Restor 2.5D Review and Comments

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First, thank you very much to Sue.An and everyone else on this forum for the extremely helpful insight during this very difficult process. I’m going to apologize, in advance, for the length of this post.

I’m writing this because I had not found a single review of the newer, Restor 2.5D lenses online, just one or two complaints but the issues didn't seem to be related to the choice of IOL itself. This lens is a lower-add and re-designed (center-distance) version of the older Restor lenses. There are many older Restor posts online but many of these are quite old and, unfortunately, most patients don’t indicate which of the various Restor lenses they had. I had many questions about this lens such as the loss of contrast, nighttime halos, dip in vision between focal points, and similar and other than the company sponsored research and studies there was very little out there. Contrast this with Symfony where there are hundreds of personal reviews and comments. It’s an oddity as there are many, many Restor 2.5D’s being installed. I decided to write my in-depth thoughts and comments on this lens. My left is still unaffected by its cataract, so I think I can do a decent job of comparing the two eyes (which wouldn’t be possible otherwise). Hopefully this will help someone else in the future

BACKGROUND

I am a healthy male (just turned 51). I have cataracts in both eyes which were diagnosed about 2 years ago. There was nothing in my family history (or in my own) which would have put me at risk for early cataracts. At the time, a surgeon told me that it would probably be about 4-5 years before I’d need surgery. That turned out not to be the case although my right eye progressed much more rapidly than my left. I am near sighted and, until recently, have been wearing Acuvue Oasys weekly disposable contacts for ~20 years (-4.5L, -3.25R, although the right was the same as the left before cataracts developed). I have a very mild astigmatism in my right eye (approx 0.25D) which was uncorrected with lenses (and also not corrected during cataract surgery). With the lenses (and before the cataracts progressed), I could see about 20/13 in my left eye and 20/15 in my right eye. At the time of surgery, the vision in my right eye was down to about 20/50 to 20/40 (under perfect lighting conditions) and essentially nothing under other lighting conditions. My left eye is still at 20/13 (so the cataract is not yet an issue in this eye).

I have been using +1.25 readers for computers and +2.00 readers for extended cell phone/tablet use for the past 3+ years. My goal was to get back computer, tablet, and some cell phone reading without glasses. I was totally fine with continued use of readers for close-up work and extended cell phone use. I should mention that I am an engineer and electrical contractor and work extensively on the computer. I have a relatively large set-up with a 34” 21:9 and (2) 27” 16:9 monitors (all at 1440P). I sit between 24” and 30” from the monitors which makes text pretty small (and means I need pretty sharp vision). My office is the lowest level of my house, so if I may refer to home and office somewhat interchangeably.

One of the biggest problems with presbyopia correcting IOL’s is nighttime halos and other problems. Since the cataract is not yet causing problem in my left eye, I wanted to try to simulate these effects before surgery and I opted to test out some multifocal contact lenses. Ultimately, I was unable to find a lens that could duplicate the nighttime halos of a multifocal IOL. However, after two completely failed attempts, the third multifocal contact I tried (Cooper Proclear 1-Day Multifocal) was a complete success. I was able to achieve 20/13 distance and pretty good intermediate vision. Unfortunately, the cataract in my right eye was too strong and even with this lens in my left eye, I still needed reading glasses. The right eye just caused too much distortion to make extended reading/computer use possible. I tired a patch over the right eye but didn’t adjust to that either.

After much research, I chose to go with multifocal Restor 2.5D lenses. I was also considering monofocal IOL’s (set for distance) and Symfony. My surgeon uses both Restor and Symfony although he does 4X as many Restor lenses. Due to my personality, I ruled out any form of monovision. I know that quite a few patients are able to read with monofocal IOL’s set for distance but there are many factors in how well this works. In my case, with contacts set at perfect distance (and some accommodation left), near and intermediate vision are absolutely horrible. I can’t imagine that a monofocal with zero accommodation would suddenly give me great intermediate vision, so I ultimately decided that I would try one of the Presbyopia correcting lenses. Mainly due to this forum, I decided to trade off the extended focus range and lower incidence of nighttime halos with Symfony for the lack of concentric rings (which seem to affect almost everyone). Also, my surgeon’s familiarity with the lenses and the fact that he has not had a single explant ultimately led me to this decision.

