Cataract Surgery - Grendahl Eye Associates ~ LASIK, PRK, laser vision correction, eye care, hyperopia - farsightedness, myopia - nearsightedness, astigmatism and excimer laser information.

CATARACT SURGERY

WHAT REPLACES THE NATURAL LENS?

Today your cloudy natural lens is replaced with an intraocular lens implant. It is inserted at the same time the cataractous lens is removed.

The implant lens was first used in the late 1940's and early 1950's, but the designs were found to result in too many problems and their use was discontinued. The modern designs were pioneered about thirty years ago and have been in use in this country for about twenty years (since 1972). Today the intraocular lens implant is considered the standard of care in cataract surgery. This lens produces a result that is much more like normal, natural vision than any other way of replacing the eye's own lens.

The implant lens is made of a special type of plastic called polymethylmethacrylate, acrylic or solid silicone. The acrylic or silicone lens folds up like a taco and is placed through the 3 millimeter scleral pocket or clear corneal incision and then unfolds inside the eye like a flower opening in the morning. The lens is very small- only about 1/4 of an inch across (the size of an aspirin) -and is fastened securely in the same place as your own lens. Usually, a lens does not need to be removed, cleaned or replaced.

The silicone lens does not react like the silicone breast implant material because this silicone is polymerized and not a liquid silicone like the breast implant. Polymerized silicone has been used safely in the body since 1970.

Rejection is not a problem with implants. Patients are frequently worried about the possibility of an implant being "rejected" because they have read of this happening with heart or kidney transplants. The implant lens is not a living organ or tissue, but an inert material. Rejection of an implant lens by the eye has never been reported.

A person has the option of choosing a monofocal IOL and may have both eyes set up for relatively clear distance vision. Then they will have to wear reading glasses for near vision. Another alternative is to have one eye set up for near vision and the other eye set up for distance vision. This is called monovision. This option allows the person to see both at distance and at near while reducing their dependence on glasses. Because there is a biologic variation (each person's eyes are different) and errors of measurement there is no guarantee that you can get this desired refractive result. Approximately 90 percent of the people who have surgery do not have to wear glasses after surgery.

The newest lens implant is a multifocal lens allowing a person to have good reading, intermediate, and distance vision without glasses. This lens is currently made in a foldable silicone version. It is also possible to use a foldable acrylic plastic for multifocal IOL's. The foldable silicone version takes advantage of the small 3 millimeter scleral pocket, or clear corneal incision, which reduces induced astigmatism and wound slippage. This type of lens implant only works well with astigmatism under 1 diopter.

A person with a multifocal lens usually has increased depth of focus, the ability to see at distance, intermediate and near. Sometimes reading vision is affected by different light levels. Some people need to practice light control. For instance, when reading the paper if you choose a very bright reading light you can see ghosting of the image. If you really concentrate you can ignore the ghosting. Visually the brain automatically ignores the ghosting image. As you turn the lights down (or choose a less intense reading light bulb) the ghosting goes away and your near vision gets better. As the light decreases so does the contrast and the reading vision drops off. There is a definite appropriate level of light that will enhance the near or reading vision. This has to do with the pupil changing size (larger in dim light and smaller in bright light). There are times when it is actually better to have low light and low contrast. The times when the shadowed image may be noticed are in bright uniformly lit rooms, such as fluorescent lighting in an office with bright white paper in a laser printer. If you have one or two incandescent lights on at home in the evening when reading a paper there are no extra images. The brighter the white background is the more likely you will see shadows around the letters. Patients who want to read the paper should experiment with different wattage bulbs. When you look at self-illuminated signs you may see multiple images of that sign.

Most people describe that point light sources at night, such as street lights and headlights, have halos around them. You will see a central point of light, a clear donut around it and then there will be a halo of light around the point source. You can see well between the central point of light and the light halo. Outside of the halo your vision is fine. When you look at a car light a long ways away, the halo seems to be larger if the car is further away then if it is up close. Actually if you look closely, the halo is always the same size but the cars' light is smaller the further away the headlights are.

