Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum.  ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Eye Care Archive  (Expert Forum)
 | 
Is Accommodating Lens working fine with only one eye implanted?
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Post a Question Back to Forum
MedHelp Member's Question

Is Accommodating Lens working fine with only one eye implanted?

by bluehippodog, Feb 15, 2007 12:00AM
I am 40 yrs old, and have cataracts in left eye only, right eye is perfectly fine (except for nearsighted).
I would like to not wearing reading glasses and able to drive at night after surgery, and here is my hard contact lens prescripton as below (hope that helps).

LEFT
- 5.00 (Sphere)
   8.00 (BC)
   10.2 (Dia)
   .14  (CT)
Right
- 5.50 (Sphere)
   8.09 (BC)
   10.2 (Dia)
   .14  (CT)

My doctor suggested me "Techis Monofocal IOL" implants left eye which would be better than "Multifocal, such as Restor, Rezoom" becuase he said my brain won't able to adjust it.
But my question is, am I lossing depth perception if I have Monofocal IOL in left eye only after surgery?
Am I able to resolve this issue if I go for Accommodating Lens (Crystalens, or a new Tetraflex), are they working fine with one eye implanted only with another eye normal.  your comments and experience are welcome.



Doctor's Answer

by Forum-OD-MP, Feb 15, 2007 12:00AM
yes, you would in theory lose some depth perception with a monofocal implant in one eye.  you may be able to function with a crystalens, you may not.  difficult to predict.  

no, all of the literature suggests that bilateral multifocal implants work way better than monocular multifocal implantation.  so no i would not say they are 'working fine' with only one eye implanted.

http://www.revoptom.com/index.asp?ArticleType=SiteSpec&page=osc/105273/lesson.htm

http://www.revoptom.com/index.asp?ArticleType=SiteSpec&page=osc/105344/lesson.htm

Member Comments (18)

by aimee37, Feb 15, 2007 12:00AM
Thanks for reply,

"yes, you would in theory lose some depth perception with a monofocal implant in one eye. you may be able to function with a crystalens, you may not. difficult to predict."

You said I might or might not be overcome the depth perception with Crystalens, is it because of duzziness when see things with both eyes together or I misunderstood?

Thanks...

by aimee37, Feb 15, 2007 12:00AM
dizzyness?  no.  this is complicated but i'll give it a shot:

an "accommodating" iol like crystalens attempts to mimic the focusing ability and amount of the human eye.  you need to focus the same amount in each eye (or unfocus the same amount) in order to obtain/retain binocularity.  easy to do in the human eye with both of your own lenses.  reasonably easy to do with 2 cyrstalens implants.  doubtful to have even accommodation/focusing with 1 implant and one natural lens.  my guess would be the implant wouldnt focus nearly as well...

unrelated to any "dizziness"

by aimee37, Feb 15, 2007 12:00AM
I see.  
Then how can a Monofocal to obtain/retain binocularity in this case, in term of amount of focusing or unfocusing to objects.  
How the monofocal solve (or not) this issue?

by aimee37, Feb 15, 2007 12:00AM
i'm confused as to what you're asking me.

a monofocal implant could very likely be worse than a cyrstalens, as far as retaining binocularity and not needing reading glasses or reading correction (bifocals, etc).  there is no great solution for this.  

by aimee37, Feb 15, 2007 12:00AM
I am trying to ask difference opinion on which "Monofocal, Multifocal, or Accomdating" lens provide the best result for my case - Speaking of only left eye implant.
Result to achieve - Without wearing glasses most of the activites including Reading, depth perception and night driving.
So far, I hear...
Monofocal - Will loss the depth perception.
Crystalens - Will have difficult time to focusing/unfocusing becuase implant len for left eye only.

my eye doctor sometimes suggest me Crystalens (due to night driving and halo), some time Rezoom (due to my job duties needs to read computer screen), and last minutes changed to Monofocal (due to better sharpness, plus my right eye is normal), I just don't know what to do.
Do you agree there is no good solution for me as of today available technology?

