For first hand information about my experience with Array Intra Occular
Multi-focal Lens replacements for cataracts, Read on...
I am 42 yrs old and live in metro Phx, AZ. Recently diagnosed with
Cataracts, probably due to many hours and years out in the sun and the lack
of wearing uv sunglasses. Anyway
I have read many posts on various web sites and boards regarding the
satsifaction and performance with the multifocal IOL replacement for
cataract patients. Most of the posts are here-say and "friend of a friend"
stories, so when choosing my lens replacement lenses, I relied on a
brother-in-law who had personal experience with the surgery and many many
hours of reading posts.
My theory about why so few posts have anything about multifocal lenses is
that for the most part, the cataract patients are older and less PC savvy.
Many don't own computers and email is nothing they ever have received. So
firsthand information is scarce. Research showed only a few firsthand user
posts, and those were 40 ish to 50 ish yrs old.
In this post, I will share preliminary details of my personal experience to
help others make an informed decision. I hope it helps someone. I am not
affiliated with any lens maker, or Physician.
First, I went to Optometrists for years. I will NEVER do that again. My
experience is Optometrists only prescribe vision correction aids, and none
of them I went to diagnosed my cataracts. My opthomologist saw it right
away, less than 3 months after the Optometrist told me I might have a
floater, but I should see a Opthomologist expert to be sure. Bogus Dude...
After my diagnosis, The Dr asked some questions and offered me a choice in
which lenses. Multi-focal or Mono. The questions screen you for type of
lifestyle and activity levels, also your expectation level of outcome after
surgery. We both chose the Array multifocal lenses for a variety of reasons.
My reasons were based on the results and satisfaction levels of many people
in dozens of different studies using the Multi lens and mono lenses. Using
Multifocals, I read a definite benefit in intermediate distance vision and a
potential for better close up vision and little difference in distance
vision. The biggest drawback was potential Halo effects which are more
common in the Multi lenses but still possible with mono lenses. Also some
users reported the Multi's are not quite as sharp at long distances, but the
potentila for clearer closeup with decent distance was appealing.
Surgery was quite easy and the most pain I had was getting the IV installed
before surgery. I was awake but sort of "out of it" for the surgery which
took 15 minutes or so. I was home in less than 2 hours from the time we
left. The 1st eye was the worst and the plan was to do my right eye and 2
weeks later, do the left eye. My right eye also has moderate to high
astigmatism. I had a bandage on for 24 hours and then took off the bandage
and began to see. Over the day,my vision improved and colors were noticibly
more vivid and sharper. I did experience Halos around lights in dark rooms
or on the road at night, but with the removal of the cataract, the
cloudiness was gone. Sort of a trade off at that point I felt.
2 days after surgery I had 20/30 vision in the right eye, which was 20/200
before.
For the next 2 weeks I wore a contact on my left eye and found things pretty
good. Halos are a problem, and I was somewhat worried about night driving
when the other eye was done.
My vision got worse and better in the right eye over the next 2 weeks.
Essentially I had better days and worse days. I wound up with 20/70 in the
right eye 3 weeks after surgery, (but that was a bad day).
After 5 weeks, I was tested again and am told that with Astigmatism
correction, My right eye vision is 20/15. The Dr recommended night driving
glasses for the astigmatism to help sharpen images and potentially lessen
the halos. Glasses or lenses will not lessen your full recovery following
this surgery. I have noticed the halos are getting less with time, and the
lens maker says it can take 3-6 months to diminish to a point where it is
not a problem. My brother in-law said it was more like a year for him.By the
way, The IOL does not help asitgmatism, so I knew it could be a problem. In
The studies I read, Most problems with users having Halos and lower
satisfaction levels come from users with higher astigmatism before surgery!
After my left Eye was done, I had a pinhole pupil problem for 2-3 days which
gradually returned to fully normal in a week - 10 days. Dr said it was not
un-common and not to worry. During the time with the pinhole pupil, I could
see so clearly, I think I could read a phone book from 10 feet away! No
halos either, but if I was in a dark room, that eye was useless. As the
pupil opened up, I began seeing halos and clarity was reduced but it was
similar to the right eye.
Recovery was similar to the right eye, 3 weeks later I had 20/30 and I have
been fairly happy overall. Not 100% but better than before surgery.
