What is the Crystalens?
The Crystalens is a new technology that is designed to mimic the eye’s natural ability to focus on distant, middle and near objects. Used in conjunction with standard lens extraction methods, the Crystalens can restore a full range of functional vision, from distance to reading vision without total dependence on glasses or contact lenses.
What makes the Crystalens different from other intraocular lenses?
The Crystalens has the unique ability to focus on objects at varying distances using the eye’s natural muscle. This means that the Crystalens can provide sharper vision, without corrective lenses, throughout a full range of vision from near to far and everything in between.
Standard (single vision) lens implants do not have the ability to provide a full range of vision. Most people who have single vision lens implants MUST wear glasses for middle and near vision.
Can my vision be corrected to 20/20, for both reading & distance?
The Crystalens has been designed to focus your eyes at all distances after implant surgery. While virtually everyone will experience a significant improvement in their uncorrected vision after surgery, some people will not see 20/20 at all distances.
It is interesting to note that many people who have not had surgery are not able to see 20/20 at both near and far even with glasses or contact lenses. This is due to a variety of ocular and physiological problems as well as lifestyle preferences, yet most of these people function quite normally although their vision is reduced.
The Crystalens FDA two-year clinical study results indicate that 92% of the people enrolled in the study (implanted bilaterally) could see 20/25 or better at distance, 96% could see 20/20 at arm’s length and 73% could see 20/25 at near without glasses or contact lenses.
What is more exciting is that 98% of these people could pass their driver’s test, 100% could see their computer and dashboard, read the prices in the supermarket or put on their makeup, and 98% could read the telephone book or newspaper, all without glasses or contact lenses.
What about my middle vision, like working on the computer. Will it be like wearing trifocals?
Your ability to see at approximately arm’s length (middle vision) will be greatly enhanced with the Crystalens. Over 96% of people enrolled in the clinical study were able to see 20/20 at arm’s length without correction.
In addition, the quality of vision compared to wearing trifocals is significantly improved. You will have a full range of vision, without having to tilt your head to find that portion of your glasses that allows you to see clearly. You simply look at something and the Crystalens will automatically focus your eye at near, arm’s length or distance. The Crystalens mimics the natural focusing ability of your eye.
Will I be able to read in all light conditions?
The Crystalens functions very much like the normal human lens. It is important to remember that reading vision in low light is also influenced by the overall health of your eye and by the condition of the light sensors in the retina. As we get older, our ability to see in low light conditions may start to decrease. It is always best to read in good light conditions.
How do I know if I am a good candidate for Crystalens implantation?
Your doctor will perform a thorough examination and advise you of a customized treatment plan for effectively correcting your vision.
Virtually everyone with good general health is a candidate for implant surgery, but people with chronic infections, uncontrolled diabetes or other health problems may have to wait until these conditions are under control prior to surgery.
People who have had prior corneal refractive surgery are acceptable candidates for Crystalens implantation as long as their eye is in good health. Talk to your doctor.
If you have had cataract surgery, you are not a candidate for the Crystalens procedure.
Should I have the Crystalens implant put in both eyes?
Typically, you will want to have the Crystalens implanted in both eyes. The surgeon usually starts with the ‘non-dominant’ eye. Your doctor will also look at a number of additional factors in deciding which eye to implant first and when to implant the other eye. Most surgeons prefer to wait two to three weeks between surgeries, but this may vary based on how well the first eye is healing and the visual outcome.
How long with the surgery take? Will I feel anything?
The Crystalens procedure is typically performed in an outpatient surgical facility. You will arrive at the surgery center about an hour before the procedure. A number of topical drops will be placed in your eye and oral medications may be administered to help you relax. The eye drops anesthetize your eye and dilate your pupil.
Once in the surgery suite, you will lie down on a comfortable bed, a microscope will be positioned over your eye and you will be asked to look up into the light of the microscope.
The actual surgery usually takes less than 20 minutes. The surgeon will stabilize your eye with a device to keep your eyelids open. You will feel no pain, only slight pressure on your eye. All you have to do is to relax and hold still.
