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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
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Help! I am having cataract surgery on October 13th. I have

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Help! I am having cataract surgery on October 13th. I have two types of cataracts in each eye and I'm only 39 years old. I am nearly blind at night and have very little peripheral vision. I have had myopia since I was very young, wearing glasses since I was six and contacts since I was 8. I also have an astigmatism. The surgeon will correct the astigmatism at the time of the cataract surgery For the cataract surgery, I was given the choice of either the standard lens or the Crystalens and after researching the possibilities, decided upon the Crystalens. I made the decision over a month ago and have now been told it may be the wrong choice. I am going for a second opinion, but time is running out. I need some advice:

*Since I am so young, might the surgery need to be redone in 20 years or so?
*Which type of lens will offer me the best vision? (is the Crystalens as good far as it is near? I know the standard lens removes near vision to correct for far and that is one reason I chose the Crystalens.
*Am I at higher risk of a retinal detachment from the Crystalens than the standard lens?
*the websites I have looked at shows a high success rate for Crystalens, but the patients are all much older. What has been the success rate in your patients?

I probably have more questions, but that is a good place to start. Thank you for your time. I just want to see that stars (I never have) and I am a reading specialist so can't afford to lose close up vision.

Heidi
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. James replied 3 years ago.
Chat Conversation Started
Dr. James :

Hello.

Customer :

Hi! Thank you for your quick response. I'm in a bit of a crisis here! :-)

Dr. James :

Please Note:
JustAnswer is a public forum. Information provided is for educational purposes & does not establish a patient-physician relationship nor substitute for a personal consultation with a physician.

Do you understand and accept those terms?

Customer :

Please tell me what you know about the Crystalens.

Customer :

Yes, I understand the terms.

Dr. James :

Crystalens is slightly different than the other lens on the market. It works on hinges which allows it to flex forward slightly to allow reading vision.

Dr. James :

The other lens and concentric rings of different powers -- so called multifocal intraocular lenses.

Dr. James :

Those are the ReStor and ReZoom type lenses.

Customer :

I was not given the option of multifocal lenses... I was told I was not a candidate.

Dr. James :

What was the reason given for you not be a candidate?

Customer :

I actually don't remember. I put it out of my mind and concentrated on the other two options. Have you had patients who had the Crystalens?

Dr. James :

I do not. The ReStor lens is more popular in the Texas area.

Dr. James :

What were the two options given to you?

Customer :

Is there a reason you do not offer this choice?

Customer :

Crystalens or standard lens were my options

Dr. James :

Expense for the most part.

Dr. James :

The multifocal lens has it drawbacks with decreased contrast sensitivity. The Crystalens does have some limitations. It is gives you better vision up close than the standard lens.

Dr. James :

The advantage of crystalens is that it does not have problems with halos since it is not a multifocal design.

Customer :

If someone "young" like me (39) has a lens implant due to cataract surgery, lets say 20 years from now my vision worsens... is there a possibility of replacing the IOL for a new one? That's one problem I see with the Crystalens... it hasn't been around long enough to know its longevity.

Dr. James :

It is very unlikely to have a lens removed in the future. Lenses implanted in the eye has been around for a very long time. Though the crystalens design is slightly different, it is similar enough to know that it should not need removal in the future.

Dr. James :

Most often after cataract surgery, your vision may worsen again due to scarring behind the lens implant. This can be cleared up with a simple in office laser procedure. This can happen with any of the intraocular lens options.

Customer :

By having cataract surgery, am I more likely to have a detached retina? I was told the crytalens may increase the chance of having this problem.

Dr. James :

Cataract surgery does increase your risk of retinal detachment. The rates of retinal detachment would be the same as the other lenses.

Customer :

I have to pay $5400 out of pocket for the Crystalens, but this also includes the laser touch-ups you mentioned and the Astigmatism surgery which I need in order to hopefully be without glasses or contacts after surgery.

Dr. James :

Yes, that sounds about right.

Customer :

If it weren't for the costs... would you recommend the Crystalens to your patients who were candidate? And what would make someone a good candidate?

Dr. James :

It is a matter of managing expectations. No lens can mimic the natural lens before you developed a cataract. These lenses give a greater range than the standard monofocal lenses. There may be times you may still need reading glasses, especially for fine print.

Dr. James :

If you understand the goal is the reduce your dependence of glasses, but may not take it away completely, then you would be a good candidate.

Customer :

Does the standard lens offer better acuity with distance than the Crystalens?

Dr. James :

They would be about equal.

Customer :

It sounds like I may have made the correct decision in choosing the Crytalens. I don't like the idea of having reading glasses if I can help it, and thought the Crystalens at least might give me that chance. With standard lenses I would immediately need reading glasses. I have copied that website you have given and will check it out.

Dr. James :

Your other option to have both lenses focus up close for reading, but that would require glasses for distance/driving.

Customer :

Yes. I have never seen far, but have always had my near vision. I hope to improve the far, but don't want to lose the near too. I have also always had very poor night vision. I am hoping to be able to see the stars! (I never have). I just want to do what is best for my eyes, regardless of cost.

Dr. James :

Best wishes to you. :)

Dr. James :

Please remember to press the accept button so I can receive credit for assisting you today.




Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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