Approximately 1-5 percent of the people, who choose to have a multifocal lens implant, is affected when driving a car in lower light conditions at night in rain, fog, or snow. All of these minor aberrations are intensified if you have astigmatism. That is why astigmatism needs to be corrected. If astigmatism is present, starburst affect is added on top of the halos. All of these minor aberrations tend to become less and less over time. Usually it takes the brain 2-3 months to adjust to the new optics. Putting the multifocal lens in the second eye quickens the brains adjustment time. The multifocal lens implants work the best when both eyes are implanted with the multifocal IOL.

We think something that is important about the multifocal intraocular lens is that every week the aberrations get less. We don't know how the brain makes this adaptation but we know that it does from talking with people, including ophthalmologists that have received the multifocal intraocular lens.

ReSTOR® and ReZoom® Multifocal IOLs
Finally, the opportunity for freedom from reading glasses and bifocals has arrived.

Until recently, life with less dependency on reading glasses or bifocals was limited to monovision (one eye set for distance and one eye set for near). Now there are other options for people with cataracts and others that do not have cataracts but want to be spectacle independent. You now have two more options. The AcrySof® ReSTOR®, and ReZoom® IOLs (Figure 1, 2) are unique technological innovations providing you with quality vision throughout the entire visual spectrum – near, intermediate and distance – with increased independence from reading glasses and bifocals!

Grendahl Eye Associates is pleased to introduce a breakthrough in vision surgery. These are called the presbyopia IOLs. Now there are revolutionary new ways to potentially leave your glasses behind – introducing two new IOLs- AcrySof® ReSTOR®, and ReZoom® intraocular lens (IOL), a breakthrough in vision surgery. AcrySof® ReSTOR®, and ReZoom® are uniquely designed to improve vision at all distances -near, far and everything in-between. This gives cataract and non-cataract (clear lens extraction) patients their best chance to gain independence from glasses.

Back in the 1980’s, I tried all available multifocal intraocular lens implants to allow cataract patients to see both at distance and near. I used the bull’s eye styles, the Array, and diffractive optic multifocals. These were the lens manufacturer’s first attempt to develop multifocal IOLs. Although spectacle independence was the goal, many times we fell short of that goal. We learned that using the 1980’s multifocal IOLs resulted in optical aberrations or imperfections seen at night (halos, glare, glowing light, etc).

After one to three years, most surgeons stopped implanting these. But now, something has changed! We now have new hybrid IOLs that have reduced optical side effects for improved quality of night vision. Newer lenses tout much greater spectacle independence. Eighty percent (80%) of people do not use spectacles with the new ReSTOR® Multifocal IOL. Ninety two percent (92%) of the people that received the ReZoom® IOL did not wear spectacles, not at all (31%) or sometime (61%). If we employ additional technology such as Corneal Relaxing Incisions (CRI), Limbal Relaxing Incisions (LRI), Astigmatic Keratotomy (AK), Laser Vision Correction (PRK or LASIK), spectacle independence is much higher at 90% for the ReSTOR® IOL. But one does not get something for nothing. This technology is expensive.

Multifocal Lens Implants
The most exciting development in the lens implant field in over 30 years! Used for people with or without cataracts that want spectacle independence.
The recently FDA approved Alcon AcrySof® ReSTOR® Apodized Diffractive (Fig 1) and the ReZoom® (Fig 2) Posterior Chamber Intraocular Lens (IOL) is a landmark in vision care technology. It provides good vision in patients for both distance and near without the need for reading glasses. Standard lens implants give good distance vision but often require the use of reading glasses for near vision.

Approved for use in patients by the FDA on March 23, 2005, the first U.S. lens implants were performed in Erie, Pennsylvania in June 2005. Those patients are now excited that they are able to see to perform tasks at a distance such as driving without glasses, as well as near vision, reading the newspaper, sewing, playing cards or looking at fine print without glasses.

