planning crystalens surgery

[bocalady]

After reading some of the comments about results of implanting Crystalens I am getting nervous about doing it.  I can use all the comments I ca get regarding it to educate me, ease my mind and make a decision. Thanks. bopcalady

[eyesonyou]

Hi,

I totally understand your fears and reservations.  This is an important decision for you.

I've had a Crystalens in my left eye for 1 year.  I haven't had the other cataract extracted yet due to personal and financial reasons (and the cataract is not at a "terrible" stage as of yet).

Due to my own reasons, and from having a very successful ERM peel in the same eye following cataract surgery, I felt I needed more time to evaluate the Crystalens as my retina healed.

In the last few months, I've had lots of practice reading from the computer.  Thus, I've had the best results with intermediate vision, and I have experienced at least some accommodation.  I no longer need glasses to read from the computer screen!  Reading from printed materials is more difficult.  I definitely wear glasses to drive a car.

This is a pretty good report, considering that I have only one Crystalens.

I have not needed the YAG capsulotomy, and I am going to cross my fingers that I won't need it in the future.

And, yes, I was farsighted, and was left nearsighted.  My cataract in the remaining eye has progressed further, I think.

I speculate that vision with a cataract is fairly inconsistent and unpredictable.  In other words, a year from now, my vision could be better or worse in that eye.  Just from 2008 to 2009, I suddenly had glasses that were "too strong for me", and the Rx had to be changed.  The constant fine-tuning and changing of glasses gets to be annoying, but based on my medical records, the course of visual acuity cannot be predicted with any accuracy.

I really feel that I have a good cataract surgeon, and I'm sticking with him.  If I decide to have cataract surgery in another 6 months, I'll go with the Crystalens again.  Oh, by the way, if you tell the surgeon that it's financially difficult for you to afford two Crystalenses, he may be willing to knock a little off the price of the lense (at least mine will do this!).

My surgeon says that I am one of the smartest patients that he has.  If only he knew how much I researched, prayed, and deliberated before making my decision about my surgery.

[icyone]

Really interesting information -- much appreciated.   My priority was distance vision, hopefully without contacts.  I was "farsighted" but used contacts for distance vision, which I was hopeful of being able to go without on the water.

What I got with Crystalens was (quote) "You were farsighted, and I made you nearsighted." (I can read just about anything close, but can't read the overhead signs on the Interstate -- or pass the driver test -- without contacts.) Unfortunately that is the opposite of what was expected. I've been trying to figure out ever since what the real issue was: the preop measurements, the surgeon's skill, the Crystalens, or something else. The more I learn about eye surgery the better my chances to finally figure this out to my own satisfaction.

Dr. O definitely has it right -- understanding this surgery really takes a lot of digging.  I may as well have flushed $6500 down the toilet -- would  be better off with monofocal & readers.

[BUTTERCUP109]

I would like to hear about your experience. I also had a terrible result from crystalens, ie no accommodation. I was consumed by wanting to understand why some had a good result and others not. I came upon the answer in an accidental way. I read the FDA studies from 2003 that showed 100% success rates!!! How could this be, when success in actual practice was barely better than 50%?  I noticed that 0% of the patients studied developed posterior capsule opacification, while about 20-30% of patients in practice develop this. This is a clouding that occurs when cells remain in the lens sack. When the lens sack is properly cleaned or "polished", these cells are removed. I suspect that the relationship is that debris left in the lens sack simply encases the hinges restricting movement of the crystalens. Thus the doctor's technique is key.
An independent exam revealed excessive fibrosis around my implants and no movement as measured by ultrasound.
Another surgery to clean things up is possible but risky and not recommended for me. If you wish to check all this out, perhaps you would be a better candidate if you are brave enough to try.

[JodieJ]

Get additional opinions from experienced surgeons about what can be done to improve your vision.  Don't assume that your problems are incurable--I suspect that there's a lot that can be done for you.

[SusanRB]

I don't know if my doctor was part of the "Center of Excellence" but at the time I selected him he was on some list with Crystalens of having done a certain number of procedures with Crystalens which at the time (14 months ago) was apparently a big deal. I can't find that info now so maybe they've changed their guidelines, but he was highly experienced with this lens; however, he gave me no post op instructions other than use the drops in my eyes. The results have been abominable. I thought it is a problem with the Crystalens but according to Dr. Oyakawa, perhaps the problem lies with the doctor. Either way, I don't think anything can be done about it now and I am heartbroken about the seemingly incurable problems with my eye. Wish I could go back and get a standard lens.

Surely would like to hear from someone who has done something a year after surgery to make it better.

[Ray T Oyakawa, MD]

The success of the Crystalens depends on the skill of the surgeon-preop, intraop and post op care.  Check with the Crystalens site and see if you doctor is a "Center of Excellence."

Dr. O.