Now at 6 weeks and 3 weeks post op, I have to say that my closeup vision is
much better than before surgery,but not as good as I had 10-15 years ago.
My distance vision is pretty good and slowly improving. I still see a faint
ghost images which become larger the farther away I get from what I am
looking at. Daytime in full sun, my vision is very good, and as the daylight
dims, my vision also dims a bit. Just enought to notice it.
Knowing that I would have had to wear reading glasses with single or mono
vision IOLs I think this choce was best for me. I have to read very small
print in my work and a lot of it. I only use readers in rare cases since
surgery. Maybe 3-5 minutes total out of 40 plus hours of reading fine print.
I am hopeful and trying to be patient in waiting for final outcome.
Will update this post as time progresses.
By the way, Total cost SO FAR is around $6500.00 for both eyes.
Good luck on your surgery, and be sure to choose a GOOD surgeon! I didn't
want a trainee! My Surgeon has been doing this type of surgery for 20 plus
years and has a good reputation.
Dr. Leukoma - 25 Mar 2004 14:18 GMT
snip
> I have read many posts on various web sites and boards regarding the
> satsifaction and performance with the multifocal IOL replacement for
> cataract patients. Most of the posts are here-say and "friend of a
> friend" stories, so when choosing my lens replacement lenses, I
> relied on a brother-in-law who had personal experience with the
> surgery and many many hours of reading posts.
Multifocal IOL's have the same drawbacks as multifocal contact lenses, i.e.
blurred vision that is pupil-dependant. Some do well, some do not, and the
amount of near correction is limited. Fortunately, you can remove a
contact lens easily.
> My theory about why so few posts have anything about multifocal lenses
> is that for the most part, the cataract patients are older and less PC
> savvy. Many don't own computers and email is nothing they ever have
> received. So firsthand information is scarce. Research showed only a
> few firsthand user posts, and those were 40 ish to 50 ish yrs old.
snip>
> First, I went to Optometrists for years. I will NEVER do that again.
> My experience is Optometrists only prescribe vision correction aids,
> and none of them I went to diagnosed my cataracts. My opthomologist
> saw it right away, less than 3 months after the Optometrist told me I
> might have a floater, but I should see a Opthomologist expert to be
> sure. Bogus Dude...
UNFAIR LOW BLOW! As an optometrist, I have picked-up cataracts that were
missed by an ophthalmologist. Obviously you went to the MD after you saw
the OD, but you didn't say how much time elapsed. I have had patients who
went from 20/20 to 20/200 in one year as a result of an early onset
cataract.
You are correct that the OD's financial interest is primarily in providing
vision correction with glasses or contacts, and failing that they should
diagnose the problem. OTOH, the MD is primarily interested in cataract
surgery.
snip
DrG
Dan Abel - 25 Mar 2004 22:20 GMT
> > saw it right away, less than 3 months after the Optometrist told me I
> the OD, but you didn't say how much time elapsed. I have had patients who
I think that you need to go see an eye doctor and get new glasses.
:-)

Signature
Dan Abel
Sonoma State University
AIS
dabel@sonic.net
Dan Abel - 25 Mar 2004 22:17 GMT
> For first hand information about my experience with Array Intra Occular
> Multi-focal Lens replacements for cataracts, Read on...
Thanks for your post. Although I chose single strength IOLs in each eye,
I always wanted to read some more first-hand experience with these.
> First, I went to Optometrists for years. I will NEVER do that again. My
> experience is Optometrists only prescribe vision correction aids, and none
> of them I went to diagnosed my cataracts. My opthomologist saw it right
> away, less than 3 months after the Optometrist told me I might have a
> floater, but I should see a Opthomologist expert to be sure. Bogus Dude...
Maybe you didn't have cataract (or not enough to make any difference) when
you went to see the ODs? Cataract is a progressive problem, and can't be
detected until you have it. What was your best corrected vision at your
last visit to an OD before your cataract was diagnosed? If it was 20/20
then I would contend that you didn't have cataract at that point.
My OD diagnosed my cataract. I complained that my vision in the right eye
wasn't good. He was unable to correct it, and so took a look inside and
found cataract. When I went to the optho, he confirmed the diagnosis and
said I had some in the other eye, but not enough to affect vision.