FDA test results of the ReSTOR® Multifocal implant are excellent. This is because the lens is based on the highly successful AcrySof® lens implant that has been used in patients around the world for many years in standard cataract lens surgery. The ReSTOR® technology adds the Apodized Diffractive surface to this already successful lens to provide patients greater visual freedom.


Figure 1	Figure 2

How Does The ReSTOR® Lens Work?
This lens works by applying four technologies into one lens implant. This is truly a remarkable hybrid IOL. First, it contains a refractive optic element in the peripheral portion of the lens (Figure 1, 3). Second, a central diffractive optical element 3.6 mm in diameter in the center of the IOL (Figure 3). Third, the diffractive element is apodized. Lastly, the back surface of the IOL is aspheric (Figures 4 and 5).


	Figure 3	Figure 4 (spherical) Figure 5 (aspheric)

Diffraction and Refraction
Light can be bent by one of two ways: first, by refraction and second, by diffraction.

Figure 6

When light hits a transparent substance it slows down and is bent (Figure 6). If we arrange the substance in a symmetric circular shape called a lens (Figures 1, 2, 3, 4, 5), the light from 360 degrees impinging on the lens gets bent to a focal point. Second, light is "slowed down" when it impinges upon an abrupt edge. Some examples would be that of a tiny hole (Figure 7), fine scratch in glass, the edges of a razor blade, a coin (Figure 8), or a finger. Slowing of light results in bending of light. If we arrange fine scratches or steps in a piece of glass or acrylic plastic in consecutive circles, light gets bent to a focal point (Figures 1, 3, 11, 12).


Figure 7	Figure 8

Aspheric Design
Reduces Diffractive Harmonics, an optical imperfection of diffractive optics.
The older IOLs with diffractive optics created a rainbow of colors in the peripheral vision. This is called Diffractive Harmonics. The Alcon Company’s optical engineers were very clever by placing an aspheric surface on the backside of the IOL to alleviate this aberration. The optical aberrations (or rainbow of colors seen) were thus eliminated. Not only does the aspheric back surface of the IOL reduce the intensity of the diffractive harmonics (rainbow of colors), it directs it into the extreme periphery so the human eye will not perceive it. Clever and down right ingenious.

Apodization
Apodization is an optic design of a diffractive optical element with a gradual reduction or blending of step heights and widths in adjacent and subsequent diffractive rings that optimally (Figure 11, 12) manages light energy delivered to the retina. It distributes the appropriate amount of light to near, intermediate, and far focal points regardless of the lighting situation. The precise reduction in the diffractive step heights from center to periphery of the 3.6-mm diameter diffractive region directs less light to the near focus. Larger step heights and spacing of the center of the diffractive optic portion divides light equally between two images near and distance. The steps reduce from 1.3 microns to .2 microns. As the pupil becomes larger (when you direct your eyes from reading to distance) all the light that impinges on the peripheral refractive portion of the optic is directed to the distance focus. A red blood cell is 7 microns in diameter and a human hair is 20 microns in diameter (Figure 9, 10).


Figure 9	Figure 10

The apodized diffractive and peripheral refractive portion is designed to improve image quality while minimizing visual disturbances (aberration or imperfections). It results in increase contrast and more precise focusing on to the retina. Objects that are distant, intermediate, and near are in focus under all lighting conditions and pupil sizes.

Figure 11

Figure 12

This is truly a remarkable intraocular lens design- creating distance, intermediate and near vision- focusing (near for reading, distance for far vision, and intermediate for computer and grocery shopping) all with optimized night vision.

How does the ReZoom® Work?
The recently FDA approved the ReZoom® Posterior Chamber Intraocular Lens (IOL), is a landmark in vision care technology. This is a second-generation full range refractive multifocal alternative to monofocal IOL’s. It provides good vision in patients for both distance, intermediate and near vision to become less dependant on reading glasses.

