Seeking advice between Cyrstalens and Tecnis

Discussion in 'Optometry Archives' started by Wayne Stidolph, Jan 10, 2005.

  1. I need to have an ICL and crystalline lense replaced by a standard IOL
    put in my right eye, and am trying to decide what to do - advice welcomed!

    Background: I am naturally hyperopic, 50 yr old, software
    engineer/manager (spend lots of time at a computer screen), and like to
    go mountain biking. I wore monovision contats for a few years, but I
    really disliked the maintenance and dust-sensitivity of the contact
    lenses, and I was scared of night-vision effects with LASIK, so I
    entered the FDA Phase III trial for Staar ICL, and had lenses implanted
    bilaterally when I was about 45. Worked great for a while, but
    eventually both eyes developed cataracts,probably due to zero vault of
    the ICL over the crystalline lense.

    Left eye: The left eye failed first. The doc took out the ICL and
    crystalline lense and put in a standard IOL; good results, but then a
    year later it clouded over (PCO) and so he YAG-blasted that eye. Fine,
    except I have a monocular diplopia that is really annoying looking at
    bright points in low-light conditions (as in, I can't read text on a TV
    subtitle). I do fine wearing +2.75 readers with my computer and papers,
    but can't read many street signs, car dashboards, etc.

    Right eye: Next the right eye developed a cataract, but I held off on
    treatment - I was hoping the Crystalens would get approved and I'd get
    some accomodation, even from a unilateral implant. Well, the lense got
    approved in Nov 2003, but just as I got ready for the operation, I
    thought to call the FAA about it (I'd like to become a private pilot).
    They said 'no' to that lens for at least another year; and, Eyeonics
    didn't want my doc to do my eye until he had done ten "simpler"
    implantations (the piggyback ICL was considered a complicating factor)
    so I held off again. The lense has clouded over until I no useful vision
    in that eye - I can see a bright light as a general glow in the haze. I
    run into door frames from time to time :) and I don't go mountain biking.

    Which IOL: while I was waiting out that year, the doctor wavered in his
    belief about how good the Crystalens was and how much accomodation might
    be achieved; and, I saw the Tecnis IOL come on the market, saying great
    things about "Functional Vision." And that lens wouldn't have the
    "multi-focal" characteristic the FAA is wary about. So this has left me
    wondering which course to pursue, and needing information/advice:

    (1) How much benefit am I likely to achieve in a unilateral Crystalens?
    If I'm still going to need readers, then the benefit seems small; but
    since I adapted well to monovision before, maybe that says the right
    (Crystalens) eye might handle reading, then both eyes kick in for
    distance? If one eye adapts and the other doesn't, am I going to have an
    near-field depth perception, anyway?

    (2) Is the Tecnis really as great as the marketing material claims?

    (3) Monocular diplopia - I see sharply (if dimly :) through a pinhole.
    The doc confirmed there wasn't any significant astigatism nor re-growth
    after the YAG treatment. So, what can cause the ghost, and is there
    anything I/he can do about it?

    Thanks for any advice,
    Wayne Stidolph, Jan 10, 2005
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  2. Wayne Stidolph

    DroneMan Guest

    DroneMan, Jan 11, 2005
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  3. Wayne Stidolph

    DroneMan Guest

    I am an ophthalmologist, and a busy refractive surgeon - I don't think
    you're going to get too much help with the Crystalens, (but it would be
    better than nothing) and there are glare issues. Since you want to be a
    pilot, the Tecnis lens would be good It minimizes spherical
    aberrations), but I would avoid all bifocal and multifocal lenses
    (Array lens from AMO) . Your right eye may have a lot of higher order
    aberrations, and any of the wave scan analyses might help you find the
    answer, if they can get a good scan through your implant. Treatment
    (?Laser PRK) is a complicated matter as well.
    Best of luck
    DroneMan, Jan 11, 2005
  4. Wayne Stidolph

    Jim Sharpe Guest

    Hi Wayne,

    I had similar questions regarding unilateral Crystalens implantation.
    However due to rapid cataract development I ended up getting them in
    both eyes in April and May of last year. I as only 42 at the time and
    was excited about the opportunity to have an accommodating option.
    However, even under the excellent care of Dr. Doane, arguably the
    surgeon with the most experience with the Crystalens the experience has
    been a dismal failure and I will likely be having the them explanted.
    In addition to having no accommodation, the physiology of my eyes
    caused the power calculation to be off. But the most substantial
    problem is that the lenses have essentially ruined my night vision due
    to halos, flares and other effects. Although I suspect I'm in a
    minority of patients with these problems, I think it's important to be
    aware that such problems are a real possibility. Feel free to contact
    me if would like to hear more about my research and experience.

    Jim Sharpe
    Jim Sharpe, Jan 23, 2005
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