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Dr. James
Dr. James, Board Certified Ophthalmologist
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Attention Dr. James ophthalmologist.I had cataract surgery

Resolved Question:

Attention Dr. James ophthalmologist.

I had cataract surgery on November 29, 2011. The lens installed was a crystalens which was strongly recommended by my surgeon. I had a lot of astigmatism that was somewhat but not totally corrected by the new lens and lumbar relaxing incisions. The colors that I see are much more vivid, but the distance, intermediate and close vision are still not very good. My doctor has suggested 4 possible solutions. 1.Wait for awhile to give the cryatalens more time to adjust and perform the accommodating features of lens better 2. Perform a PRK 3.Replace the lens with a toric lens 4. Wear glasses. I am reluctant to have the PRK because I understand that the surgery is quite uncomfortable. Which option (or another) would you suggest as a solution? How long does it typically take for the crystalens to get as good as it can get?

I also need cataract surgery in my other eye and am reluctant to proceed until I am satisfied with the outcome on the first eye. What suggestions do you have?

Thank you,

John Tellier
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. James replied 2 years ago.

Dr. James :

Hello.

Dr. James :

I do not implant the crystalens or other multifocal lens myself.

Dr. James :

From discussions with colleagues, the crystalens has not been as great as predicted in terms of accommodation.

Dr. James :

There are two reasons for your stilled blurred vision. If you have residual astigmatism that the timbal relaxing incision did not take care of, then that could cause blurred vision.

Dr. James :

You can test to see if this is the problem by being fitted with a toric contact lens. If this gives you the vision you were expecting, then PRK or LASIK would be a good option.

Dr. James :

wearing glasses is the least invasive, but then that was what you were trying to avoid by choosing the crystalens.

Dr. James :

with a toric lens, you would still need to wear reading glasses.

Dr. James :

What is your vision at distance currently? 20/25? 20/30? etc

Customer:

My surgeon apparently does not do Lasik only PRK, so I am concerned that he has a vested interest to do PRK rather than Lasik. Do you have an opinion about this? I don't like the idea of either one. My most recent eye exam gave me about 20/50 which is not very good.

Customer:

He also told me that I would have "some

Dr. James :

when you were checked for glasses, what was your vision?

Customer:

20/30 with glasses correction.

Customer:

He told me that I would have some reading ability with a toric lens

Dr. James :

why is it not 20/20 with glasses?

Customer:

I don't know other than I have too much astigmatism .

Dr. James :

hmm... you may have some irregular astigmatism. i agree with you that i wouldn't rush into another surgery.

Dr. James :

if you do have irregular astigmatism which is on the cornea, a toric lens would leave you with the same problem.

Customer:

What do you think about removing the crystalens and replacing it with a toric or regular lens. Is that dangerous removing and replacing?

Dr. James :

if you have irregular astigmatism in the cornea, a toric lens may not necessarily fix that.

Dr. James :

it's not dangerous, but has some risk as any other surgery.

Customer:

There does not seem to be a clear cut choice for me to make. What would you suggest?

Dr. James :

i think you should push your doctor to see why you can't see 20/20.

Dr. James :

if it is a matter of astigmatism, then maybe PRK.

Dr. James :

I would try contact lenses first to test drive out what PRK can achieve.

Customer:

OK, I'll discuss this with my doctor. At this point, I am apprehensive about the whole situation and think that I should only get the basic lens in my other eye.

Dr. James :

the basic lens is a very good lens.

Dr. James :

dont' think of it as inferior in any way.

Dr. James :

it just means you'll still need to wear glasses.

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