Restor 2.5D Review and Comments
Posted , 16 users are following.
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.
3 likes, 85 replies
derek40125
Posted
1) EYE DROPS - I noticed significant improvement once I completed the eye-drop regimen (at 6-weeks). I had initially noticed some delays in focus switching between near and far and overall clarity and everything now much improved compared to 2-3 weeks post-surgery.
2) FAR DISTANCE VISION (Infinity to ~12 ft) - I’ve had several vision tests and over the past ~3 weeks I’m always reading 20/20 or 20/15 at distance. Edges are sharp and “crisp”. They sometimes can measure an astigmatism in the 0.25D to 0.5D range but other times they don’t measure it at all (possibly still some healing or maybe irritation some days). I have to say that I am 100% satisfied in terms of distance vision with the Restor 2.5D. We’ve gone on a few trips out of town where I’ve had to drive 7+ hours and I do a lot of left/right, open/close checking and I don’t notice any difference between my Restor eye and the other eye (with either a multifocal contact or a fixed-distance contact). The only difference is the halos which I mention below.
3) MID DISTANCE VISION (12 ft to 5 ft) – This range could be better. I’m pretty confident that this is just the combination of my pupil size, axial length and other factors and not the fault of the lens (the surgeon pretty much nailed plano). I lose “best vision” at around 10ft to 12 ft depending on lighting. I have a pocket eye chart that is meant to be placed at 6 ft and I’m about 20/30 at this range. Even this line is a bit fuzzy. Vision is “functional” in this range just not as clear and crisp as it is looking further out.
4) INTERMEDIATE VISION (5 ft to 16 inches) – My 2nd focal point from the Restor 2.5D gives me pretty decent vision in the 16 in to 24 in range (I can usually read 3-pt or 4-pt type). The edges of letters aren’t consistently as “sharp” and defined as they are with my left eye though and I think that’s just the nature of this lens. Beyond that range, clarity drops off and then starts improving again around 5 ft. I’m on the tall side, 6’ 3”, and one thing I find funny is that the Restor literature and vision “simulator” use clear vision of a car dashboard to simulate the near focus point. Being tall I’ve found that the car dashboard is actually beyond my inner focus range. I’m probably reading 20/40 or so at that distance which is OK but not great (certainly not as crisp and clear as it is in the literature).
5) CLOSE VISION (16” and less) – Vision drops off really quickly up close. Reading glasses work very well, as you’d expect but I’ve also found that I really don’t use close range vision very much. I can use my cell phone with all the default font sizes without issue.
6) HALOS and Night Driving – This was my biggest fear in terms of IOL selection. I was prepared for small, bright halos which are a “feature” of this lens design and pretty much that is exactly what I see. My earlier comments are still valid. I also see the halos periodically during the day (such as the sun glaring off the edge of a piece of metal or even LED headlights). The Restor literature shows intense halos gradually reducing in intensity over time. I haven’t really noticed much, if any, decrease in intensity, but due to the small size they really don’t bother me that much. What I have noticed is that I will notice them much more at the beginning of a long drive than I do several hours later. Also, I don’t notice any halos around stars at night or point sources of light while watching TV/Movies.
7) CONTRAST SENSITIVITY – When I first got the IOL, I did notice some differences between my two eyes (see my earlier posts). At this point, I really no longer can discern any difference between the two eyes in terms of contrast sensitivity, colors, or anything of this nature (when looking at objects within my “good” focus ranges). I find I need to use a light for something like reading menus in many restaurants, but both eyes seem equally affected and I’ve felt this way for the past 4+ years, so really, I don’t think it’s gotten any worse. Maybe the cataract in my left eye is just slightly reducing the overall light hitting my retina and that is why they seem the same or maybe the design of the lens works as advertised but either way, I’m very happy with the results in terms of contrast sensitivity (as it was my second biggest concern prior to surgery).
8) PERSISTENT ISSUES – I’m fortunate in that I have not had any starbursts and I don’t suffer from any unusual dryness (although I try to use a lubricating drop 2-3 times per day). It does take maybe 30 minutes in the morning before I reach the point of “best vision” but it’s pretty functional from the moment I wake up. I also periodically notice a “jiggle” when I’m reading something close (and my eyes are moving side to side). I originally thought it was the IOL itself moving as I see it flicker in the mirror but I now think it’s just the muscle in my eyes causing a small twitch This seems to go away for a day or two and then come back so I’m hoping it will someday disappear altogether. I don’t blame this on the IOL itself, it’s probably just related to the overall surgery. Other than this the only other issue I have is that I do see flashes of light out of the corner of my eye or sometimes I will notice a spot of light (such as on my desk) that isn’t actually there when I look towards it. This is a “feature” of the design of the lens and occurs when light strikes the eye at sharp angle. I don’t expect it to ever go away. However, it is controllable by removing the light source, blocking it, or turning my head.