Once the surgery is complete, additional drops will be placed in your eye to prevent infection, decrease inflammation, and keep your pupil dilated. A patch may be placed over your eye and someone will need to drive you home. Once at home, you should rest for the remainder of the day. You should avoid any strenuous activities. Your doctor will see you the day after surgery to remove the eye patch and examine your eye. Do not rub your eye.
The doctor will give you additional medications that you will need to put in your eye for the next week or two. These drugs help the eye heal leaving, no residual effects.
What are the chances that something could go wrong with the surgery? What would they be?
The contemporary treatment for lens extraction is to remove the crystalline lens and replace it with an artificial lens. The Crystalens represents the state-of-the-art in artificial lens design and is the result of over 50 years’ evolution in the treatment of cataracts.
The medical procedure to implant the Crystalens is the same safe, proven lens surgery performed annually on over 7 million eyes with cataracts globally. Over 40 million procedures have been done in the last 25 years. But because it is surgery, it is not completely risk-free.
Complications of implant surgery range from minor, usually temporary side effects, to sight-threatening complications. Fortunately, significant sight-threatening complications are extremely rare, and include, but are not limited to, infection, hemorrhage and retinal detachment. People with existing medical conditions such as diabetes, high blood pressure, chronic inflammatory conditions and chronic infections are at a higher risk of developing complications. Current data indicate that 98% of people have no complications after implant surgery and more than 95% have improved vision.
Your doctor will perform a thorough examination and fully inform you of any increased risk of a complication.
What will my vision be like after surgery?
Your distance vision will usually be very good within a day or two after surgery. However, your middle and near vision may be somewhat blurred at first.
Drops will be applied to your eye after surgery, preventing the eye from changing focus from far to near. These drops dilate your pupil, making you sensitive to light until the drops wear off. This is done to ensure that the Crystalens is correctly positioned in your eye as it heals. It will take 7 to 14 days for the effects of this drug to wear off. You may need to wear reading glasses to help you read during this time.
After about two weeks, you will notice that your middle (arm’s length) vision is improving and your near vision is also starting to get better. It is important that you discontinue the use of the reading glasses at this time so that you strengthen the focusing muscle of your eyes.
It may take several months for your eyes to reach their full focusing potential. The more you try to read without reading glasses, the quicker you will be able to read without them. You may notice a difference in your vision from one eye to the other after your eyes heal. This is normal. If the difference in your vision is significant, your doctor may recommend additional corneal refractive surgery. This is often done for the correction of astigmatism after implant surgery.
Everyone’s focusing ability is different. Most people will be able to see clearly in the distance, have excellent middle vision and will be able to read a newspaper without glasses, but some people may be more comfortable with additional correction, particularly at night or in dim light.
It is important to remember that implant surgery cannot resolve pre-existing visual conditions such as floaters, flashes or visual field loss that are a result of conditions of the eye and not related to the lens.
Your doctor will thoroughly discuss the restoration of your vision after surgery and will recommend a specific plan for optimizing your uncorrected vision for near and far. It is important to remember that while virtually everyone experiences much improved vision after implant surgery, some people will have better uncorrected vision than others.
It may be necessary for some people to wear glasses for distance and/or near vision to obtain optimal visual acuity. The difference from standard lenses is that most people will not be dependent on these supplemental vision aids to function normally.
Since this information isn’t intended to replace the advice of a health care professional, be sure and talk with your doctor before making any decisions regarding vision correction procedures.
The long-term safety and effectiveness of this lens have not been established.
What about glare, problems driving at night and sensitivity to light? Can implant surgery create these problems?
Yes. These symptoms can be produced or exacerbated by implant surgery. Many people report these problems before implant surgery and even after surgery; however, they are rarely debilitating.
Sensitivity to light is often a temporary symptom. The Crystalens optic material is so clear that, in some people, it takes time to get used to how bright colors are and how intense lights can be, particularly at night.
As with any intraocular lens, glare can be a problem at night when the pupil widely dilates and occasionally light can reflect off the edge of the implant and create a flash or halo of light. This typically does not occur in your central field of vision, but rather in the periphery. People who have worn contact lenses in the past may be familiar with this phenomenon.