Figure 13

Figure 14 N= Near F= Far

The ReZoom IOL distributes light over five optic zones so that each lens has a distance-dominant central zone, a large, distance-dominant third zone and a distance-dominant fifth zone. Zones two and four focus light for near vision (Fig. 13, 14)

Cost
This is a Premium Service, and the cost of the AcrySof® ReSTOR® and ReZoom® Multifocal lens implant is higher than standard monofocal lens implants ($1,435.00 vs. $150.00). These IOLs are considered by most insurance companies (including Medicare) to be non-standard IOLs and are only partially covered ($150.00 of the cost). Additional tests are required to evaluate a patient for this implant. A complex office exam, numerous tests and a special consultation is required to determine a patient’s eligibility for ReSTOR® or ReZoom®, Multifocal Lens. This imparts additional costs to the surgeon’s fee. Many times additional procedures done at the time of cataract or clear lens extraction like CRI, LRI, or AK are required to correct pre-existing astigmatism, thus imparting another additional cost to this procedure. These IOLs don't work if there is greater than .5 diopters of spherical or astigmatic (more about this later) refractive errors. Sometimes fine-tuning the spherical component of the refraction (the better one better two eye test) is necessary to achieve the best visual results by adding PRK or LASIK after lens implantation. This imparts additional costs to the procedure. It is impossible to give you the exact cost of the procedure for several reasons. First, each person has a slightly different insurance coverage, and different insurance companies cover varying costs differently. Third, costs and insurance coverage continue to change. We cover pricing with each person who is a candidate on a case-by-case basis. To make this deluxe technology affordable to nearly every one, we have established flexible payment plans. Ask about our 0 % financing and extended payment plans offered by Care Credit. Or go to www.carecredit.com for more information.

Refractive Lens Implants
Refractive Lens Exchange, Clear Lens Replacement
Since the 1970s, eye doctors have used LASIK, PRK, and other refractive surgeries to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Unlike LASIK and PRK, which are surgical procedures that alter the surface of the eye (the cornea), refractive lens implant surgery uses techniques and materials similar to those used for over 30 years for cataract surgery. This procedure is for people that are not candidates for Verisyse (more about this later), for people generally over age 40, or for those people that have cataracts and want to maintain good distance, intermediate, and near vision. Refractive Lens Implant surgery or Refractive Lens Exchange is a procedure that removes the natural lens in your eye and exchanges it with an artificial intraocular lens (IOL) (clear lens replacement).

Clear Lens Replacement (CLR) or Refractive Lens Exchange (RLE)
For individuals over 40 who are considering refractive surgery to decrease dependence on glasses and contact lenses, clear lens replacement (CLR) is an exciting option. In essence, this procedure involves removing the natural lens of the eye and replacing it with an artificial intraocular lens (IOL) implant.

This procedure is essentially the same as a cataract surgery with lens implant, however; in this case, the procedure is completed prior to cataract development for the refractive advantage. Usually a monofocal or fixed-focus lens implant is used during cataract surgery. With such lens implants, reading glasses and/or bifocals are usually required for achieving one’s best vision after surgery. CLR changes the refractive power of the eye to give better-uncorrected vision. Now we can use the Restore Multifocal IOL to reduce your dependency on glasses. This IOL will give you good distance, intermediate and near vision. These IOLs are considered by most insurance companies to be non-standard IOLs and are only partially covered.

Monofocal Intraocular Lens Implant (Monovision)
A second alternative for patients who are considering CLR, but who do not embrace the notion of wearing reading glasses following surgery, is monovision. With monovision, the traditional monofocal IOL implant is inserted bilaterally, however, the patient’s dominant eye is corrected for distance and the non-dominant eye is corrected for near. This choice is also an excellent one, but not necessarily an option that would be tolerated by everyone. Ninety eight percent (98%) of patients can tolerate monovision, but 2% cannot. This is also a bit of a compromise in the sense that some people want to wear distance glasses to fine tune or balance their vision from one eye to the other, for driving a car at night in the rain, fog, or snow. Some people also want glasses for reading a long time, as in reading a novel or when they are at the computer for hours. These IOLs come in an aspheric version that I routinely use to give patients better quality night vision. These IOLs are considered by most insurance companies to be standard IOLs and are covered.