Although these terms get somewhat interchanged, I’m going to use the term “Halo” to refer to one or more circular/rectangular rings centered around a light source, “Glare” to refer to a more diffuse “blob” of light around an object and “Starburst” to refer to fewer but long, spokes or vertical lines of light radiating away from the central source. When I’m mentioning Halos, I’m talking about artifacts specifically related to the design of the lens while I think most starbursts are artifacts caused by the capsule, scarring or similar and are mostly independent of the choice of IOL.

Day 1 (Thursday 2/8/18) – Surgery was at 10:30 AM. Femtolaser room was first, with no sedation, only numbing drops in the eye. I was nervous about this, but it did not hurt and it was over quickly (less than 1 minute). The machine has a suction-like device which helps greatly as you just have to stay “reasonably” still.

Once the femtolaser is done, they immediately started IV Sedation and wheeled me to the surgery room. I was pretty much out of it but did get some direction from the surgeon. There was no pain and I was on my way home by noon. My surgeon puts a dressing and shield over the eye for the first night (most surgeons seem to just use a clear shield), so I went home like this and had no idea if I could see at all. There was really no pain, but the bandage over my eye did itch and occasionally I would open my eye below the bandages and it would sting. The gauze itched my eyelid and the sides of my eyes. I would say that dealing with the bandage the first afternoon/evening was far worse than the surgery but it really wasn’t that bad.

Day 2 (Friday) – Doctor’s office at 9:30 AM.

My bandage was removed and the overall feeling was …underwhelming. I have read many comments on peoples’ first impressions about how everything was so clear and the colors so vibrant and I didn’t feel any of that. The cloudy “veil” was removed but colors looked pretty much the same as before and pretty much exactly like my left eye. This was likely due to the type of cataract I had which was a posterior subcapsular cataract. The surgeon also told me today that I would definitely need YAG within 3 months. He had told me ahead of time that YAG was likely going to be required but now it’s a certainty. I am hoping to see the benefits of the near focal point before we get to that point. At this time, I don’t feel my intermediate vision is good at all. We’ll see how this changes over time, though.

Day 2 (Friday) – Back home around 11:30 AM.

My vision is not very sharp but it is not horrible either, certainly much better than before the surgery. At distance, I am about 20/50 (I have a chart in my office set at the correct distance). At 6 ft, about 20/70 and at 21 inches (the near focus point for the Restor 2.5D) I am about 20/100 (14-pt font). For near testing, I am using a chart meant to be held at 31cm (which has conversions into metric and feet), but I am holding it close to the 53 cm (21 in) point for the Restor. This means that my actual vision would be a little better than 20/100 (because I am holding the chart further out). Nevertheless, I think it’s a fair measure to see what happens over time and I’ll be doing the same thing as I progress to see if it gets better or worse over time.

I tried small distance add glasses (-0.5D and -1.0D) as well as reading glasses (+0.75 and +1.25) and neither of these seemed to make any improvement which I’m hoping is a positive sign that I’m just feeling effects of the surgery itself and not a miss in the target. I am also seeing flashes of light which appear to be emanating from the outside edge of my viewing. They are not constant and the relatively large QTY of floaters I had prior to surgery seems about the same so the surgeon doesn’t believe that I have a retinal detachment.

Day 2 (Friday) – Mid-Afternoon

I wanted to take the day off, but I had to try to do some work. I got on the computer and forced myself to NOT use my normal +1.25 computer reading glasses. It took about 15-20 minutes but then my vision settled down and seemed to get better and better over the next few hours. I actually worked close to 4 hours without reading glasses for the first time in 2+ years! After this, I went outside to the back yard (it’s been over 70 deg F for the past week here in San Francisco) and lied down by my fire pit with my tablet for more than 2 hours. No reading glasses. I can also use my cell phone now without reading glasses. What I found is that the moderate improvement to my right eye from the new IOL coupled with the multifocal contact in the left eye creates some really impressive combined vision. I am really excited and happy about this.

Day 3 (Saturday) – Pretty much exactly 48 hours post-surgery

This morning, my distance vision has improved to 20/30 and my near (using the same procedure as yesterday) is up to 20/50 (8-pt font). With both eyes together, it is 20/13 distance and 20/25 near (4-pt font). However, I am noticing significant flickering at the right edge of my vision while my eyes are moving (mostly during reading). There is a very good (and long) thread on this forum regarding this symptom. With +2.0 reading glasses I was able to look into the mirror and see the implant itself move and kind of flicker while this happened. I’m hopeful that this condition will lessen as the lens gets held more firmly. Already, I can say that my brain is somewhat tuning them out as I don’t notice them all the time. I also see occasional flashes from an off-angle light source, although this is not frequent.