9) SUMMARY – Overall, I’m satisfied with this lens choice. In 2 months I’ve had to use reading glasses maybe 6 times (and a magnifying app on my phone a few times as well). Before the surgery I needed reading glasses for almost anything inside of 5 ft, so this is a massive improvement. I’ll admit that I am a little jealous of the extended range of clear vision that Symfony wearers get (and I may end up using that when my other eye finally needs surgery). I have another comment which may sound odd as many people are worried about their close vision and many surgeons use a combination of 2.5 and 3.0 Restor IOL’s. I actually think that the inner focus point is too close for me and I wish that Alcon made a Restor 2.0D lens with a near focus point of maybe 32” (the 2.5D is 21”). It’s not a problem now as my left eye covers that range but I’m worried that I won’t be as happy if I had this lens in both eyes. I guess we’ll see when the time comes.
Thanks again to everyone on this forum for all the help which allowed me to make an informed decision for my surgery.
Sue.An derek40125
Posted
I think I recall your mentioning in an email earlier post that your surgeon uses this IOL more often than other multifocals. Did he say your results would be typical if the results he had been getting with this lens? Wondering if in his opinion he sees more satisfied patients with Restor vs Symfony overall.
It does seem the night issues with Restor are less than with Symfony. Sometimes I wonder how much other issues unrelated to any lens comes into play with our final results. Looks like you may consider a different lens for the other eye when it comes time. The fact that you don’t have many night time issues with Restor will help if you go with the Symfony Lens.
I do like the seamless vision with Symfony- haven’t noticed any drop off or distances where anything gets blurry except when things get really close. It is something I experiment with and if I concentrate can make out words or be able to do a task like finding small clasping a necklace 5 or 6 inches from my face. But definitely everything from 11 inches outwards is sharp in good lighting. I too have used the flashlight in a dim restaurant with the menu. But I tend to not let things like that bother me. I just giggle and say my bionic eyes need a bit of help!
For me the bigger challenge was driving at night but even that had gotten much better. Likely if I drive a truck for a living or was a pilot Symfony lenses would not be for me but for my lifestyle it is definitely worth the trade off for day time vision. And the starburst and glare have really diminished since the beginning.
Good luck Derek with deciding on 2nd eye.
Sue.An derek40125
Posted
The AT LARA 829MP (Zeiss) is the latest EDOF lens to appear. It has a diffractive aspheric design, chromatic correction and smoother phase zones that optimise contrast sensitivity and minimise light scattering and visual side-effects. In pre-clinical studies, it has shown higher visual acuity over wider range of focus than the Symfony.
derek40125
Posted
Hello Sue An:
My surgeon said he's never explanted one of the newer Restor lenses. He estimated he had done about (300) Restor 2.5 and maybe (50) Symfony implants. He says both are good lenses and he'll use whatever the patient wants. He did say that he's had so much experience with this line of lenses (including the older ones) that he'`s had very good luck predicted the outcomes. He mentioned one explant of a Symfony lens due to night vision but that was it. I have a feeling that including any required Lasik tune-up as part of the overall package is a pretty profitable decision for them.
Thank you very much for the link to that new EDOF lens. I'm definitely going to follow the progress and patient comments on that lens. If they can reduce the size of those concentric ring artifacts, it would be a "no brainer" decision for me. If object colors don't look too different between my eyes I think that an EDOF would be a good complement to what I have now,
I think that type of lens is the best technology in the near term (< 10 yrs). I keep reading about many of the accommodating lenses in various stages of trials and the one thing I worry about is that you still need eye muscle control to make them adjust the focus (unlike an EDOF) and as we age, those muscles may not continue to function as well.
I've had to use a cell phone flashlight at restaurants for at least 4-5 years already so I'm quite used to doing that. I'm not alone either, when I'm at a darker restaurant, I almost always see some other people doing the same thing. Fortunately, due to technological changes, it's not an issue as I pretty much always have my cell phone with me. Also, almost all of my "intense" reading now is done digitally and that makes everything easier as you can always adjust the brightness and even font size as needed. I really don't feel like I'm missing out on much by losing the close vision since reading glasses work perfectly for those near tasks.
