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
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
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