Again, glare is rarely debilitating and if it does bother you, there are a number of things that your doctor can do to improve your vision at night, including medications or night driving glasses.
When will I be able to return to normal activities after Crystalens refractive implantation?
Typically, you will be able to return to normal activities within several days after implantation with some limitations. Your eye may be sensitive to touch and bright light, but you should be able to drive and return to work in two to three days.
Your doctor will provide you with medications to prevent infection and decrease inflammation and may provide a protective shield to cover your eye while sleeping. A pair of plastic, disposable sunglasses will decrease your sensitivity to light as well as providing protection during the day.
It is important that you avoid heavy lifting or straining that would increase the pressure in your eye for several days after surgery. You also must avoid rubbing or pushing on your eye. You should refrain from activities that could increase your chances of getting hit in the eye. Wear your protective sunglasses when outdoors.
You can shower and wash your hair as long as you avoid getting soap or shampoo in your eye. Refrain from using eye makeup, lid liner and mascara for several weeks after implantation. You should avoid public swimming pools, hot tubs or other sources of bacterial contamination for several weeks.
Consult your doctor on recommendations for specific activities.
How often do I need to have my eyes checked after surgery?
Your doctor will advise you as to how often your eyes need to be checked. Typically, the doctor will see you one day after surgery, after 2 to 4 weeks and again around 3 to 6 months after surgery. Thereafter, an annual exam is usually sufficient unless you have a specific problem.
Can I go to any eye doctor for check-ups after the surgery?
Your surgeon and/or his/her staff will want to see you right after the surgery to ensure your eye is healing properly. This includes the first post-operative visit and usually the following visit. After that, the surgeon may allow you to see another qualified doctor to perform your follow-up visits.
You should inform your surgeon if you would like a different doctor to follow-up with you after surgery so he/she can consult with that doctor to ensure a high level of care. You should immediately contact your surgeon if you have problems or any doubts about your eyes after surgery.
Will I also have to have cataract surgery in the future?
Once your natural lenses are removed and replaced with an artificial lens, you will never have to have cataract surgery. Occasionally, several months after the lens has been placed in the eye, the vision may start to become cloudy once again. This is sometimes called a secondary cataract and refers to the clouding of the membrane that surrounds the implant.
This membrane (the capsular bag) originally surrounded the human lens. When the lens was removed, all that remained was this membrane into which the artificial lens was implanted. The membrane healed around the artificial lens, securely holding it in place in the eye. Unfortunately, sometimes the same conditions that can cause a cataract will cause the build up of cells on the membrane behind the implant. These cells will block the vision and have to be removed.
A laser is used to make an opening in the membrane behind the implant, immediately improving vision. This is done painlessly without an anesthetic and takes just a few minutes. Once this is done, no further surgery related to your lenses will be required.
What happens if my eye is injured sometime in the future?
Eye injury can involve many different parts of the eye. The clear front part of the eye, the cornea, and the back part of the eye, the retina, are most often affected by injury.
The presence of an artificial lens does not make the eye any more vulnerable to trauma. Indeed, once the human lens has been replaced by the Crystalens, eye trauma would not cause a cataract.
What will the Crystalens procedure cost? Will insurance cover any of it?
Insurance coverage varies greatly from policy to policy and state to state. Generally speaking, private insurance will only consider covering the surgical procedure and anesthesia if you have a cataract that is affecting your quality of life and may also allow a certain additional amount for the artificial lens implant. The insured is then required to pay a deductible as well as any additional amount above the primary coverage.
If your lens implant is considered elective surgery (cosmetic), most health insurance plans do not cover it at all. However, it may be tax deductible depending on your filing status. Please consult your accountant. If your company has a flexible benefits program, you can usually use this for vision correction surgery.
Your surgeon will review your insurance coverage and your surgical alternatives prior to your implant surgery. It may also be beneficial for you to contact your insurance carrier. Financing options are available to make implant surgery more affordable. For more information about financing, ask your eye doctor.