Sue.An derek40125
Posted
I think that drawing by David Taylor’s son (England) had that setup of Restor in one eye and Symfony in the other. Perhaps if his blog is still active you could inquire about differences in color. From what I recall he was satisfied with that setup.
derek40125 Sue.An
Posted
Thanks for the suggestion. There weren't any current comments on his blog but I left one for him. I'll post back here if he responds.
bill99918 derek40125
Posted
I appreciate knowing your experience with the Restor 2.5D. Has it continued to improve with time?
I am going through the process of determining which lens is the best for me. I am considering the Crystelens Accommodative lens, Restor 2.5D, and the Symfony. I have found it very difficult to fine any definitive comparison. I would appreciate any comments regarding these lenses and why the selection of the Restor 2.5D over these other lenses.
Thanks
derek40125 bill99918
Posted
How old are you? The thing that led me away from the Crystalens was that they seem work less well over time. Sue An linked a study in this thread that showed the Symfony and Restor 2.5D as being the overwhelming favorites of surgeons in the US.
It's a tough call between them. I ended up choosing the Restor primarily because my surgeon implants them 5 to 1 over Symfony and has never explained a single one. I figured I'd rather go with something with which he had the most experience.
Most of my initial issues are gone. The most obvious side effect of this lens design to me is period flashes of light or visible areas of light (at the edge of my vision) which aren't actually there. It's caused by a light source catching the rings of the lens at an angle. It's a bit annoying but not really that bad and, to me, a fair tradeoff for the second focus point. You'll find yourself having to turn your head or block a light source once in a while.
Vision for nighttime driving is extremely good. The halos are very small and manageable. They don't occur at all around stars, the moon, credits on a dark screen or similar. Also, no issues at a concert or watching fireworks (these were some of my concerns pre-surgery).
It does still take a little while in the morning to get my best vision but then it's solid for the entire day/night. The main issue I have is that my depth of field isn't the best and this most likely has to do with the physical makeup of my eyes. I lose best vision around 10 ft, so the 3ft to 10ft range isn't great (maybe 20/40).
However, I think that this could be fixed with Lasik if I want to (it would not be an added cost). I tested +0.25D to 1.0D reading glasses (with one lens) and found that with a +0.5D add my vision in the 4ft to 10ft range came into pretty much perfect focus with no reduction in distance (I wore these on a long drive to confirm this). However, the negative is that this pushes my close focus point in too far (12" to 24"
and I can't work on the computer due to the size and number of screens I use.
In this regard, the Symfony is clearly better but since different people have different ranges of focus using exactly the same iol, you might not notice anything like I do.
derek40125
Posted
BobDob derek40125
Posted
Flashes of light are also symptoms of Posterior Vitreous Detachment, (PVD) retinal tears, and retinal detachment, so might not hurt to have your ophthalmologist rule those out. The flashes result from a pull on the retina. I'm currently undergoing PVD, which in itself is no big deal and doesn't need treatment, but there is a low risk of retinal tears. I see arcs of light in the left peripheral of my left eye. Supposedly, these go away after awhile (when the vitreous detaches).
derek40125 BobDob
Posted
Given my age (51) and sex (male) I was worried about this possibly being PVD as well. However, I did have it checked out and it's always related to a specific light source. I probably used the term, "flash", incorrectly. It's only seems like a flash if my head or the light source is moving. If both are stationary, it's solved every time by just blocking the light source with my hand or moving my head so that the light hits the eyes at a different angle.
I'm convinced that this is simply an artifact of a light hitting the different rings that make up the zones in the IOL at an acute angle. Just one of the prices to pay to have multiple focal points.
BobDob derek40125
Posted
Sounds like you have it right if the flashes are due to an actual light source. With my PVD, I only see the flashes in a darkened room. There is no visible source for the flashes as they are generated by the retina when tugged by the vitreous, which occurs when I move my eye from left to right. As I mentioned, the PVD itself is not a big deal, but it's onset with me (I'm 66) brought on a large floater that may need to be dealt with in the future if it doesn't go away or reduce.
Sorry for the digression.
bill99918 derek40125
Posted
I originally considered the accommodating lens (only one FDA approved in US), but I have found too many negative comments from research papers and two doctors that I have seen did not recommend them. I was initially staying away from the multifocal lenses, since the halos and light aberrations would be a problem with sailing particularly at night. The Restor 2.5D seems to be a reasonable compromise that would give the critical distant and intermediate vision with reduced halos.