Verisyse Lenses
This procedure is for people with moderate to high myopia, hyperopia, or who are not candidates for Laser Vision Correction. Verisyse Lenses are optical devices that function much like glasses or contact lenses. The difference is Verisyse Lenses are placed inside the eye between the cornea (outer clear portion of the eye) and the Iris (the inner colored portion of the eye). Just as glasses and contact lenses correct vision, Verisyse Lenses refocus light rays onto the retina (the back part of the eye) to correct vision. Since Verisyse Lenses are inside the eye, no cleaning or handling of lenses is necessary. Verisyse Lenses are designed for surgical implantation into the eye to correct myopia (nearsightedness) and hyperopia (farsightedness). They are called phakic IOLs because the eye still has its natural lens in place. This allows for natural accommodation (reading and intermediate vision). The Verisyse lenses are made of a hard plastic (ultraviolet light absorbing polymethylmethacrylate) or a soft foldable version, materials that have been used to make intraocular lens implants to treat cataracts for over 50 years. Although Verisyse Lenses can be surgically removed, they are intended to remain in the eye permanently until cataracts develop. These IOLs are considered by most insurance companies to be non-standard IOLs and are only partially covered.
The Verisyse, ReSTOR®, and ReZoom® intraocular lenses do not work with astigmatism. Astigmatism must be corrected by other methods- LASIK, PRK, AK, LRI, or CRI.

What Is Astigmatism?
Astigmatism usually occurs when the front surface of the eye, the cornea, has an irregular curvature. You may make the comparison to an egg and a ping-pong ball. The ping-pong ball is spherical in shape as is the eye without astigmatism, while the eye shaped like an egg has astigmatism. Another example would be the back surface of a tablespoon compared to the back surface of a soupspoon. Astigmatism is one of a group of eye conditions known as refractive errors. Refractive errors cause a disturbance in the way light rays are focused within the eye. Astigmatism often occurs with nearsightedness and farsightedness, conditions also resulting from refractive errors. Astigmatism is not a disease nor does it mean you have “bad eyes”. It simply means you have a variation or disturbance in the shape of your cornea.

What Causes Astigmatism?
Normally the cornea is smooth and equally curved in all directions and light entering the cornea is focused equally on all planes, or in all directions. With astigmatism, the front surface of the cornea is curved more in one direction that in the other. This abnormality may result in vision that is much like looking into a distorted, wavy mirror. The distortion results because of an inability of the eye to focus light rays to a point.

If the corneal surface has a high degree of variation in its curvature, light refraction may be impaired to the degree that corrective lenses are needed to help focus light rays. At any time, only a small portion of the rays are focused and the remainder is not, so that the image formed is blurred. Usually, astigmatism causes blurred vision at all distances. Some people with very high degrees of astigmatism may have cornea problems such as keratoconus.

Astigmatism is very common. Some experts believe almost everyone has a degree of astigmatism, often from birth, which may remain the same throughout life. The exact reason for differences in corneal shape remains unknown, but the tendency to develop astigmatism is inherited. For this reasons, some people are more prone to develop astigmatism than others.

Symptoms of Astigmatism
1. Distortion or blurring of images at all distances
2. Headache and fatigue
3. Squinting, eye discomfort, or irritation

The symptoms described above may not necessarily mean you have astigmatism. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.

Treatment of Astigmatism
If the degree of astigmatism is slight and no other problems of refraction (such as nearsightedness or farsightedness) are present, corrective lenses may not be needed. If the degree of astigmatism is great enough to cause eyestrain, headache, or distortion of vision, prescription lenses will be needed for clear and comfortable vision.

The corrective lenses needed when astigmatism is present are called Toric lenses and have an additional power element called a cylinder. They have greater light-bending power in one axis than in others. Refractive surgery (AK, CRI, or LRI) may correct some forms of astigmatism.

What is Astigmatic Keratotomy (AK), Corneal Relaxing Incisions (CRI) or Limbal Relaxing Incisions (LRI)?
Limbal Relaxing Incisions (LRI) and Corneal Relaxing Incisions (CRI) are a modification of Astigmatic Keratotomy (AK). Both are procedures to treat astigmatism.

