Michael J Kutryb, MD  

Specialties: Ophthalmology, Cataract Surgery, glaucoma

Interests: Ophthalmology
Kutryb Eye Institute - Titusville
Titusville, FL
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Multifocal IOL Decisions Should be Made Very Carefully

Oct 05, 2010 - 6 comments

     Some of the most common comments I hear on the forums here at Medhelp are patients worried and upset after multifocal Intraocular lenses (IOL's) such as the Restor and Rezoom.  (The Crystalens is a different type of IOL and I will discuss that another time.)   Now I'm not here to bash either lens because countless thousands of hours of research and millions of dollars have been expended to develop them with a legitimate goal of reducing dependance on glasses after cataract surgery.  They have their pluses and minuses.
     Talking about Multifocal IOL's is sort of like talking about big SUV's like Hummers or Suburbans..  They're not all bad, not all good, just very different.  Perfect for some people but terribly wrong for others.  I dislike the label "Premium Lenses" that are used for multifocal IOL's because that gives the impression that these IOL's are "better."  The premium price tag also lends itselft to the thought that these lenses must be "better" in some way.  "Of course they must be much better or why would they cost so much more" one might say.

     My final take home message is that if you are thinking about selecting a multifocal IOL for your cataract surgery, you need to do your due diligence.  You cannot try out these IOL's before surgery.  Remember that.  If you had to buy a new SUV, without being allowed to look it over or test drive it, you would be very cautious, right.  Be cautious with your IOL selection.  Make sure you get feedback from real patients, who have already had the IOL you are considering.  Preferably get feedback from friends, family or neigbors.  People you trust.  If you can't get the type of recommendations you were looking for, please don't feel ashamed to have a standard monofocal implant.  You could call standard monofocal IOL's the Toyota Camrys or Honda Accords of implants.  There is a reason why millions and millions of people are very safisfied with them.

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Avatar universal
by Restorsucess, Oct 08, 2010
That's a great analogy!

Avatar universal
by Cst1245, Oct 28, 2010
Dr. Kutryb,
How DO you feel about Crystalens?  I am 55, and have a cataract that has developed rather quickly.  Without the cataract, my vision is not very bad.  I did not wear glasses until late 30s - early 40s, and then just readers for a long time.  We added a little distance to the prescription a few years ago.

Although my doctor will use the Crystalens if I so choose, he is not a fan.  He said it works great for some, but he has seen many patients where their expectations of the Crystalens exceeded the performance of the lens.  He said many still need glasses and then they are unhappy they spent the extra money for the Crytalens.  He is steering me toward the monofocal.

Your note hit close to home for me, as people are telling me that I should get the very best for my eyes and the best product on the market indicating I should go for the Crystalens, not the old technology monofocal.  To watch the Crystalens website video and to look at websites of doctors who really promote this product, one would think one would never need glasses again.

I read somewhere that monofocal lens have a clearer distance vision.  I also read that due to the movement of the Crytalens, sometimes an astigmatism can develop.  I already have an astigmatism.  Could it get worse?  I also read that if YAG is needed later, the Crystalens is more likely to shift than a monofocal lens.  In addition, I've read several horror stories on this website about Crstalens.

So, to sum things up, I'm trying to decide what is best for me. I realize everyone's eyes are different, and what works well for one may not work well for another.  I guess I'm also trying to convince myself that it is not archaic to go with the monofocal.  Please share your thoughts with me.  Thanks!  

Avatar universal
by SusanRB, Dec 20, 2010
I got a Crystalens because it came so highly recommended by a friend and by my doctor. I am one of the nightmare stories; it seems like there is a carnival in my eye with shimmering lights clouded by a layer of dust. For some reason at night the upper portion (say 40%) of my field of vision is dark and the TV has a halo around it with the picture extending out on all sides. I am just heartsick that it appears nothing can be done and my doctor still acts as if it cannot possibly be a problem with the lens. I've done the Yag which made it worse and now he wants to do lasik but I am scared to have anything else done. I was better off with the cataract. Apparently, this is not the typical outcome but I would say it is not worth the risk.

If you have it done with Crystalens, I surely would like to hear about it.

Avatar universal
by sunshinett55, Nov 16, 2012
Hello I have had both eyes with RLE Mplus multifocal lens.  1st eye on 31st oct and 2nd eye on 7 nov 2012.

reading has been good soon after the operations, but distance has never been clear and still is not clear now.  

In fact I am not driving at the moment as feel it is unsafe for me to do so as still think my eyes are not good at distance vision.  Watching tv is not clear either.

I  am getting worried that i might not get good clear distance vision.  

in the adverts it says good distance and good near.

so do your eyes improve still further?  should i get good clear vision in distance,middle and near vision?  i am feeling a bit concerned now.  i dont want to be left blurry forever

this company told me that they offer aftercare after teh 12 months, but i did point out to them that in their literature it says up to 12 months free treatment, they are a big popular company

do the RLE MPlus multifocal lens give no problems after 12 months is this why?  do problems occur before this and that is why they give this in their literature?

what problems can happen after 12 months that woudl spoil your lens vision?

I am still trying not to lift anything, not to get water in my eyes so wash my hair backwards.  had an eye check two days ago and the right eye is not healed quite.  Stopped two days ago putting eye drops in teh first eye operated but continuing with the prescribed eye drops in the 2nd eye that was done on the 7th Nov.

I also use dry eye drops, have used these for a few years, but make sure i dont dilute the other eye drops with them so leave a gap.

is my blurry distance vision due to my eyes still adjusting, my brain trying to work out my new eyes, or one of them yet to heal properly?

If i rested my eyes during the day time, as it does make them feel tired looking at things like the tv, things in teh distance as its blurry, so am i making my eyes worse by watching a blurry tv etc?

or would using my eyes more force them to get adjusted more quickly?

my eyes do feel tired. or is it just me thinking that they do.

i want to do the right thing.

thank you for any help from others that read this

Avatar universal
by Normandie, Apr 29, 2013
Hi Dr. Kutryb,

I have been told that Restor lenses are not so forgiving of dry eyes.  I may be explanting the Restor lens that I now have.  Will I feel less "foreign eye sensation", probably due to dry eye, than I now feel with the Restor lens?  I would be implanting a Nanoflex monofocal lens, such as I have in the right eye, and though this eye may also be dry, I have no symptoms or any unpleasant feelings/sensations at all.  Please respond with your expertise.  Thank you.


Avatar universal
by dewhica, Jan 09, 2014
Hi Dr. Kutryb,

I am a high myopic 53 year old woman with healthy eyes and retinas.  Have been wearing disposable contacts for years with vision around -11 in both eyes.  No problems.  Now I have cataracts in both eyes, the left eye being the worst and needs to be done right away.  It is so difficult finding a good doctor; too many advertisements, etc...  I want to use premium IOLs but have conflicting doctors suggesting Restor and the other Tecnis.  Do you have any thoughts on this or could you recommend a doctor in the NJ/NJ metro area?  thank you!  Caroline

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