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What’s new in the world of lens implants?  

Scott Grealish M.D.

Results and Experience with the Crystalens Accomodating Lens Implant

Starting in 2004 the FDA approved a new class of lens implants which allow surgeons to offer patients a greater range of vision with less need for glasses after surgery.  The first lens to receive FDA approval was the Crystalens.  I have used all three generations of this lens over the years and the results keep getting better.  The original company behind the lens, Eyeonics, was bought by Bausch and Lomb, a major company in Ophthalmology, in 2008 so we can expect even better versions of the lens in years to come.

However, if you have a cataract now, you can expect significant benefits from choosing the Crystalens in it’s current version.  Here is a summary of typical results from my practice based on over 100 eyes receiving the Crystalens.  I strongly counsel all patients to recognize that their own healing response to their surgery is a critical factor in what they may see after surgery, and that results to date are no guarantee of their particular outcome.

In my experience, the greatest advantage of the Crystalens over any other lens implant on the market in 2009 in the US is the ability to expand the range of focus without glasses without causing significant unwanted side effects.

The results below are taken from an online database I use to track all deluxe lens implant and Lasik surgery outcomes in my practice.  We are able to compare the results to hundreds of other surgeons who have together performed thousands of  surgeries.  In this way I can easily advise patients on their best options using both my own experience and that of many expert surgeons from around the world.

Distance Vision (Driving)

At one month after surgery Crystalens patients could see 20/40 or better in the distance 96% of the time.  That is well enough to pass the drivers test without glasses.  Only about half could see 20/20, but since we use both eyes to see, in fact less than 10% requested a touch up Lasik type surgery to improve their vision.  100% of my patients to date stated they never wore distance glasses after surgery.

Intermediate (Computer/Shopping) Vision

100% could see 20/40 or better for tasks at 24”, which means functional computer/cell phone work.  Again, only about half could see 20/20 at this distance prior to any enhancement laser surgery.  I think every patient should have a good understanding of the roughly 10% chance that they will need a laser surgery months or even years down the road to improve their vision by compensating for their individual healing.  We do this either with a laser to remove scar tissue, or haze, that can form behind the lens implant, or with Lasik type technology to actually change the focus of the eye.  Both are routine and can be performed in minutes.  It is rare to encounter a patient with the Crystalens who feels the need to wear glasses for intermediate tasks.

Near Vision (Reading)

About 80% could read 20/40 or better at near.  This means most of the newspaper, but not stock quotes or medicine bottle type fine print.  Again, about half could see finer print at the 20/25 level which explains why 60% said they never wore readers, 30% wore them sometimes, and 10% wore them all the time.  I tell every patient that they should expect to need reading glasses after surgery.  At this time the odds are just too high that they might not achieve the reading sharpness they want without glasses.  However, compared to those who receive “standard” monofocal lens implants, the patient’s with the Crystalens are much less dependant on glasses after surgery.  Almost 100% of our patient’s with “standard” lens implants need reading compared with only 10-40% with the Crystalens.  I’m certain that in 5-10 years we will see the elimination of reading glasses after surgery, but until then the Crystalens is a remarkable design that safely provides real advantages to patient’s undergoing Cataract surgery in 2009.

Updated February 2009

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