I walked around quite a bit last night and definitely see Halos around most light sources of differing intensity (depending on the light source). I am seeing pretty much exactly what is drawn by David Taylor’s son (Search for, “David Taylor my intraocular lens experience”) in his Restor ere image but WITHOUT the long starburst “spoke” lines (I just see the circles). They are very noticeable but also quite small relative to the size of the light source. The same sources through my left eye appear as slightly smaller and uniform, fuzzy “balls of glare” (probably the only visual evidence of my cataract in that eye). One difference is that with the Restor eye I can make out the actual shape of the light source clearly in the center. For example, a square LED light fixture across the street looks square and more sharp inside 3 or 4larger halo rings (with Restor) where it’s more of a single, diffuse blob with my left eye (and maybe a little smaller overall). Due to my research, this is exactly what I expected to see and while this effect should lessen over time, due to the relatively small size I don’t feel it will cause much of a problem in terms of driving. I may be wrong about this, so we’ll have to try it in a few days.

I also tried to see how much of a loss of contrast there is with this lens alternating back and forth between my two eyes. It was pretty hard to see much of a difference. However, in a very dark room I can detect a subtly better image through my left eye. Looking at my bedroom door, for example, I can just make out the hinge and door handle with my left eye but not with my right. I can also see some added detail looking at a power receptacle about 12 feet away whereas I can only see the outline with the Restor eye. It’s really a subtle difference however but I will make note of any differences I see in other situations.

I watched a movie and some TV last night in a completely dark room. I wanted to see if I’d notice halos around credits or other objects on the screen. This was a concern of mine as I like to play compute/console games and watch movies. I did not notice any artifacts from the Restor eye, but I will continue to do the left/right eye test on this over the next few weeks.

I also wanted to comment on the dropoff in vision that should be there between the two focal points (maybe around the 6 ft, 2m point). At this stage, I cannot notice this, but my vision isn’t sharp enough yet, so I will revisit this late on. This is another area where the Symfony should be superior.

 

Overall Summary and a Quandary

At this point my visual results (numerically) seem to not be optimal but they are improving and hopefully this will continue. However, my overall vision has improved so much over my pre-surgery condition that I am already very happy at this point while still expecting additional improvement. Had I done an RLE (clear lens exchange), I would probably feel completely different. With my two eyes together (RESTOR 2.5D + Multifocal Contact) my vision is now quite good. I can read my cell in to about 12”(with its default font size) and it’s the Restor providing most of the clarity at this distance. I’ve been able to use a tablet or computer for several hours without glasses. I have regained my depth perception and watching TV just seemed so much more clear and sharp.

The problem is that multifocal IOL’s supposedly work much better if implanted bilaterally and I am scheduled to have my left eye surgery in less than 3 weeks. I don’t know if I’m going to go through with it or delay it for a while. The surgery on my right eye was an easy choice – my vision was already poor – but that’s not yet the case with the left. I don’t know if I have another 2-3 months of clear vision or 2-3 years. Also, since I have a multifocal contact paired with a multifocal IOL, does this improve the performance of the IOL (relative to a standard contact lens) or does it mean the Restor side doesn’t improve to its full potential? I haven’t found a single comment or study about this as it’s probably an uncommon situation. I see the surgeon again on Wednesday and I am going to push for a delay on the other eye but I will report back either way.  Any comments or suggestions would be appreciated.

 

Finally, in case any contact lens wearers considering an RLE happen upon this post in the future I want to encourage you to exhaust every possible presbyopia curing contact lens option before getting an IOL implant. In my case, the first two multifocal contacts I tried didn’t work at all. I did get good intermediate vision, but my distance vision dropped below 20/40. With one lens, I could get the distance up to 20/20 only if I turned my head sideways and look back at a very sharp angle. On paper, the design of the lens that worked is very similar to the lenses that didn’t worked, but boy did lens #3 work for me. Just find an optometrist that will give you multiple trials of different lenses until you’ve exhausted every option. No matter how good your surgeon replacing doing an RLE will come with some sacrifices. Unfortunately, the contacts will only work for me for a limited time but they feel like magic to me.

