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AcrySof ReSTOR Lens - CRYSTALENS, ReSTOR LENS & OTHER SURGICAL OPTIONS TO CORRECT PRESBYOPIA
AcrySof® ReSTOR® Apodized Diffractive IOL
What is the ReSTOR Lens?
The AcrySof ReSTOR Apodized Diffractive Intraocular Lens is the most recent innovation in lens implant technology. The ReSTOR lens is implanted in the eye as a lens replacement at the time of cataract surgery or refractive lens exchange. The best candidate is the individual who is 45 or older who is dependent on glasses and/or contacts to see near, far and in-between.
How does it work?
The AcrySof ReSTOR IOL replaces the natural lens and is implanted into the eye in a procedure identical to cataract surgery. It has a patented apodized diffractive optic design that works like a bifocal lens inside the eye. For long-distance vision, the ReSTOR lens creates a clear image of the far away object while at the same time a second, highly defocused image is created for near vision. For near vision, the ReSTOR lens creates a clear, sharply focused near image and a second highly defocused far away image This apodized diffractive optic design gives it the ability to provide clear vision near, far and in-between without mechanical movement of the lens.
What is unique about ReSTOR?
The lens has the ability to consistently offer patients improved vision at a range of distances, from close-up to middle and far. Because ReSTOR doesn’t work with the muscles of the eye, it is not dependent on a mechanical process or the movement of the lens to give clear vision.
The ReSTOR lens is similar to two lenses in one. One, a refractive lens is for distance, the other, an apodized diffractive lens is for near vision. This gives ReSTOR more consistent results and more satisfied patients who can enjoy activities like reading, sewing, playing cards or looking at the fine print, all without the hassle of reading glasses, bifocals, progressive lenses or contact lenses.
When is it used?
The AcrySof ReSTOR IOL is used in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased independence from glasses following cataract or lens replacement surgery. Anyone who has a normal eye exam and is dependent on reading glasses or bifocals may be a candidate. Although ReSTOR lenses are a breakthrough technology initially approved for cataract patients with or without presbyopia, it is not necessary to need cataract surgery to qualify for the ReSTOR lens, just a desire to experience the benefits of the lens.
What will the ReSTOR Lens accomplish?
The AcrySof ReSTOR IOL has been shown in a clinical study to provide good near, intermediate and distance vision with increased independence from glasses in patients who have undergone cataract surgery.
When should it not be used?
There are no known contraindications. However, based on the FDA clinical trials, Alcon, the lens manufacturer, has indicated the following types of patients possibly should not have the AcrySof ReSTOR Apodized Diffractive IOL:
- Individuals that are hypercritical with unrealistic expectations
- Individuals with excessive complaints about their prescription
- Individuals who drive at night for a living or whose occupation or hobbies depend on good night vision
- Individuals who are amateur or commercial airline pilots
- Individuals who have life-long complaints about glare
- Individuals who are happy wearing glasses
- Individuals who want guarantees on surgical outcomes
Clinical Results
The FDA-approved AcrySof ReSTOR is a breakthrough in intraocular lens technology for most people with cataracts, with or without presbyopia, that may restore more youthful vision. Results from a controlled clinical study of the AcrySof ReSTOR IOL revealed that maximum visual performance is achieved when the ReSTOR lens is implanted in both eyes. Benefits are apparent with individuals in whom the lens is used in only one eye as well. Clinical data demonstrates that AcrySof ReSTOR IOL greatly reduces dependence on glasses or bifocals:
- 80% of patients reported that after lens implant surgery with ReSTOR lenses, they never needed glasses or contact lenses to see clearly at all distances near, far and in-between.
- 99% of patients could see well enough to drive a car without glasses or contacts
- 97% of patients could read the newspaper without reading glasses or bifocals
- 90% of patients could shave or put on makeup without glasses or contacts
- 80% of patients NEVER wear glasses for any activities
Everyone’s focusing ability is different. Most people will be able to see clearly in the distance, have very good reading vision and functional intermediate vision without glasses, but some people may be more comfortable with additional correction, particularly at night or in dim light or for long periods of computer work. After surgery with the ReSTOR lens, it may be necessary for some people to wear glasses for distance, intermediate and/or near vision to obtain optimal visual acuity. The difference from standard lenses is that most people will not be as dependent on these supplemental vision aids to function normally.
Who is a good candidate for the ReSTOR IOL?
Virtually everyone who has cataracts and/or presbyopia (loss of ability to refocus vision noticed after age 45) and is in good general health may be a candidate for refractive lens exchange and/or cataract surgery with the ReSTOR lens or the Crystalens. During your eye exam, we will determine if there are pre-existing conditions that would make lens replacement surgery with the ReSTOR and/or Crystalens not advisable. People who have had prior corneal refractive surgery (i.e. LASIK, IntraLASIK, RK or PRK) may be acceptable candidates for ReSTOR implantation as long as their eyes are in good health. After a thorough examination, we will be able to better advise you if you qualify for the ReSTOR implant. Also individuals with more extreme levels of nearsightedness or farsightedness may be better candidates for lens replacement surgery with the Crystalens and/or the ReSTOR lens than laser vision correction. If you’ve already had cataract surgery, you may still be a candidate for the ReSTOR lens. In some situations, a ReSTOR lens can be inserted in front of your existing fixed-focus lens implant in what is known as a piggyback lens configuration. Having a piggyback ReSTOR lens would be a way to upgrade your fixed focus vision to better vision near and far as if the ReSTOR lens had been inserted at the time of your original cataract surgery.
What can I expect after the procedure??
Similar to other lens implant procedures, you can expect your vision to be improved the day following surgery. There is minimal discomfort after surgery that usually resolves within hours. Most individuals can return to a normal work schedule/routine the day after surgery.
