Near Vision difficulties after ReStor implant one month ago

Discussion in 'Eye-Care' started by Felix, May 19, 2007.

  1. Felix

    Felix Guest

    I don't have the technical measurement information about my current/
    pre surgery vision which may render my questions impossible to answer
    but I'm hoping to find others who may share their experiences with me.

    Pre-surgery I was very near-sighted with apparenly mild astigmatism
    and steep corneas. I have worn glasses for about 45 years and use my
    eyes intensively/extensively at all distances, including alot of PC
    work and reading on the job as well as for close work hobbies. My work
    requires that I view alot of different distances minute by minute
    through-out the day.

    One month after cataract surgery on my dominant eye I now drive
    without my glasses for the first time in my life. I go to lectures and
    no longer have to sit in the front seat to view. I am able to see the
    alarm clock without my glasses. In fact, I've not used my glasses for
    the last 3 weeks at all.

    Although I'm EXTREMELY pleased with this distant vision, I am
    distressed that my "second sight" cataract-caused vision in my non-
    operated-on second eye with cataract is so superior to my near vision
    in my dominant, newly implanted ReStor eye. I had considerable
    swelling (edema) with my surgery and my recovery seemed to be at least
    one week behind most other people's recovery. I really couldn't see
    well enough to drive to my job for about 5-6 days. (I still have to
    get on my hands and knees to get my eyes close enough to my work to do
    my work.)

    I realize that my "good" "second sight" in my non-dominant eye will
    eventually cease due to increasing cataract growth and then I will be
    forced to implant some lens in my second eye.
    I hate to let my cataract become more dense as I let the dominant eye
    cataract get too dense before surgery BUT I can't see giving up my
    presently good near vision in my non-dominant eye yet.

    I am assured that with the second ReStor implant my near vision will
    be much better and that my vision won't really improve until I do get
    the second implant.

    I wonder how my near vision can improve with a second ReStor implant
    when the near vision in the first eye is so much poorer than my
    "second sight" in my non-operated eye. It doesn't make sense that if I
    can't see up close now that I would see so much better up close with a
    second ReStor implant. How can two negatives make up a positive in my
    layman's way of thinking?

    When I was researching recovery from cataract surgery, I mainly found
    articles referring to a very speedy return to work. Acquaintances who
    I polled said they were playing cards that evening after cataract

    Now I understand that neuroadaptation takes as long as up to a year
    before one's new lens and brain learn to see as well as they are going
    to. One month isn't very far into that process.

    It is difficult for me to just "trust" that my near vision will be
    better with a second ReStor. I have no desire to have alot of follow-
    surgery to get my near vision back. I have no desire to start wearing
    readers/glasses for my nearly constant up-close reading needs when
    I've not had to wear glasses for up-close reading for the last 2-3

    I have difficulty reading my piano music now through the blur. I can't
    read the blurry page of a book 8-10 inches from my eyes without the
    aid of my non-implanted/original cataracted eye. If I cover my "bad"
    eye, this computer text is blurry. With both eyes in use, the blur is
    much less.

    I feel like I have traded near-sightedness for far-sightedness now and
    I'm not sure I'm happy with the exchange. I realize that no implanted
    vision is as good as one's healthy original vision (providing that one
    did have original good vision!)

    With the relatively early onset of my cataracts, the decisions I make
    now on my second implant will likely be what I'll have to live with
    the rest of my life (hopefully 30-40 years) as I'm not interested in
    any more surgery. I know that surgery outcomes can't be predicted and
    that each recovery is different.

    Thank you for any insights to my near vision concerns.
    Felix, May 19, 2007
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  2. Felix wrote:

    BUT I can't see giving up my
    How close in (in inches from your face) do you have to get to see
    clearly with that eye?
    I doubt it will be unless your surgeon "over plusses" you, which will
    improve your near vision at the expense of distance vision in that eye.
    There are two possibilities that come to mind: 1. You may be "over
    minused" so that you are actually using the near focus of the ReStor for
    seeing distance. 2. You may only be able to use the distance part of the
    Restor lens due, e.g. to pupil size. If 1. is true, adjusting the
    power may help. If 2, probably not.

    It doesn't make sense that if I
    They don't, and you are on exactly the right track.

    One thing you might try. Pick up a cheap pair of + 2.00 OTC readers and
    remove the lens from the side that your non-IOL (cataractous) eye will
    see through.

    Now put those on and compare R & L vision at far and near.

    If the vision is now much better on the IOL eye than the other, you
    might want to go for surgery sooner than later. If not as good or about
    the same, forget surgery for now. You might like using this "custom Rx"
    for some functions.

    If you elect surgery, I'd strongly oppose any multifocal IOL including
    the ReStor, Crystalens, etc. I would recommend a prolate optics lens
    like the Technis, and have them purposely over plus the eye by an amount
    equivalent to your most common close work distance.

    Good Luck.

    w.stacy, o.d.
    William Stacy, O.D., May 19, 2007
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  3. Felix

    Jane Guest

    The archives of the Eye Care Forum (Optometry) at Med Help
    International contain multiple postings from people who were in your
    situation. For some, it just took more time for their near vision to
    "come in," and they were eventually pleased with their ReStors. For
    others, a second ReStor resulted in no improvement in near vision,
    even after more than a year.

    I only skimmed through the recent EyeQ Report of the 2007 ASCRS
    meeting, but I do remember a few details. It is now believed that it
    takes from 9-12 months for your brain to adapt to multifocals, and
    reportedly a small percentage of people never adapt. (I guess they
    become explant candidates.)

    In your place, I'd postpone surgery on my second eye for as long as
    possible. If there's been no change in near vision with the ReStor
    when a second surgery becomes unavoidable, I'd go with Dr. Stacy's
    suggestions. You might also consider consulting another doctor who is
    very experienced with multifocals about your concerns.
    Jane, May 20, 2007
  4. Felix

    FKS Guest

    Then, get a monofocal IOL set for near vision.
    FKS, May 21, 2007
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