 

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  • Posted

    Thank you for sharing all those details on the Restor 2.5D lens.   I recall trying to find info online but could only find a few dated threads.  I am sure others looking into multifocal lenses will benefit from your experience.

    The healing process really varies from one person to the next and I have found it has little bearing on final outcomes.  For some clarity comes once the regiment of drops ends.  By 3 weeks I was told half of the healing takes place and 6 weeks for full healing.  If there is no rush to have the 2nd surgery you might want to hold off.

    I was interested in your description of the laser surgery since my own was traditional.  I was sent home with a clear eye shield that I could see through (it was just taped to my face top and bottom).  Only told to leave it on 2 hours and put it on whenever I slept for first week.  The wait to have it removed must have been difficult for you.

    The flashes of light could still be healing that is taking place.  My 2nd surgery all lights even inside ones had these odd streaks everywhere for about 24 hours whereas I had none of that after first one.   Night Hawk posted something awhile back on pupil dialation as one ages.  Those in their 50s our eyes tend to dialate more and can get the flashes of light etc from edge of IOL.  I assume the Restor you have is at least a 6mm in diameter?  But given it has only been a few days this is likely due to eye healing and IOL settling.

    Yes it’s amazing to see a tablet or computer first time without glasses.  I too work a lot with a computer and I must say it has been easier without glassses.  I also had my first holiday away since surgeries and enjoyed some snorkeling in Bonaire.  First time ever that I can actually see!  Truly amazing.   2 years ago I had to enjoy the underwater world from my GoPro.   

    Wishing you a full recovery Derek and many years of good vision.  Not something I take for granted.   It gives you a new perspective.   All the best to you.

    • Posted

      Hi Sue An:

      Glad to hear that your holiday went well.

      Cheers,

      Ed

    • Posted

      Thanks Ed.  It sure was nice to escape the winter for a bit.   Looks like we picked a good week to go. Schools had 3 snow days while we were gone.  Hard to come back.
  • Posted

    Hi Derek:

    My $.02 worth regarding your "left-eye surgery" is that unless your doctor is providing a compelling reason to do it, then you might as well "delay" it.

    It sounds as if your vision has been good and it is improving.

    If it ain't broke...

    Cheers,

    Ed

  • Posted

    Hi Derek. Thank you for your details, I found it very helpful. I also recently received the restor 2.5 multifocal toric lens in right eye ( non dominate first surgery) and then a restor 2.5 multifocal in left eye. Unfortunately my final results are still waiting to happen. My right eye was stated to be at the wrong power ( I’m a previous lasik patient of @ 20 years ago) but the dr assured me he would get the left eye dialed in and proceded to do surgery one week after first eye. It’s been a rollercoaster ride of recovery ever since. Surgery dates were 12/21/2017 and 12/28/2017. I wish we would have waiting for second surgery until the non dominate eye settled so that I do not need to go back and have an exchange done. It appears to me, now, that both lenses will need to be replaced and then further lasik enhancement will be needed to get crisp clear vision. Currently I have ghosting/double vision in right eye and dr assures me that the astigmatism is zero and he’s not sure why I’m not seeing well.

    What has happened over the past 6 weeks is a lot of fluctuations. I had a red hue to everything for a day or two, lots of lens edge glimmers for a lack of better description. And lastly and the most troublesome, is coming down off steroid drops. I’ve had a lot of pain and light sensitivity causing a horrific episode in the middle of the night. I was wearing my darkest sunglasses in the house before the sun came up. Eyes watering profusely.  We finally changed steroid to durezol after the 3rd episode. ( mind you two of these episodes happened over the holiday weekend where the dr was not available and once I was able to speak with dr the following business day, the episode had passed and more drops were prescribed)  I have had one more slight pain/strain light sensitivity issue last week. One week being off all meds. And was prescribed one drop of durezol for 3 days. 

    Yes everyone heals differently and at different paces. I’m 48 and in relatively good shape I have an active job. So having lens replacement was really the only logical step for me to take. I’m glad I did it early when cataracts were just starting to effect me ( low lighting conditions. Readers really not working for me etc). 

    So on a positive ending, my low light and night driving has been wonderful. Where I once had star bursts around lights and beams that would follow me, I now have concentric rings around lights, which greatly reduces the glare. I live in a remote location and only a two lane road, so someone driving at me  at night with their bright lights on would cause me to have blindness of my lane. This is no longer an issue ( even with the current blurry vision) where I once couldn’t see in a shadows, I can today.  So I still have hope that things will improve. 