by aimee37, Feb 15, 2007 12:00AM
To: Bluehippodog
Your doctor has given you sound advise with regards to not having a multifocal lens at any cost.  The Tecnis lens is a fine lens, but a standard monofocal lens.  How do I know this, I worked on the tecnis monofocal lens during the clinical trial phase.  I can categorically tell you that all patients needed glasses for intermediate and near vision. Lets be honest here, the only lens that will give you good vision at all distances without unwanted abberations. is the accommodating lens by eyeonics.  Since the lauch of their latest product the five-O they have the competition running scared.  The lens provides excellent distance, superb intermediate and J2 near - no loss of depth perception or other unwanted  abberations.  You mentioned the Tetraflex, that lens is currently in clinical trials here in the US, it is available in europe Do yourself a huge favor and at least check out the five-O by eyeonics. You can find a doctor in your neighborhood from their website.  I am totally sold on this product I personally know at least 50 people who have had the eyeonics product, even my mother-in-law

by aimee37, Feb 15, 2007 12:00AM
To: Dr Crysta
Quote from "Forum OD_RMP" from above.
"an "accommodating" iol like crystalens attempts to mimic the focusing ability and amount of the human eye. you need to focus the same amount in each eye (or unfocus the same amount) in order to obtain/retain binocularity. easy to do in the human eye with both of your own lenses. reasonably easy to do with 2 cyrstalens implants. doubtful to have even accommodation/focusing with 1 implant and one natural lens. my guess would be the implant wouldnt focus nearly as well..."

Then how the new Five-0 handle the issue of obtain/retain binocularity if I have only LEFT eye implant with Crystalens Five-0

by aimee37, Feb 15, 2007 12:00AM
To: Dr. Crysta, bluehippodog
Dr. Crysta, no offense intended, but you sound more like an Eyeonics rep than a doctor.  In all fairness to readers of this forum, please let us know what your credentials are.

Bluehippodog, you're saying that you're 40 years old, have a cataract in one eye only and have moderate/high myopia in your other eye.  And you're also saying that you don't want to wear reading glasses.  I'm not an eye care professional (just a post-cataract patient myself), but I think that your doctor's suggestion of a monofocal lens is a good one.  If you don't need reading glasses now, I don't see why you would need them post-surgery.  You undoubtedly will begin to develop presbyopia in the next few years.  If you don't want to wear reading glasses, you can either do monovision or get bifocal/multifocal contact lenses.  By the way, I hope that your doctor has explained that if your surgical eye is corrected for distance, you will need to wear a contact lens in your other eye all the time.  Glasses won't work for you post-surgery.  

by aimee37, Feb 15, 2007 12:00AM
To: JodieJ
I am flattered that you think I am an eyonics sales rep. That would be incorrect. I have been involved with the design and implementation of ophthalmic clinical research trials for the US and europe for over 18 years.  My comments are my own personal observations. With regards to the original question " can you have one accommodating eye implanted".  I suggest, you under freedom of information read the FDA transcript with regards to the crystalens.  You will see that in Phase I of this study 100 eyes were implanted unilateraly. All eyes received excellent results with no complications. You can draw your own conclusions.  

by aimee37, Feb 16, 2007 12:00AM
To: Dr. Prince, bluehippodog
bluehippo, I have the post-op eye situation you describe and my pre-surgical Rx was almost identical to your Rx.  I have a monofocal implant in one eye and a contact lens in the other.  The last eye exam I had, IMO, I did just awful on the depth perception test. It seemed that out of ten or so examples, I only perceived "depth" in one of them, however, I have not noticed any limitation on my daily activities.  Without having the test, I would have thought that I was doing OK. I wonder what I am missing? I do, however, have to wear a contact lens in my non-surgical eye virtually all waking hours as the visual disparity I have between my surgical and non-surgical eye is about 5 diopters.  I have been told that the maximum visual disparity the brain can tolerate in a pair of glasses is in the range of 2.5 diopters or so. It is a pain to always have to have a contact in my other eye, but I'm not yet ready to go through another cataract procedure, so I'm coping.

Dr. Prince, is it worrisome to not do well on the depth perception test?  The optometrist who did the test did not seem that concerned.  

by aimee37, Feb 16, 2007 12:00AM
no, not worrisome.  IMO binocularity is a subjective thing.  some patients (like me) have no binocularity and dont miss it.  on the other hand some patients can definitely tell when their binocularity is compromised.  but is it "worrisome" to have little or no depth perception?  definitely not.

by aimee37, Feb 16, 2007 12:00AM
To: Jmadison and Forum OD_RMP
Jmadison, THANK YOU SO MUCH for sharing me with your post-surgical experience.  It was very helpful for me to understand what I walk into.
Do you have any issue seeing near objects (reading book), intermediate object (computer screen) and far objects (driving), halo after wearing contact lens, except issue other than depth perception.

Forum OD_RMP, to be my best (limited) knowledge, Part of the depth perception could be resolved by using Accommodating IOL such as Crystalens or Tetraflex (available in UK).  But it introduces to another issue; such as "discrepancy of focusing/unfocusing the same amount between implanted accommodating lens and one natural les" which you mentioned above.
How difficult a patient to overcome this issue,  and wil