Cataract Surgery with Restore Multifocal 2.5? Anyone?
Posted , 8 users are following.
Hi All! I'm scheduled for Cataract Surgery next Wednesday on my left eye, right the following wednesday. I'm getting extremely anxious as this gets closer and have a call into my surgeon in hopes to answer a few last questions before surgery.
Background:
I'm a 46 year old female who was told I was developing cataracts 6 or so years ago. Posterior subcapsular cataracts. I have had pretty poor vision since my teens and wear contacts of -7.5 in each eye. I do need readers but have been in denial and just deal with it. The past few years my vision is worse - very cloudy in the left, less in the right, but it has been affecting my night driving and I can only see a persons shape when a light source is behind them. Also note I have light blue eyes that are extremely sensitive to light - I wear sunglasses on any kind of bright day - even the cloudy bright days. My regular eye dr does perform cataract surgery. However, when I started looking around I wanted the best and most experienced surgeon. On the recommendation of a co-worker whose wife worked at an opthamologist, I looked into their doctors and ultimately picked a dr. based on reviews and posted experience. Of course he is at the one location 45 minutes away but to me it is worth it. He performs the surgery with the femtosecond laser as an option and is recommended if you choose a multifocal lens.
I met with him for the first time last November (2018) and he did all the measurments for the lens/surgery. We discussed the pros/cons of the multifocal. I love the idea of being free of glasses for most things (distance, driving, computer) but don't mind so much if I wear readers to read fine print or menus. Via a follow up call to answer some of my questions, he said he uses Restore multifocals and would use a "active focal distant dominant" lens in my first eye and then see how he'd need to adjust the second based on my vision.
So after rescheduling this surgery twice, i thought i was ready to go. Until I started researching the lenses. Then I got confused and scared.
My concerns are this:
Picking the wrong lens - I've read there are more side effects with the multi than mono but I'd really prefer the multi.
I don't know the surgeon well and don't have that relationship and I guess comfort level i would like only seeing him once. Though when i asked if this was normal, his scheduler said it was and people have flown in for surgeries never meeting him until that day.
I've also read and seen a few horror stories about pupils being mis-shaped after surgery. Or glow in the dark pupils. Please tell me i won't look weird to people after surgery (I know it is vain). I'm wondering if this is lens related or just a possibility with any cataract surgery?
I also read somewhere the restore multis have a higher rate of glistenings?
I'm also worried about light sensitivity after the cataracts are removed.
A final note - I decided not go with my regular eye doctor because she doesn't have the experience or number of surgeries as the surgeon 45 minutes away. She also does not use the femtosecond laser and said it hasn't proved to have any better outcomes. She uses Tecnis multifocals. She told me I can transfer all of the measurements to her or anyone and suggested I wait until my dry eye under control. My eyes aren't overly dry, but they become irritated from contacts and I think it's more the contacts than dryness, but not sure.
So that has me a bit confused. Did any of you use a surgeon other than your regular eye dr? Is it normal to only meet a surgeon once and go for it?
Sorry for the long post. Thank you all for your time and any input!
0 likes, 20 replies
W-H crista83503
Posted
We have seen our surgeon twice now. OP in 2 weeks and we are still deciding between monovision with Zeiss Asphina 509 vs Zeiss Lisa Trifocal.
Until 3 months ago we did not know our eye doctor and until 3 weeks ago we had never met our surgeon.
We met 3 other surgeons before picking the 4th one. I think most people meet the surgeon only once. You are not looking for a marriage partner as such 😃
You mean Symfony? It is called EDOF- Extended Depth of Field lens. Sue here has that lens.
If I personally was going multifocal route then I would go Zeiss trifocal, it is called AtLisa.
More importantly which country do you live in? As it looks we in Europe have more choices.
crista83503 W-H
Posted
Thank you - I've read your discussions and see your wife and i are in similar situation.
I'm in the US. I believe the only multi focals FDA approved are the restore or tecnis. And i think it depends on what the dr. chooses to work with or has the most experience with. Neither dr. gave me the choice - more like either this brand of multi or choose a mono.
W-H crista83503
Posted
PanOptix trifocal IOL just got approved in the US. You might have issues finding a surgeon though near you.
What I find amazing is that your
Posterior subcapsular cataracts was diagnosed 6 years ago 😮
My wife's was only 3 months ago and has become dense. I guess not all Posterior subcapsular cataracts spread at the same speed.
crista83503 W-H
Posted
I'm not sure. I was surprised when she saw it 6 years ago, so it was very small. I was just my routine exam...
I could probably go another 6 months but everyone tells me why wait? But I think there may be better lenses available if you wait. But the idea of being contact lens free is very appealing.
W-H crista83503
Posted
In 6 months there won't be huge change but maybe try to get the best lens available currently.
Don't you live near some big city? Maybe travel bit further if you can afford?
crista83503 W-H
Posted
I am near Philadelphia. My surgeon operates at both Wills Eye in Philadelphia and his own suite just outside the city. I'm waiting for his call to go over the final lens choice and a few questions I have. Will ask about panoptix and see. Part of me wouldn't mind waiting bc i'm chicken!
soks crista83503
Posted
Hi crista,
Wills Eye is superb ranked #2. They were the first to implant Symfony in US and I am pretty sure they will be among the first to implant Pan Optix. I saw Dr. Blecher at Wills but did not have surgery with him.
soks W-H
Posted
W-H
My right eye PSC has taken 2 years to get into the line of sight after detection. Maybe it was there I never even knew about it. So it really depends on where the cataract starts. If it starts at the edges it can take a while.
soks
Posted
Oh and I saw him that day and then I would have seen him on the day of surgery. They have the catalys femto at Wills and you can also ask for the ORA. it is a teaching hospital and I asked that my surgery not be done by a resident. To that he agreed but said there will be residents present.
crista83503 soks
Posted
Any idea if that CATALYS laser is better than the LenSX?