    I too am in agreement to postpone second surgery if there is any hesitation on your part. My non dominate eye became dominate at first and now the battle of dominance had begun. Daily it’s a struggle which eye I can see better out of. I don’t wish this on anyone. Lots of frustration. But I tell myself daily, it’s all part of the healing process. 

    Good luck to you Derek and again thank you for your post. 

    • Posted

      Julielyn:

      I'm sorry to hear about your issues and thanks for the comments. Can I ask if the intensity or size of the halos your see has decreased for you or if it's pretty much the same as right after surgery? Honestly, I don't find them to be that bad. I'm really glad that I went with the lower ADD multifocal as the size of the halos is a clear function of the add power. 

      I too am having some issues with light hitting the side of the lens, but I expected this to happen based on the design of the lens and my age (which affects pupil size). Hopefully this will lessen over time. One thing I didn't expect was a "jiggle" or slight shift in the implant as I'm reading. It's not an issue watching TV or even much of an issue while on the computer (where the screen is further away) but it's noticeable on my tablet or a book. Hopefully as healing progresses the IOL will be held in place more firmly. Also, I will definitely need YAG soon and that might help this issue as well. I think I can learn to live with the "light from the side" issue however.

      Julielyn/Ed:

      Unless my surgeon can give me some pretty solid evidence that it will screw up the brain adjusting to the inner focal point, I am definitely going to delay the second eye. I understand the issue with both eyes needing to work together but it really feels like that is happening now anyway because of the multifocal contact in the left eye. The "best focus" distances are a little different (21" with Restor and maybe 30" with the contact) but that's pretty close and at both distances, I can see considerably better with both eyes open and working together.

      I wish there was an accurate way to predict when the cataract in the second eye will become noticeable. This doesn't seem to be the case.unfortunately.  

    • Posted

      Hi Derek. Most things that were an initial distraction have lessened or disappeared. For example the red hue seemed to fade quickly, within a few days. The glimmer that I thought was the edge of the lens seemed to take about two weeks to fully disappear. Every now and then, when light comes from the side, I do I have some blinding for a lack of better word. It’s like when the sun hits a window just right and your not able to see through it. But that’s easily resolved by turning my head or looking away.

      As for halos, when it’s a good vision day I see defined concentric circles. This is a welcome change to previous surgery vision. I really expected my night vision not to change at all due to all the information out there about this problem. I guess my night vision was horrible and I just didn’t realize how bad. My normal routine rarely involves night driving. But last year, we were in aspen to ski and one night I wanted to go into town to shop/eat whatever. We were staying up the mountain, the weather called for snow @6pm and I opted not to take the chance to drive back up a mountain road I’m not too familiar with while snowing, in the dark—had a car come down with its brights on I would have had to come to a complete stop for fear of running off the road. My lane would become total darkness. Lately I’ve been practicing some night driving in familiar territory. And although my depth perception is slightly off due to my current situation, I’m able to see much better at night. The fear is gone for now. We are headed to mammoth next month and will drive from Reno over, so that will be a big test for sure.  Hopeful at least one exchange surgery can be scheduled before I leave. But honestly, the halos have been my biggest asset of the restor lens so far ( gosh, I hope that statement changes soon—if not I will exchange these lenses to clear and be forced to wear glasses or contacts) I refuse to wear glasses with these multifocal lenses—it’s so counterproductive to me. 

      As for our pupil size at this age, at first I thought my pupil was extremely large and the left eye was off center. I don’t recall that ever happening before when the optometrist dialated a few years ago for an annual exam. But at 5-6 weeks Out pupils seem to be back to normal and in the lowest of light conditions I do not see the glimmer at the edge of lens anymore. I saw that effect mostly in the mornings before coffee. So I chalked it up to not being fully awake yet and eyes still sleepy — makes sense to me, but I’m sure there is a scientific explanation to that as well. 

