explanting Restor IOL, decision help needed

[MsLN]

sparing repeating the details from  my prior posts, regarding dissatisfaction  with Restor multifocal IOLs, my primary problem is loss of quality of  prior (nearsighted) sharp near vision. Now it feels like I'm farsighted, its been about 6 weeks with no improvement. The original Dr said he would discuss changing them if I wanted,  after upcoming  next post-op check  and I believe he is a good surgeon, though he convinced me these lenses would do it all, but that didn't happen. I am going for second opinion  right after that with supposed renowned Dr., if both give same opinion, if my best solution is explanting them,  HOW do I decide, WHAT do I ask, to know , find  and decide who is best choice for explanting these? any helpful input, advice or suggestions would be appreciated

[MsLN]

thanks again for your kind attention and helpful answers. Out of curiosity, I actually tried a +2 contact in both eyes and the small sacrifice of distance was well worth being able to see everything I need to function in close and intermediate distance, so much more practical. But found my eyes felt tired after wearing contacts all day. Am I correct in assuming if I change to monofocal lenses I will also be rid of the “lesser” side effects of ghosting, halos, flickering and vision will be sharper and not effected by lighting conditions? I will be seeing the original Dr next week to discuss all this and what to do. The sad part is I never should have done this surgery, I lost way more than I gained , so basically I need to go back to nearsighted and glasses and if I retain some better distance that’s a plus.   Just hope  changing lenses doesn’t create any more problems, why Dr thought my vision would be better is beyond my comprehension, and I was so enticed by no more glasses. If prescription indicates this,  I was a -3.00 , so I suppose that further answers why the Restor lenses didn’t work. I believe he truly wants to make this right and his surgical skills are not in question, so I just need to make sure about what decision to make. I will get the records from the extremely thorough exam by the 2nd opinion Dr. Thanks for your input, at least I feel you get “it”, by  understanding the problem I appreciate being able to vent my frustration and anger. I will ask about your suggestion, it sounds logical , hope I can move forward and feel comfortable and enjoy life again, the thought of most likely redoing this surgery as the best option is going to be unnerving until I know I can still see,  & hopefully better

[JodieJ]

I checked, too, but couldn't find the original article I had read.  I did find another paper stating that patients with less than 4 diopters of nearsightedness are poor candidates for ReStor.

Consider mini-monovision with a near vision bias--dominant eye set for intermediate vision, non-dominant eye for near.  If all goes well, you should have excellent uncorrected near and intermediate vision.  You'd still need glasses for driving.

[MsLN]

I think  I found the article, it did reference exactly what you said, being used to my nearsighted with excellent up close vision  for most of 50+ years makes  me the most difficult patient to satisfy. At least 2nd opinion eye exam revealed nothing wrong with surgery skill and lenses from 1st Dr , though he did not properly consider "me" as per the article information.  Given some suggestions  to try before deciding what to do and  then need to decide what vision I would be happiest to try for

[JodieJ]

I read the article I referred to online awhile ago (but where?)  Try googling combinations like "ReStor mildly nearsighted".  You could also try other search engines--it's there someplace.

You may not have been the ideal ReStor patient for other reasons, too.  Having higher order aberrations, larger pupils or residual astigmatism would jeopardize a good outcome.  I completely reject the notion that your dissatisfaction with ReStor has anything to do with your personality.  (This was what was claimed in an earlier post of this thread.)

If two surgeons are both experienced explanting IOLs, it's your choice.

[MsLN]

any possibility of how I can find that article?  In my wildest dreams I would never have imagined my nearsighted -could see tiny details-vision would be so compromised, even being told I'd lose a little and being shown "difference" by letters on eye chart in no way illustrated what I'm experiencing.  Thanks for the information as the Dr said PRK might make a 10% improvement,  probably won't be enough, and to try it and then find I still want  to explant  lenses after doesn't sound like a good idea. Read every post I could find and people seem happier with vision after explanting. (as long as nothing else happens)  Getting 2nd opinion tomorrow, and was told this Dr is extremely thorough and direct,   (aquainted with his office manager through close friend and this made the connection & immediate appointment). I really don't doubt the skill of the first Dr who said he would change the lenses, and is comfortable doing this, sometimes I wonder if my outcome was not what he expected, he has given me a lot of time and attention with this problem, definitely not dismisssing me.  But my feeling is to just change the lenses, especially if the 2nd Dr recommends it. This question may be premature  and difficult to answer but how do I decide who to use? Do I even consider using the original surgeon?(1st Dr is in NY, 2nd is in FL, not that this will effect decision, unless timing and fact that my primary residence and other doctors are in NY)  
again, thanks so much for the feedback, I  finally feel I'm getting some guidance to move forward from this nightmare

[JodieJ]

I agree that you were misled.  I read an article written for cataract surgeons that stated that mildly nearsighted patients (and I assume this includes you) are the LEAST likely to be happy with their ReStor results.  This is because their near vision with ReStors is (at best) not as good as their uncorrected near vision before they had cataract surgery.  This leads me to believe that even after PRK and sufficient healing time, you are still unlikely to be happy with your ReStor vision.  The article went on to state that farsighted patients are most likely to be happy with ReStors, followed by very nearsighted patients.  Maybe your surgeon missed this article.

There's a lot of good info in the archives of this site about explanting ReSors.  You'd want someone who is experienced with this procedure to do it.  Good luck with whatever you decide, and keep us posted.