Astigmatism is present when the cornea is not spherical, i.e., it is steeper in one meridian than the opposite meridian 180 degrees away. The cornea with astigmatism may be thought of as being more football shaped rather than basketball shaped. LRIs are incisions that are placed in the far peripheral aspect of the cornea (the limbus) resulting in a cornea that is "more round". The astigmatism is thus reduced and uncorrected vision is improved.

The procedure can be completed in a few minutes after numbing the eye with anesthetic drops. There is usually little, if any, post-operative discomfort. The procedure is very safe and is not associated with glare or starburst. Furthermore, the cornea is usually stable within a week, indicating that visual fluctuations have typically resolved by that time interval.

Limbal relaxing incisions have gained widespread acceptance among cataract surgeons where it is often combined with the cataract operation to reduce pre-existing astigmatism. This results in better post-operative vision without glasses. The procedure can also be used in individuals whose primary refractive error is astigmatism.

Recent Studies
Resent investigations demonstrate that the best results are obtained when a ReZoom® multifocal is placed in one eye and a ReSTOR® multifocal is placed in the other eye. The studies show that over 90% of people are spectacle free when this combination is used.
This is why we at Grendahl Eye Associates recommend that a ReSTOR® is placed in one eye and a ReZoom® in the other.

Frequently Asked Questions
Is surgery the only option to treat a cataract?
Just because you have a cataract does not mean that you need to have it removed. Cataract surgery only becomes necessary if you are not happy with your vision and want to see well. Talk to your doctor if you have any questions or concerns about your vision.

Is intraocular lens surgery the only option to treat refractive errors?
No, other alternatives are glasses, contacts, PRK, or LASIK.

Does cataract or clear lens extraction surgery hurt?
Thanks to numbing drops and medications to help you relax, this procedure involves minimal discomfort.

Will I be asleep during cataract or clear lens extraction surgery?
Since this procedure does not take very long, it is unnecessary to put you completely asleep with general anesthesia. Instead, your surgeon will use a local/topical anesthetic to numb your eye and you will remain awake during the surgery. You will be given Versed and Mepergan Fortis to tone you down and partially block the memory.

Who performs the procedure, a surgeon or technician?
A surgeon will perform the procedure. There will be a technician and nurse in the room to assist them.

I have cataracts in both eyes. Will the doctor treat both at the same time?
Typically, doctors will perform surgery in the second eye two or three weeks after the first eye. All patients are different, so talk to your doctor about what is right for you.

I have refractive errors in both eyes. Will the doctor treat both at the same time?
Typically, doctors will perform surgery in the second eye two or three weeks after the first eye. All patients are different, so talk to your doctor about what is right for you.

How long will I be in the hospital or surgery center?
Patients commonly spend only a four to five hours at the hospital or surgery center, and are allowed to go home the very same day.

How long before I can see after surgery?
Every patient and every eye is different. Patients commonly see well enough to drive the day after surgery. Ask your doctor how quickly he or she expects you to recover.

How long until I can return to normal activities?
Most patients can resume normal basic activities like reading and watching TV by the next day, and return to work within two to seven days. Doctors typically recommend against any strenuous activity for two or more weeks. However, results vary for different patients, so you should ask your doctor what is best for you.

After surgery, will I be able to drive at night?
Your ability to drive at night should be much enhanced once your cataract is removed. Patients with the AcrySof® ReSTOR® and ReZoom IOLs may notice a ring of light around headlights and other point-light sources. These are typically mild, rarely bothersome, and tend to diminish with time.

Will I need glasses after cataract or clear lens exchange surgery?
It depends on what type of intraocular lens you elect to have implanted. Most patients do not need glasses or contacts for distance tasks following cataract or clear lens extraction surgery with traditional monofocal IOLs. In the case of the AcrySof® ReSTOR® IOL Eighty percent (80%) of people’s unaided vision for distance, intermediate, and near tasks after their surgery is quite remarkably clear. In the case of the ReZoom® IOL Ninety two percent (92%) of the people that received the ReZoom® IOL did not wear spectacles, not at all (31%) or sometime (61%). If AK, LRI, CRI, PRK or LASIK are added on to the procedure 90% of people never need glasses with the ReSTOR®.