      What I’ve learned is that healing just takes time. For me it seems to take a lot longer than normal. Daily fluctuations happen. Perhaps if it’s windy outside or the humidity is high or low. Perhaps I ate too much salt the night before. My god the possibilities are endless. So I’m really trying not to overthink the solution. That’s my dr job. I’m just an impatient patient expecting to be the normal outcome, and that didn’t happen so on to the next plan to correct the problem. I go back to dr Wednesday. And my second opinion is scheduled for the following Tuesday. Fingers crossed prayers said smile

      Good luck derek I wish you an uncomplicated decision smile 

  • Posted

    Hi derek, thank you very much for your Count Dracula's diary like long but very helpful discussion. I hope your condition will improve by the time. I just want to share a link which I think might be useful for all the readers here, the link is

    http://altered-states.net/barry/update303/

    • Posted

      My dr has a pinhole test. Very similar to the “paddle” you hold up to one eye while reading the chart, this pinhole paddle has several holes to look through. It was one of the first things the tech handed me when I complained of blurry vision. The pinhole paddle did allow for clearer vision, but I think I still had quite a bit of inflammation at the time to see through it and have an “ah ha” moment. Thanks for the link 
    • Posted

      There is an IOL called the IC-8 based on the pinhole effect.  The company that makes it is in the U.S., but the lens itself is currently only available in Europe to my knowledge.  I've read good things about it, but haven't seen any patient reviews.  I'm curious as to whether there are any night vision issues, but I don't plan on going to Europe for my cataract surgery anyway.

  • Posted

    WOW is a lot to say:  Derek, Sue, Ed, Julielyn

    So much you have all said I've been through since June 14,2017 so tomorrow being valentine day will be 8 months for me.  I am still healing, but I am slowly improving.  I've done my best to have my patience, but I do have my moments of Frustration.. Cataract surgery June 14, then June 28 laser surgery (YAG).  waiting to be better before trying left eye cataract on aug 15 and then needing YAG laser surgery on Sept 27.  So many issues with feeling like scales over my eyes. not seeing clear at all, everything very blurry and fuzzy.  overall about 14 different types of drops and at one time I was doing 18 drops a day.  (too many as for as I was concerned) currently only on 2 drops now twice a day. 

    I am 69 and also have extremely dry eyes.  My eyes very dilated for about 7 weeks.  I've had the floaters, very large ones.  I still have the halo's and bursting.  Difficult for night driving.  I didn't drive for 54 days because I didn't feel I could see well enough, but driving now is fine.  Since May 2017 I've been to the eye dr, surgeon and cornea specialist about 52 times now.  Trying everything they have thought to help me.  (3 different eye dr) but as I say I am slowly improving.  I can actually see distance in both eyes, but on my last visit he inserted a contact in my right eye because it wasn't seeing distance yet and I couldn't even make out people's faces.  Now I can.  I go back again on Feb 21.  I have to have readers to read almost anything. Cell phone, paper, books.  I have had even amniotic membrane insert into my eyes.  Which the left eye within 2 days I could see distance for the first time.  right eye it never worked on me like the left. So dealing with the right eye to see properly.   Never would I have thought of going through all this in 8 months.  But I can see light at the end of the tunnel, just want to continue to get better and well.   I appreciate this site so much by reading what others have went through also.  At least I don't feel all alone and it only happened to me.  I know at least a dozen people since mine in June (friends, relatives) with absolutely no issues and see perfectly good.  I tell them they are blessed that all went well.  I have my faith that I will get better and see.  Longest journey I have been on to being able to see.   Good luck to everyone.  Thanks for all your comments and notes to read.  I appreciate you all.   Just knowing it is not me is a big help.   Some people can be very rude and make all sorts of comments and stupid accusations about me and my Dr's.  It hurts!  So next step will be next week on the 21st.  I am expecting I might have to wear a contact in my right eye.  Reader to read. 

    thanks all.

    Charlene

     

  • Posted

    Hi Derek- thought I’d share this review published recently Jan 10 2018.  Interesting article - surgeons weigh in on IOL selection.   Hopefully link allowed but if not google Review of Opthamology- surgeons share their views on IOLs.  Latest update I have seen.

    https://www.reviewofophthalmology.com/article/surgeons-share-their-views-on-iols

    • Posted

      Thank you sue.An for the link. I was hoping for more info on the restor multifocal toric lens..finding it difficult to gather info on that particular lens 

    • Posted

      Yes Julielyn I too found next to nothing about the Restor lens online (in terms of patient reviews).   Was hoping to find something before Derek had his surgery.  Seems the surgeons that commented on that link think there is a longer adjustment period and that both eyes require this lens for maximum benefit.  I often think if one isn’t completely satisfied with results after first surgery they should give it as much time as they can (if possible) to consider other options.  

