restor anyway, as the much-touted close up vision was hopelessly unpredictable and therefore less usable than one might suppose.
I feel (as did Lorraine, disappointed-no-more, Yay!) as though I can breathe again, and while (as Dr said) nothing can ever replace the subtle behaviour of your own lens, the world is now a more sane and normal place, not some House of Horrors.
Night "special effects" cut down by about 80%. There are still a few, but nothing in comparison - never thought I'd "appreciate" the traffic on our main road so much, I literally stood one-eyed and admired the lack of halos, the relatively "normal" traffic lights, tail lights etc. I also, in daylight, admired my fenceposts - the ghosting that used to surround them (and much else) was a particular grievance. Nothing like a major trauma to make one appreciate the small things in life, LOL. I also peered one-eyed at non-ghosted people in the street in a manner likely to lead to complaints...
Dim light acuity:
One drawback though - acuity in poor light, such as a very badly lit suburban street or park at night is bad. Things are clear enough, but many shades darker than I feel they ought to be, as though the "dimmer switch" is right down. Can you believe I'm not sure what implant I had, as Dr said he had tecnical worries with the eye measurements and getting the refraction correct, and might have to make different choices than he may have otherwise done.
I'm pretty sure it's an Acrysof IQ like Jodie's - asked so many questions and let that one get away, it's been one very big stressful week. Can anyone comment on the dim-light situation? "Ordinary" poor light seems troublesome as well. I really was hoping that would improve as everything else has. I will take it up with Dr this coming Wednesday. I'm *quite* worried about this, but still have a vast improvement on the dreaded Restor.
Am scheduled for second explant on Sept 28. Still very worried about *everything* but will know a lot more after Wednesday's consult. I could worry about two ants crawling up a wall at present...
Regards, Restornomore
I've been waiting a bit before posting more about explant no 1 as I wanted a bit more technical info first, which I still don't have. It went well, and after nearly a week the eye has settled down a bit. Dr told me I had come out of the Restor surgery significantly nearsighted for distance, which didn't help at all! Lens power correct by the measurements, but not correct "in the wild" in my head! Even with a distance glasses correction though, the Restor eye cannot hold a candle to the mono eye for clarity and acuity. The distance correction cut the blur, but did absolutely nothing for the other horrible effects, ghosting, bleeding of colours, haloing etc.
Right across the visual spectrum, till just before the proverbial "arms length" things are nicely sharp and clear without glasses. Unaided close up / close-intermediate vision blurred, but not nearly as bad as I'd been led to believe. My old reading glasses bring up the computer/print etc beautifully and predictably, though they are now no longer quite right. I needed readers with the Restor anyway, as the much-touted close up vision was hopelessly unpredictable and therefore less usable than one might suppose.
I feel (as did Lorraine, disappointed-no-more, Yay!) as though I can breathe again, and while (as Dr said) nothing can ever replace the subtle behaviour of your own lens, the world is now a more sane and normal place, not some House of Horrors.
Night "special effects" cut down by about 80%. There are still a few, but nothing in comparison - never thought I'd "appreciate" the traffic on our main road so much, I literally stood one-eyed and admired the lack of halos, the relatively "normal" traffic lights, tail lights etc. I also, in daylight, admired my fenceposts - the ghosting that used to surround them (and much else) was a particular grievance. Nothing like a major trauma to make one appreciate the small things in life, LOL. I also peered one-eyed at non-ghosted people in the street in a manner likely to lead to complaints...
Dim light acuity:
One drawback though - acuity in poor light, such as a very badly lit suburban street or park at night is bad. Things are clear enough, but many shades darker than I feel they ought to be, as though the "dimmer switch" is right down. Can you believe I'm not sure what implant I had, as Dr said he had tecnical worries with the eye measurements and getting the refraction correct, and might have to make different choices than he may have otherwise done.
I'm pretty sure it's an Acrysof IQ like Jodie's - asked so many questions and let that one get away, it's been one very big stressful week. Can anyone comment on the dim-light situation? "Ordinary" poor light seems troublesome as well. I really was hoping that would improve as everything else has. I will take it up with Dr this coming Wednesday. I'm *quite* worried about this, but still have a vast improvement on the dreaded Restor.
Am scheduled for second explant on Sept 28. Still very worried about *everything* but will know a lot more after Wednesday's consult. I could worry about two ants crawling up a wall at present...
Regards, Restornomore
Hi,
Just wanted to update you on my progress. My computer was in for repairs for 4 days! I finally got back to Restornomore..