How soon after the procedure will I be able to see at varying distances??
For most patients, near vision is good the next day, and improves over the following week. Results are best when both eyes have ReSTOR lenses implanted.
How many patients are 100% glasses free after having the ReSTOR Lens implant?
The results are very good. After having ReSTOR Lenses implanted to both eyes, 80% of patients say they never wear glasses.
When did the ReSTOR receive FDA approval?
March 23, 2005. It has been approved for use in Europe since April 4, 2003.
What are the risks of lens replacement surgery with the ReSTOR Lens implant?
Lens replacement surgery is identical to cataract surgery and results in safe and successful outcomes in approximately 98% of eyes treated. Like any surgical procedure, there are risks. During your visit the risks, benefits and surgical alternatives will be discussed with you. Fortunately, cataract surgery is one of the most common and safest surgical procedures performed in the US today with 2.7 million procedures performed annually. Additionally, individuals who are planning to receive the ReSTOR lens may need additional surgery to “fine-tune” their vision. These procedures may be done before, during or after their ReSTOR lens is inserted. In rare instances a monofocal lens implant may be used during surgery rather than the ReSTOR.
Is this a reversible procedure?
Once the natural lens is removed, it cannot be replaced. However, if one is over 40 and dependent on reading glasses or bifocals, the lens is already not normal. It has lost its accommodation ability. If the patient desires, the ReSTOR lens implant can be removed and replaced. In the US arm of the FDA Clinical Trials for ReSTOR, no patient requested removal of the lens because the benefit of a full range of vision outweighed their complaints of visual disturbances. The only medical indication for lens replacement is if the lens power needs to be changed to help distance vision.
Is the Lens more effective than other lens implants?
The ReSTOR lens is like two lenses in one. One refractive lens is for distance, and the other one, a diffractive lens, is for near. ReSTOR is not dependent on the movement of the lens but has a unique Apodized Diffractive optic that is new to IOL design. The optical design of the lens distributes light between near vision and distant vision to accommodate vision at a range of distances. The ReSTOR lens does not rely on movement of the lens implant inside the eye to produce clear near and far vision. Standard monofocal (fixed-focus) lens implants provide excellent vision after cataract surgery. With a standard lens implant, most individuals will need bifocal glasses and/or contacts to have clear vision near and far. With the restor and/or crystalens, you have the opportunity to see near and far seamlessly without glasses and have more youthful vision. Both the ReSTOR and the Crystalens implants work well in properly selected individuals. Still each lens implant has it’s relative strengths and weaknesses. The advantages of the ReSTOR lens over the Crystalens: 1) in some individuals, the ability to see very fine print up-close will exceed the near vision of the Crystalens, 2) FDA studies show that 80% of patients who have ReSTOR lenses in both eyes “never” wear glasses for any tasks on a daily basis. The disadvantages of the ReSTOR lens in comparison with the Crystalens: 1) intermediate (mid-distance) or computer vision distance vision with the Crystalens has been proven to be better with the Crystalens than the ReSTOR, 2) there is a 5% chance of severe nighttime glare and halos with the ReSTOR that may make night driving difficult…..night vision problems with the Crystalens are much less than the ReSTOR lens.
How much does the presbyopia surgery with ReSTOR Lens cost?
Implanting the ReSTOR IOL is a high-precision procedure requiring the skill of a highly trained ophthalmic surgeon. The global fee for the ReSTOR lens replacement/cataract surgery is $5,000 per eye. This fee includes the surgeons fee, ReSTOR lens implant, operating room fee and intraocular lens adjustments that may be needed during the peri-operative period. Most private medical insurances and Medicare will not cover the costs associated with surgery using the Crystalens or ReSTOR lens. Because use of the ReSTOR lens is not a "medical necessity," patients receiving the ReSTOR will be responsible for payment of the surgery, lens implant and surgery center charges. However, in some instances for patients with visually significant cataracts, your private medical insurance and/or Medicare may pay for cataract surgery but not the costs associated with the upgrade to the ReSTOR, Crystalens or any of the multi-focal lenses that we offer.. If you have private medical insurance or Medicare and have a visually significant cataract and wish to have the Crystalens, ReSTOR or any of our premium lenses then your fee may be as low as $2500/eye for upgrading to one of these deluxe lens implants with your cataract surgery. Monthly payment programs are available via an outside financing company which make the surgery more affordable. To apply for financing, you may call Care Credit 1-866-893-7864 or apply online at www.carecredit.com Cost is an important consideration, but surgeon experience with lens replacement surgery, personalized attention before and after your procedure, and the technology used are the most important factors in determining how well you see after surgery.
What is the difference between the ReSTOR Lens and a standard Intraocular Lens (IOL)?
The ReSTOR lens allows for continuous vision up close, far away and at all distances in between, in most cases with patients experiencing the same vision they had when they were younger, without the inconvenience of corrective lenses. In contrast, standard (single vision, fixed focus) lens implants provide vision at a fixed distance and do not have the ability to provide a full range of near, intermediate and far vision. Most people with single vision implants must wear glasses for near vision and may need to wear glasses for intermediate/arm’s length vision as well.
If I've had LASIK or INTRALASIK, can I still be a candidate for Crystalens and/or ReSTOR Lens?
Yes. People who have had prior corneal surgery are acceptable candidates for Crystalens and/or ReSTOR lens implantation as long as their eye is in good health. Consult with your ophthalmologist to understand the issues associated with use of the Crystalens and/or ReSTOR lens after previous laser vision correction
For more information, about the ReSTOR lens visit www.acrysofrestor.com. For more information about surgical vision correction with the Crystalens, visit www.crystalens.com or schedule a free consultation with our doctors at MidWest EyeCenter or attend one of our monthly surgical vision correction seminars.