      Glad I found this link - hopefully will be of some benefit.

    • Posted

      Thank you for that link. It’s a very interesting article and it reinforces my feeling that the Restor 2.5D and Symfony are both very close in terms of number of surgeries (at least in the US) and I'm still somewhat bewildered just how few forum posts exist about the newer Restor in comparison to Symfony (since they were both approved at about the same time). Maybe it's just that the Symfony is a completely different design whereas the Restor 2.5D is more of an evolution of their earlier designs? 

      I liked this comment from that article where one of the surgeons wants, "A lens that could incorporate the ReSTOR 2.5D’s benefits with the reading vision of the ReSTOR 3D, without the added side effects of the 3D." I learned about these differences doing my own research and made the decision that I'd sacrifice better reading vision in exchange for smaller nighttime halos and better contrast sensitivity. None of this information came from my surgeon, it was entirely the result of me reading mfg literature, studies, online journals, and forum posts.

      In reading through thousands of forum posts, it really seems like most surgeons don’t spend the time and effort to truly educate their patients about their choices and the tradeoffs with any lens. I’m sure some do but most leave it up to us to do the legwork which is kind of sad. The more information you get a head of time and the more you know about the tradeoffs you are making, the more satisfied or accepting you will be with the results.

      The other thing I’ve learned through reading all these posts is that doctors aren’t doing a great job telling patients with problems which types of issues are endemic to a particular lens vs those that are unrelated to the choice of lens. For example, I read dozens of complaints from new Symfony patients who hate the lens, but their complaints have nothing to do with fact they have a Symfony vs another IOL. This makes it very difficult for future patients to parse the information and educate themselves as to side effects of cataract surgery (in general) vs side effects of a particular lens choice.

    • Posted

      I tend to agree with you Derek.  Personality types play into this - by nature some of us research everything maybe to a fault whereas other personality types go with the flow and are sometimes blindsided by the unexpected.  Fault does not lie in personality traits although one cannot escape consequences that result from doing or not doing due diligence.

      Doctors should be more involved and engaged in these discussions.  They are the one person who has direct knowledge  of the results of IOLs and should disclose pros and cons - there is no perfect lens to date.  a better informed patient manages their expectations.

      In USA money might play a factor as there is obviously incentive for them to oversell premium lenses.  In Canada where there is zero incentive as our surgeons are paid the same no matter which lens a patient chooses they are too busy and no time to discuss much.  It is up to patients in Canada to ask.  You get one consult and then scheduled for surgery that can take 3 or 4 months. So if you didn’t  research you wouldn’t even know what to ask the surgeon.

      I have been keeping note of the satisfaction and dissatisfaction here on this forum with Symfony lenses.  Those like me who came here prior to surgery for info and deciding on Symfony lenses are happy with the result.  Those that posted about their results after the fact and are unhappy likely did no research and went with surgeon’s recommendation.   I even wonder if I had no prior knowledge about the concentric circles if I would be less thrilled with my end result.  Goes back to that age old formula Happiness equals Expectations divided by Reality.

      I assume it may be same for the other IOLs people choose for themselves.  

      Likely it’s true 95% of people are quite content with end result of their cataract surgery. 

      How have you been doing this week?  Hopefully all going well and eyes healing without complications.

    • Posted

      Hello Sue.An:

      I actually just got back from my 1-week follow up (which was actually at 6 days). Best distance vision fluctuates at the 20/30 to 20/20 point at this time, but there is noticeable "softness" to the edges of letters compared with my left eye. I’m expecting this to improve over time.

      I was curious to see how close they got to the target and, at this time, it looks like I alternated between 0.0D and +0.25D when selecting the "best" vision during all the testing. Obviously, it can still change over time (next appointment is in 3 weeks), but it seems like they got really close to the target. I’ll try to convince myself that the added money for all the pre-surgery measurements, ORA, femotlaser, etc. are responsible for this outcome (rather than just luck). I was told to expect some added improvement over the next few weeks, but then possibly a slight decline until I reach the 3-month mark and they do the YAG procedure.

      I do notice the "dip" in visual quality in the ~6 ft (2m) range that is more than I expected, but it's in line with the published de-focus curve for this lens. Since this curve is virtually identical to the Acrysof Monofocal, it reinforces my pre-surgery belief that I would NOT have gotten usable reading vision from a monofocal IOL. 