After about a week the fog started to clear up. Some days I wasn't sure because it was so gradual. I was just so happy I had that dreaded Restor removed. Now after almost three weeks I am seeing really well. The fog has completely gone and the vision in my left eye is 20/40 and better. I am wearing glasses with the left lens removed. When I take off my glasses, I see everything with my wonderful left eye! (except for reading) I can actually do some reading if the print is not too small. Still relying on my right eye for reading.with the glasses.
I have been afraid, but last night I ventured out in the complete dark. Quite an improvement on my night driving vision. Very little if no light glare. No problem.
I still have to have the right eye done. Will probably have it done sometime in November. I am happy the way I am right now for the time being. I can see everything and read!
My question is, when I have the right eye done should there still be an improvement in all areas?
Again, thank you both so much with all your advice. I would not be where I am if it weren't for you.
Oh, another bit of news. My old surgeon charged me for the Restor lens. He said I was not covered. I found out last night that my insurance DID cover it and I should not have had to pay a penny! I better be getting a refund from him!
Keep in touch.
Disappointed No More (L)
p.s. You are both so right --patience!
Just wanted to update you on my progress. My computer was in for repairs for 4 days! I finally got back to Restornomore..
After about a week the fog started to clear up. Some days I wasn't sure because it was so gradual. I was just so happy I had that dreaded Restor removed. Now after almost three weeks I am seeing really well. The fog has completely gone and the vision in my left eye is 20/40 and better. I am wearing glasses with the left lens removed. When I take off my glasses, I see everything with my wonderful left eye! (except for reading) I can actually do some reading if the print is not too small. Still relying on my right eye for reading.with the glasses.
I have been afraid, but last night I ventured out in the complete dark. Quite an improvement on my night driving vision. Very little if no light glare. No problem.
I still have to have the right eye done. Will probably have it done sometime in November. I am happy the way I am right now for the time being. I can see everything and read!
My question is, when I have the right eye done should there still be an improvement in all areas?
Again, thank you both so much with all your advice. I would not be where I am if it weren't for you.
Oh, another bit of news. My old surgeon charged me for the Restor lens. He said I was not covered. I found out last night that my insurance DID cover it and I should not have had to pay a penny! I better be getting a refund from him!
Keep in touch.
Disappointed No More (L)
p.s. You are both so right --patience!
Hi Restornomore,
I restled with the exact same issues as you are now. I went back and forth between doing distance/distance and distance/intermediate.
I chose distance/intermediate and have been pleased with the results. I still wear a contact in my nonoperated eye for distance and will have my second eye set that way when I finally get an IOL. I did my nondominant eye for intermediate, since that was my Restor explant. I also dislike discrepency and have always strived for the sharpest vision. I feel that my distance vision is fine this way and I can function most of the time without glasses. I do use no line bifocals for reading and for when I want to not have to take my glasses on and off such as at work when switching between tasks. My glasses correct for a slight astigmatism as well.
My surgeon also proposed distance/distance intially, probably for the same reason, I had so much trouble adapting to the restor vision and distance/distance seemed the most conservative to him.
Since I am still very nearsighted in my non operated eye, my eyes are -8.0 different in diopters without my contact and this is annoying but I have adapted and know that I can correct that eventually when I have surgery.
Hope this helps. I think even if you go distance/distance you will be 100% happier than with the restors and will adjust no matter what.
take care.
londonbridge
I restled with the exact same issues as you are now. I went back and forth between doing distance/distance and distance/intermediate.
I chose distance/intermediate and have been pleased with the results. I still wear a contact in my nonoperated eye for distance and will have my second eye set that way when I finally get an IOL. I did my nondominant eye for intermediate, since that was my Restor explant. I also dislike discrepency and have always strived for the sharpest vision. I feel that my distance vision is fine this way and I can function most of the time without glasses. I do use no line bifocals for reading and for when I want to not have to take my glasses on and off such as at work when switching between tasks. My glasses correct for a slight astigmatism as well.
My surgeon also proposed distance/distance intially, probably for the same reason, I had so much trouble adapting to the restor vision and distance/distance seemed the most conservative to him.
Since I am still very nearsighted in my non operated eye, my eyes are -8.0 different in diopters without my contact and this is annoying but I have adapted and know that I can correct that eventually when I have surgery.
Hope this helps. I think even if you go distance/distance you will be 100% happier than with the restors and will adjust no matter what.
take care.
londonbridge
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