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Medical Forum / General / Vision / May 2007

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Crystalens, Adaptation and Results

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JimC - 24 May 2007 02:40 GMT
One more time. - (I don't have the time or training to read through and
evaluate a number of technical articles.) - My ophthalmologist has
suggested the Crystalens as providing some degree of accommodation for
my presbyoptic condition. (I'm considering cataract surgery because of
difficulty in seeing under any degree of background glare due to
crystallization in the lens(?) and also, highly variable eyesight.  I
also seem to be unable to read most traffic signs clearly enough to
respond safely.)  Note that I don't expect to be able to read small
print without glasses (reading glasses are OK with me), but I would like
to be able to see both distant and mid-distance objects (e.g., 6 - 25
feet) clearly. I sense that some patients and practitioners don't think
the benefits offered by the Crystalens are worth the extra cost. -
However, I do note that they are FDA approved. According to one report:

    "In the  FDA clinical trials it was found that a vast majority, but
not all, patients implanted with a Crystalens accommodating IOL achieved
a measurable improvement in accommodation. It was also indicated that
the Crystalens provided vision quality equal to or better than a
conventional IOL..."

As understood, it takes a substantial period of time, e.g., six to eight
months, for many patients to accomplish adaptation to the Crystalens
lenses.  Does anyone have information (readily available and
understandable to a layman) concerning typical results for patients WHO
HAVE GONE THROUGH SUCH AN EXTENDED ADAPTATION PERIOD? Also, what
negative factors should I be aware of concerning such adaptive lenses?
For example, do they limit or restrict vision at night? (I'm into
amateur astronomy, in which the pupils may expand to 6-7 mm during night
viewing.)

Thanks,
Jim
Jane - 24 May 2007 03:31 GMT
According to the EyeQ Report of the 2007 ASCRS Symposium, when
cataract surgeons were asked which multifocal/accommodating lens they
would choose in their own eyes, the Crystalens received the most votes
(and the ReZoom the least).  Sales of the Crystalens are reported to
be on the rise, probably because of the many problems associated with
the other multifocal options (least of which is that apparently some
people can never neuroadapt to them).

My knowledge about all of these IOLs is limited to what I have read in
online articles and forums.  It seems to me that the biggest
disadvantages of the Crystalens is the rather steep out-of-pocket
expense and the possibility that the accommodation feature won't
work.  Reportedly most surgeons incorporate a slight monovision effect
with the Crystalens, aiming for about -.75D in the nondominant eye.
Therefore you are very likely to end up with good distance and
intermediate vision.  (Of course, you could always get monovision with
monofocal IOLs and save on the "premium" IOL surcharge.)  Adaptation
to the Crystalens is reported to be much shorter than adaptation to
the multifocals.  The Crystalens is probably a poor choice for someone
with a history of retinal disease.

Best of luck with your surgery.
JimC - 24 May 2007 18:52 GMT
> According to the EyeQ Report of the 2007 ASCRS Symposium, when
> cataract surgeons were asked which multifocal/accommodating lens they
[quoted text clipped - 18 lines]
>
> Best of luck with your surgery.

Thanks for the helpful comments.

Jim
 
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