Also, I saw Dr. Tipperman with Opthalmic Partners in Bala Cynwyd. I was opting for the surgery out there rather than Philadelphia Wills Eye because he had limited availability in Philadelphia.
Who did you go with for your surgery?
soks crista83503
Posted
technically catalys is better than lensx because in addition to the capsular hexis it breaks up the lens. i went with tal raviv in nyc.
Guest crista83503
Posted
About this laser thing - the eye clinic where I had surgeries, offer Femtosecond Laser surgery for iol implants, but the surgeon said in his opinion it was a waste of money, he said traditional surgery is just as safe.
What is right or wrong I think depends on personal opinion amongst the surgeons, but I had done without laser, I felt no reason to choose laser, when the surgeon had this opinion about it.
kevin77191 Guest
Posted
My surgeon said something similar. He said if your cataract is really dense/hard, then you should consider getting the laser. In my case, my cataract came on Sept and I had surgery in Feb, so he said I don't need the laser. Since your cataract has been forming for 6 years, it could be a lot denser.
Guest crista83503
Posted
Hi Crista
I am guessing you live in the US, right?
I understand all your worries, we all have them before surgery.
8 weeks ago I had the Zeiss Lara (similar to Symfony) in one eye, and 3 weeks ago I had the Zeiss Lisa trifocal in the other eye.
And now - I really don´t know how to say it, because many people will read it, and I am not trying to put anyone down, but fact is that the Panoptix trifocal is just now released in the US, and you really should hold off with the Restor bifocal, because now you have a better iol to choose.
Trifocals have been used in Europe since 2010, and you don´t loose anything with the trifocal, but you gain a lot over the bifocals you mention. The trifocal add midrange without loosing any near, and because they have a newer design, the have less contrast loss than the older bifocal designs. The visual side effects are also known to be less on the trifocals, because the contrast loss is making some of the side effects, and with less contrast loss, you get less side effects.
The Panoptix are the newest trifocal on the marked, but it is widely used, and works really well.
About your thoughts regarding which surgeon to use.
I believe they all can do a good job, when it comes to a standard cataracts surgery. The type of surgery used today are more than 30 years old, and even in the third world with minimum of equipment, they have really good results.
You should choose the surgeon that makes you feel safe.
In my own case, I have had surgery by two different surgeons, I just booked with whoever was working at the clinic those days that fit my calendar, and both eyes have turned out really well.
You will not look weird after surgery, or at least your eyes will not look weird 😃
I also have blue eyes, I had no idea they were more sensitive to light, but cataracts makes you sensitive to light as well, at least it is much easier to be blinded by light with cataracts.
After surgery you will be extra sensitive for a few weeks, but your brain will adapt. The first days after surgery I used sunglasses indoor as well, but 3 weeks after I don´t use sunglasses even out in the sunlight.
crista83503 Guest
Posted
Wow - thank you so much! Until today, I didn't understand restore were essentially just bifocal. And didn't know that Panoptix was now approved US. I would rather wait for the better lens if it is not too long. My cataracts are bothersome, but not disabling. I will see what my surgeon says if he ever calls back. I called them yesterday...
Thank you so much for your input! I'm glad I posted.
Guest crista83503
Posted
Your welcome.
You can find the post "Received toric PanOptix yesterday" in this forum, the Panoptix is in practical use now in the US, no doubt it will change the scene completely, here in Denmark no surgeons have used bifocals for years.
The Finevision trifocal came in 2010, and the Zeiss trifocal came in 2012, and I don´t think anyone have got bifocals since that.
You can also search for Janus´ post in this forum, being from Canada he had the opportunity to choose Panoptix before the lens was approved in the US, Janus have made a good explanation of his experience with the Panoptix iol.
Beside that, don´t be scared about the surgery in itself, a regular check at the dentist is far worse in my opinion.
I had both surgeries done with only some eyedrops before surgery, no relaxing pill or other stuff like that, and it was painless and quick.
derek40125 crista83503
Posted
Crista:
You probably already understand this, but I wanted to make sure since the terminology is confusing.
A lens like the Restor is bifocal in that it has two distinct focus ranges vs a trifocal like Panotpix (which has three). It is nothing like bifocal glasses or bifocal contacts. It's more comparable to multifocal contacts. With bifocal glasses, your vision changes based where you look (distance up and near down) and you are always conscious of this. With a multifocal IOL, the lens is creating both the near and far focus points at the same time and your brain just ignores the out of focus one. You are not conscious that you are looking at a near or far object.
With that said, I am also excited that Panoptix is now approved in the US as I will eventually need surgery for eye number 2 and that lens seems like a very good choice for me to pair with the Restor 2.5D in the other eye.
If it were me, and only you know when you need surgery, I would try to wait and see how the Panoptix is received by US surgeons.