Here's an off the wall post! But it bears directly on photography so I'm hoping maybe there are some of you who will share experiences.
Anybody out there have experience with cataract surgery where instead of a single distance standard lens was used, the lens used was either a multifocal type or what's called an "accommodating" type. The trade name for the accommodating type is "Crystalens".
Both types are claimed to provide clearer vision at multiple distances reducing the need for glasses afterward except perhaps for reading or close work. The dilemma is the multifocal type can result is seeing halos around bright lights at night while the Crystalens I've been told does not provide as clear a vision. With the need now to work so much on a computer, it would be a plus to have decent vision at multiple distances without glasses such as I have to use now. I'm not sure which way to go
Posted by Jim Zablotny on April 17, 2015 at 12:45 PM
Hi John,
My dad has the Crystalens and he still needs to use reading glasses. I have standard lenses and my distance and color vision are excellent. The multifocal lenses tend to let in less light so if you experienced any laser treatment for retinopathy or other retinal surgery, then they would not work as well for you. That's why my ophthalmologist insisted on standard lenses for me....................Jim
I had cataract surgery with the standard lens, I have 20/20 vision but need to use a pair of readers for reading or the computer. The ones I use are $9 at Walmart for 3 pairs
My friend had laser eye surgery several years ago, as he thought that it was the answer to his vision problems.
Then many years later, another eye surgeon advised that he could not conduct cataract surgery because of the earlier laser work.
So we don't realize the long term impact because we do not have adequate info...often it seems that we need to learn PhD knowledge to understand the impact of the choices and to make a reasonable decision.
Good luck.
Frank
I had both eyes done in 2006 and chose Crystalens for one eye and Technis (slightly higher contrast sensitivity) in the other. Acuity is similar in both, and varies by light...sometimes one better than the other. In good light I can achieve 20/15. I do not think the Crystalens can give crisp vision at both infinity and reading distance. I chose infinity and improved mid range vision. The nicest feature of the improved mid range is viewing instrument panel of a vehicle during night driving when the pupil is dilated. It keeps that clear and I only wear readers for computer and closer. If you wanted to have close-up priority, I think you would sacrifice a little at infinity. I had a great doctor, willing to make tweaks to improve my astigmatism and reduce halo/glare issues, which I experienced in the Crystalens eye.
John, you have raised a very valid set of questions. I am a retired optometrist who worked in a large multidisciplinary medical group. I did all the pre and post op work for our cataract surgeons, and spent a lot of time discussing the various options. I will try to detail the main points.
The most common form of multifocal lens works by using a series of concentric circles acting like a diffraction grating. This is what causes the halos, especially at night when your pupil is larger. I never liked this concept. While there is some success with useable vision at varying distances most people whose vision demands are critical, like photographers, are not happy. There are a lot of second surgeries to replace these lenses. A second surgery to replace is not very straight forward and has its own risks.
The Crystal Lens works by having the patient's own eye focusing muscle flex and move the lens position within the eye. I used to quote success rates at virtually (but not all) everyone would achieve distance acuity equal to a standard distance implant. I also used to tell patients that the data says 80% of the Crystal Lens patients had acceptable mid range vision, like a dashboard, but only a small percentage had good reading distance (16 inches) vision and good distance vision. One of the aspects about the crystal Lens which needs further experience and learning curve by the profession is the system's ability to maintain its ability to adjust position within the eye over a long period of years. Some docs think that future adhesion of the eye's capsule, within which the lens implant sits, to the lens flanges will reduce the effectiveness of the refocusing. Jury is out on this one.
The other question is if a patient wants a standard lens focused for near instead of distance. This of course will require distance glasses to drive and see infinity, but computer work without glasses would be possible. Not many patients choose this, but it is an option.
For those of you with astigmatism, there are now very good implants which are very effective at eliminating or dramatically reducing this. The lens implanted is calculated to correct for this anomaly.
FWIW, I had one eye done about 3 years ago. My second eye does not yet need the surgery. I do not have astigmatism to any significant degree. I chose a standard implant focused for distance and have been very happy. When my second eye is ready I will make the same choice.
Thanks to all for your most informative input. Anybody else, do keep it coming. My surgery is tentative for June and I'm still up in the air
Posted by George Givens on April 22, 2015 at 9:16 PM
John, I had cataract surgery February 2012 on both eyes. I can't you tell what lens I received but over time, about a month, my night vision for driving markedly improved. At first I did see the halos and had some adjustment done after which the halos, I called bokeh, disappeared. I'm glad I had the surgery. I still wear readers for very small text and computer optimized glasses to prevent dry and tired eyes. The computer glasses are the new kind that I can use to see up to about 5 to 6 feet but remove when walking very far. Hope I've helped some.
Discussion
8 repliesAnybody out there have experience with cataract surgery where instead of a single distance standard lens was used, the lens used was either a multifocal type or what's called an "accommodating" type. The trade name for the accommodating type is "Crystalens".
Both types are claimed to provide clearer vision at multiple distances reducing the need for glasses afterward except perhaps for reading or close work. The dilemma is the multifocal type can result is seeing halos around bright lights at night while the Crystalens I've been told does not provide as clear a vision. With the need now to work so much on a computer, it would be a plus to have decent vision at multiple distances without glasses such as I have to use now. I'm not sure which way to go
My dad has the Crystalens and he still needs to use reading glasses. I have standard lenses and my distance and color vision are excellent. The multifocal lenses tend to let in less light so if you experienced any laser treatment for retinopathy or other retinal surgery, then they would not work as well for you. That's why my ophthalmologist insisted on standard lenses for me....................Jim
Then many years later, another eye surgeon advised that he could not conduct cataract surgery because of the earlier laser work.
So we don't realize the long term impact because we do not have adequate info...often it seems that we need to learn PhD knowledge to understand the impact of the choices and to make a reasonable decision.
Good luck.
Frank
The most common form of multifocal lens works by using a series of concentric circles acting like a diffraction grating. This is what causes the halos, especially at night when your pupil is larger. I never liked this concept. While there is some success with useable vision at varying distances most people whose vision demands are critical, like photographers, are not happy. There are a lot of second surgeries to replace these lenses. A second surgery to replace is not very straight forward and has its own risks.
The Crystal Lens works by having the patient's own eye focusing muscle flex and move the lens position within the eye. I used to quote success rates at virtually (but not all) everyone would achieve distance acuity equal to a standard distance implant. I also used to tell patients that the data says 80% of the Crystal Lens patients had acceptable mid range vision, like a dashboard, but only a small percentage had good reading distance (16 inches) vision and good distance vision. One of the aspects about the crystal Lens which needs further experience and learning curve by the profession is the system's ability to maintain its ability to adjust position within the eye over a long period of years. Some docs think that future adhesion of the eye's capsule, within which the lens implant sits, to the lens flanges will reduce the effectiveness of the refocusing. Jury is out on this one.
The other question is if a patient wants a standard lens focused for near instead of distance. This of course will require distance glasses to drive and see infinity, but computer work without glasses would be possible. Not many patients choose this, but it is an option.
For those of you with astigmatism, there are now very good implants which are very effective at eliminating or dramatically reducing this. The lens implanted is calculated to correct for this anomaly.
FWIW, I had one eye done about 3 years ago. My second eye does not yet need the surgery. I do not have astigmatism to any significant degree. I chose a standard implant focused for distance and have been very happy. When my second eye is ready I will make the same choice.
I hope this helps.
Cheers,
Ed
George