Signature
Dan Abel
Sonoma State University
AIS
dabel@sonic.net
John Doe - 26 Mar 2004 06:41 GMT
Dr Leukoma
No offense intended, but it was just my experience. The OD tried to get my
vision corrected with several toric lenses for 18-24 months and
progressively I got worse results. I think he just got where he didn't think
I knew what I was talking about. I complained repeatedly of vision
cloudiness, similar to looking through dirty glasses. Also some Starbursting
from lights, and worsened light sensitivity even painful at times. I found
out later on my own that all were common symptoms of cataracts. The OD kept
scripting me antibiotics for a non existent infection saying "there is a
lot of stuff in the air lately"and sending me out for another 10 days.
I even told him that I couldn't see people's faces clearly (just an outline)
when they were backlit by lights or sunshine. He looked again, and said I
might have a couple floaters but I needed to go to a specialist and he gave
me the name of an Opthomologist. Maybe he was the One that gives OD's a bad
rap.??
My vision could only be corrected to 20/30 in my right eye prior to surgery,
however I was light sensitive and in brighter lights, my vision was very
washed out. He said, as long as I could be corrected to 20/40, I would
probably have to live with it.
Your assesment of the DR wanting to do surgery and the OD wanting to sell
lenses is basically what I was saying. Except with malpractice cases, a DR
is less likely to push surgery that is not needed. I would have settled for
lasik or any procedure that that would have worked so I don't think I was
one who got surgery and didn't really need it.
Dan Abel
I had a less dense cataract in my left eye, but it was affecting vision
enough that I was light sensitive and had lost a lot of clarity. I figured I
would need it sooner or later, so opted to do both.
An example of loss of clarity:
I play golf, and I could not track a ball of any color with sunglasses more
than 50 yards. Without sunglasses I could follow it for 100 yards or so, but
then I could only tell the direction it was heading and had to look in a
general area to find it. This had progressively gotten worse over the past
12-18 months. I started using my left eye to see things more clearly, but
within 8 months or so that was not working anymore.
I have been to the driving range 2 times now. (2 and 3 weeks after my 2nd
eye was done.) The first time I could follow the balls until they hit the
ground, but could not see them stop or visually find mine in a group. The
last time I went, I was able to see clearly where the balls hit and pick
them out of a group from even 250 yards out.
I am pleased and almost ready to go play a full round and will advise in a
follow-up as I have more to report.
Again, with the slow but steady progress I have seen, (pun intended) I feel
that with more time, my brain will adjust to the lenses and my vision will
be up to what I hope for.
It is amazing what medical science can do.
> For first hand information about my experience with Array Intra Occular
> Multi-focal Lens replacements for cataracts, Read on...
[quoted text clipped - 103 lines]
> want a trainee! My Surgeon has been doing this type of surgery for 20 plus
> years and has a good reputation.
Dr. Leukoma - 26 Mar 2004 14:02 GMT
> Dr Leukoma
> No offense intended, but it was just my experience. The OD tried to
[quoted text clipped - 24 lines]
> have settled for lasik or any procedure that that would have worked so
> I don't think I was one who got surgery and didn't really need it.
Please re-read what you just posted. I recently underwent surgery for the
removal of a basal cell carcinoma from my forehead. This was the second
one in 15 years. The first one appeared as a classical crusty lesion with
a vascular core and pearly edges. Within four weeks, I was certain of the
diagnosis, consulted a dermatologist and had it removed. The second lesion
was different, and grew more beneath the surface of the skin. It fooled me
for nearly two years (plus perhaps I was loathe to admit it). I dare say
that after the surgeon put a hole in my forehead the size of a quarter with
a four inch incision, I won't be so blithe in the future.
Some cataracts are like that, progressing from a slight discoloration of
the lens to slight milkiness over a period of months to years, i.e. very
slowly. Perhaps initially your cataract was under the detection screen of
the OD. As I said before, I have seen cataracts that MDs missed under
similar circumstances, so I don't think you ought to be so quick to
generalize. Before medicare and insurance lowered the boom, I witnessed
surgeons removing cataracts at the 20/20- level using other tests like loss
of contrast sensitivity to justify the surgery, if the patient had a vision
complaint. I wasn't implying that you didn't need surgery, but that the
two doctors were working from different perspectives at two different
points in time.
DrG