      I did decide to delay my left eye indefinitely. The optometrist in the office doing all the testing today was amazed at how good my multifocal contact is doing and she agreed that I can delay that eye until the cataract becomes too bothersome. Given our insurance system here, there is a decent financial advantage to doing it during 2018 though as I have probably hit my $7500 max annual out of pocket already and the base surgery should be 100% covered on eye #2. If I wait until 2019, then that counter starts all over again. I'm fortunate in that I can afford this added cost but $7,500 is still a lot of money, so if I start noticing any decline during this calendar year, I'll probably do the 2nd eye late in the year. 

    • Posted

      Congrats on a successful outcome close to the target desired.  

      Nice to have the option to wait rather than rush into surgery in 2nd eye.   That is a lot of money to spend.  However when one considers how much we outlay on other things - eyesight is so much more valuable.

      I too didn’t think I would get much usable near vision with a monofocal and given my age and another possible 10 years to work before retiring I think I made the right decision  for me.  

      I am curious why surgeon thinks you will need a YAG done in 3 months time.   I was never told a timeframe but to make an appointment if vision is hazy or blurry.  Hard to believe eye surgery #1 is now 7 months ago.  Vision is still very clear so no sign of needing a YAG yet.

      Seems like your eye is well on the road to recovery. I do think you’ll see improvement over next several weeks yet.  The eye drops themselves - although necessary seem to prevent best vision.  I found at the 5 or 6 week mark things were very good.  Not as much glare or starbursts at night.  Today even with the concentric circles driving at night has gotten a lot more comfortable.  

      Best wishes for your vision to get better and better!

    • Posted

      After my surgery, the doctor told me that the cataract type, "posterior subcapsular" (in general) and the thickness of the cataract (in my case) results in a high likelihood of requiring YAG relatively soon after surgery. He seemed to expect it soon after the 3-month mark, but this will be confirmed during a future appointment. I didn't ask but I'm assuming that what we saw in my eye while performing the surgery led him to this conclusion.

      Thanks for the comment about vision possibly getting better after stopping the eye drops. I didn't know this so I'll look out for it as the drops are tapered down and stopped next month. 

    • Posted

      From what I’ve gathered, yag shouldn’t be done until after the 3 month mark. Even if the bag is clouded right away. My dr suggested it to me last visit. I’m just returning from my 6 week follow up. Vision has been flicutating and we will hold off exchange surgery until I stabilize. Just so you all know, I’m 1.75 off in one eye and 2.0 off in the other eye. So ORA and drs calculations didn’t get me even close. My next visit will be end of March unless there is another inflammation flare up and it is needed. Until then I have cheaters to use for reading. Derek I’m so happy to hear that you are only .25 off. That’s incredible for a 6 day follow up congrats 
    • Posted

      So sorry Julielyn - seems incredible the calculations could be that off.  I was told it could be off + or - .50

      Did you have prior lasik surgery to correct vision when you were younger? I read that can affect accuracy of calculations.  Was also advised to remove contacts for at least a week prior to calculations as that could throw them off as well.

      Instead of a lens exchange is having lasik a possibility to correct the power? Some surgeons offer that in the premium lens package.

      Sounds like this journey has been a roller coaster ride with more downs than ups.   

      Healing though does have it’s own timing.  Not everyone wakes up the morning after with clear crisp vision although that happens too.  

      Your Dr is prudent though to wait till your eyes heal before going ahead with any course of action.

    • Posted

      Yea sue.an I did have lasik to correct my farsightedness @20 years ago. Those records were available. Additional lasik or PRK has been suggested but lens exchange must happen first. Calaculations were done ona machine ( sorry don’t know the name) in the office and the. Again in surgery with the ORA. Now I’m asked to use “natural tears” to see if dry eye is an issue. 

      It’s great to hear orthers who recovery almost immediately in so happy for them smile

    • Posted

      For dry eye I have liked Systane Ultra.  Tried Refresh but didn’t seem to work as well for me. But I also take a supplement each day - flaxseed oil.  I read Omega 3 supplement can also be helpful.
    • Posted

      I don't know if you are still following here, Julielyn, but if you are, I am curious if you had your lens exchange and how you made out with that. I also have the toric lens and am still having issues with it. My lens is only off .25 which the surgeon says is just "noise."

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