I am schedule to have my surgery in a week. The doctor originally recommended a monofocal lens, but now after further discussion of my needs is now going to use a Restor 2.5D.
An issue my doctor recently brought up is since I would only be having the surgery in the right eye that there is a potential for what he called “feels funny“ (never defined by the doctor) that some patients experienced that did not have a multifocal lens in both eyes. Since you seem to be in the same situation of only one eye having the Restor 2.5D and the other eye still not requiring surgery, have you had any noticeable issues with such a situation of only a single multifocal lens?
Thank you,
Sue.An bill99918
Posted
I do believe though if you are leaning towards a multifocal or EDOF lens like Symfony the imbalance is a little easier to deal with but I could be wrong.
You should be able to discuss more in depth the after surgery solutions. I too if only one eye was affected by cataract would only want one surgery. I do know if the diopter difference is so great that there is not a workable solution that the 2nd eye can be done on Medicare. It is grounds for it to be done. But with added time comes the possibility of newer, better lenses. Good luck to you Bill.
derek40125 bill99918
Posted
Bill:
My vision seemed a little bit weird for the first day or two after surgery but I think that it just took my brain a few days to get used to using my right eye again. When I'm wearing a monofocal contact in my left eye (set for distance), I find that I can't read comfortably for an extended period of time. I can see close up and I can read but it's not great as only the eye with the IOL is able to focus. However, no problems whatsoever at distance and intermediate (it feels completely normal and objects are the same size and overall shape between the eyes). If i had to live in this situation, for extended periods of time, I would probably wear reading glasses with the right lens removed or maybe glasses with two different strength lenses. Or I might have ended up doing the other eye already.
However, I've been very successful with one particular multi-focal contact in the left eye and the combination of the Restor in the right eye and the multifocal contact in the left it pretty much perfect (I can read, use my phone or use the computer without glasses for the entire day). If you are able to wear contacts, I urge you try find an optometrist (or perhaps you surgeon has an office that does this as well) and trial multifocal contacts and don't give up easily on it. With me, it wasn't trial A was 90%, B, 85% and the one I finally chose was 95%. It was trial A was bad, B was horrible, but C was perfect. For me, the center-near types did not work at all, I ended up with a center-distance contact and it's a perfect complement to the Restor.
I really hope your surgery goes well. Please try to go in with the perspective that your goal is to get distance vision that is comparable to a monofocal IOL with the added bonus of a useable near focal point. Your near focus point isn't going to be perfect, you'll see very clear text but what I think of as a fuzzy corona around the letters in some circumstances. It also may take some time for the close focus point to even work for you. Expect that you;ll need good lighting (not an issue with a phone or computer though). I hope that your distance and night vision are as good as mine. Give it some time though, I didn't get my best vision until after I stopped eye drops.
Please write back and give us your feedback. It's really helpful for those who will come after you.
bill99918 derek40125
Posted
Thank you Derek and Sue for your comments and suggestions. My situation is a monolateral lens replacement (right eye only). I have never worn glasses nor contacts and I am sure I would have a problem wearing a contact in my left eye. In the past 2-3 yrs I have used 1.0 reading glasses for fine print. I still can read a book or regular size text (L-eye only). My right eye cataract has clouded over so I can only see general shapes with it. The Restor 2.5D seems to be an appropriate compromise for my activity requirements, since the accommodating lens currently available has some questionable results. My only concern now is since my surgery is monolateral (left eye still healthy and good range in eye sight) and the potential complications. Monolateral is relatively uncommon compared to bilateral and very minimal literature on it. Actually one of the doctors I have seen knew of no complications in that situation, but my current doctor (more experience) mentioned that "funny feeling" situation (not explained) in some patients. I will give an update after the surgery.
Thanks
Sue.An bill99918
Posted
derek40125 Sue.An
Posted
Bill:
I'm curious to hear how it works out for you too. Since you are still able to read with your left eye (I'm assuming it's good for distance too?) I'm thinking you'll do fine with this IOL. I believe that the main reason for the bilateral implantation is because there is some "retraining" of your brain involved so that it will properly use the near focus point of that IOL. This would be a concern if you couldn't read with your left eye at all and depended solely on the Restor for reading. However, in your case, you can read decently with your left eye so I think it's very possible that the combination will work very well for you and your reading ability might improve under this combination.
I'm really hoping that's what happens for you. I think you'll see immediate improvement in terms of reading though, just removing the clouded image (which was overlapping your left eye) should help considerably.