Can my cataract come back?
No, once a cataract has been removed it cannot return. However, over time, patients may complain that their vision has once again become cloudy. Most lens implants are placed inside the capsular bag that is used to house the natural human lens. This capsule can become hazy with time. This common condition, which may occur with any type of IOL, is known as a secondary cataract or posterior capsule opacification “PCO”. Secondary cataracts can be easily treated by a simple painless laser treatment called a YAG laser Posterior capsulotomy.

After Clear Lens Extraction can my vision become blurry again?
Yes. Over time, patients may complain that their vision has once again become cloudy. Most lens implants are placed inside the capsular bag that is used to house the natural human lens. This capsule can become hazy with time. This sometime common condition can be easily treated by a simple painless laser treatment called a YAG laser posterior capsulotomy.

Are there any side effects? Anything I won't like with these IOLs?
There is a chance that you will experience halos or glare in your vision with the ReSTOR® or ReZoom® IOL, this is common and usually is markedly reduced in time and when both eyes are implanted. Your intermediate (in-between) vision with the ReSTOR® IOL may not be as crisp as your near and distance vision, but four out of five AcrySof® ReSTOR® IOL patients in the clinical study reported never needing glasses following cataract surgery in both eyes. Once both eyes are implanted with the AcrySof® ReSTOR® IOL the intermediate vision markedly improves compared to only having one implanted with the AcrySof® ReSTOR® IOL. This is because of brain adaptation. Your near vision under low light conditions with the ReZoom® IOL may not be as crisp as your intermediate and distance vision, 31% of ReZoom® IOL patients in the clinical study reported never needing glasses following cataract surgery in both eyes. Once both eyes are implanted with the ReZoom® IOL the near vision improves compared to only having one implanted with the ReZoom® IOL. This is because of brain adaptation. As with any surgical procedure, there are risks. You and your doctor should consider the potential risks and benefits, and determine if the AcrySof® ReSTOR®, or ReZoom® IOL is right for you.

Will my vision be good after the first eye has had surgery?
Your vision for distance and near will be good after surgery on one eye. However your vision will not be balanced until the second eye is done. Your Intermediate vision will not be good until the second eye is implanted with the ReSTOR® IOL. Your near vision will not be good in low light levels even when the second eye is implanted with the ReZoom® IOL. This is because the light is split up for near intermediate and distance vision. However your vision will not be balanced until the second eye is done.

Can the lens be replaced if it doesn't work?
Although this would be unlikely, the IOL can be replaced with a different one if needed. You simply may need an additional procedure like AK, CRI, LRI, PRK, or LASIK to fine-tune the vision. All of these procedures have extra costs. Ask your surgeon how they would handle this situation.

Any precautions after surgery?
Every patient is different, so be sure to ask your doctor for advice on caring for your eye after the procedure. Your doctor may ask you to refrain from rubbing your eye or engaging in any strenuous activity for a few weeks after surgery. Your doctor may ask you to wear eye shields when you sleep for the first two weeks following surgery.

Who do I call if I have a problem?
Consult your doctor immediately if you have any problems, especially if you experience decreased vision, increased redness, or pain.

ReSTOR®, and ReZoom® IOL Testimonials
The following are comments and statements made by people that have the ReSTOR®, and ReZoom® IOL in each of their eyes.

“It is just unbelievable not to wear glasses! I've worn glasses for many, many years. I would just never go back to wearing glasses unless there was no other way out of it. I really don't need them. I see far, I see close, I see itsy-bitsy print – it’s just unbelievable”.

“I can read my watch. I can read the ingredients on a nail polish bottle. The thing that I noticed most about it was that my vision was like I was 25 years old again, which was terrific”.

“My advice to anyone that was even considering this would be to go for it, because it has been wonderful for me. I just wish I had done it years before and would not have to worry about glasses at all”.