Crystalens® Overview

When talking about their vision, most people over the age of 45 "focus" on the loss of near vision generally associated with presbyopia or "aging eyes." What they may not realize is that, in addition to developing cataracts, the inevitable progression of presbyopia weakens the ability of the lens to focus in the field of vision that begins at our fingertips - known as intermediate vision. And, until now, this field of vision that has become the most important for today's active Boomers was severely compromised.

As it turns out, we live most of our "visual lives" in the intermediate range of distance between 26 and 32 inches. In fact, most of our daily lives are lived in the intermediate, also known as "lifestyle vision." Activities falling within our "lifestyle vision" include:

• Reading facial expressions during a conversation across a table or desk
• Seeing products and prices while walking down the grocery aisles
• Using a computer keyboard and looking up at the monitor
• Reading the speedometer and other dashboard gauges while driving
• Putting a golf ball on the tee
• Baiting a hook for fishing
• Shaving or putting on make up
• Playing billiards or cards
• Seeing what is on the dinner plate - and the silverware to use to eat it
• Writing a letter or checks to pay bills
• Brushing a child's hair
• Playing the piano
• Measuring ingredients for cooking and baking
• Ironing clothes
• Dialing a cell phone or using a hand-held computer

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Benefits

For those struggling with presbyopia and cataracts, there is a new option to the traditional, standard IOLs used to replace the eye's natural lens: the Crystalens®. As the most advanced intraocular lens available, the Crystalens® is the only accommodative, or naturally focusing, lens available today. Standard IOLs are "fixed" within the eye and correct vision at a single focus (usually distance). Multifocal lenses, first introduced in 1998, add near vision to the picture but also neglect the intermediate field of vision. The Crystalens® IOL is the clear choice for patients seeking to not only preserve their intermediate vision, but have a continuous range of vision:

• Clinical data show that 100 percent of Crystalens® patients had good intermediate vision (26" to 32").
• The FDA safety and effectiveness clinical data on the most recent multifocal IOL lenses shows that at a distance of 70 cm (27.5"), the percentage of eyes achieving 20/20 or better uncorrected vision and 20/25 or better distance corrected vision was "significantly worse" than the control group.
• Multifocal lens technology is based upon splitting light rays between distances to emphasize near and distance vision while providing little or no support for intermediate vision. Consequently, the vision provided by multifocals is stepped, requiring patients to overcome a gap in their range of vision.
• The Crystalens® uses the natural focusing muscles to accommodate the full range of vision. As a result, 100 percent of the light rays are focused at each distance so patients see clearly near, far and everything in between.

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Results & Candidacy

Risks & Complications

The contemporary treatment for cataracts is to remove the crystalline lens and replace it with an implantable lens. The Crystalens® represents the state-of-the-art in implantable 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 cataract surgery performed annually on over 7 million eyes 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 cataract 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. These and other complications may occur as a result of the removal of a cataract, whether or not an intraocular lens is implanted, and may result in poor vision, total loss of vision, or loss of the eye. Dislocation of the lens and the need for additional surgery, such as lens removal and replacement are also possible risks of the procedure. In addition, 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 indicates that 98% of people have no complications after cataract surgery and more than 95% have improved vision. The trusted medical team at Key-Whitman Eye Center will perform a thorough examination and fully inform you of any increased risk of a complication.

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Fees & Pricing

What will vision correction cost me? Laser Vision Correction - LASIK surgery, Lens Replacement, or Cataract surgery procedures have varying prices based on a number of factors. During your consultation and complete eye exam, the Key Whitman Eye Center will offer the best recommendation for vision correction based upon your results. We want to help you make the best, informed decision for eye surgery to reduce your dependency on glasses and contacts.

At Key Whitman, our goal is to provide to you, as a lifelong patient, the very best in care and results. We offer advanced technology, tested and proven to be the safest and most effective. Our caring surgeons and professional staff are recognized throughout the Metroplex for their exceptional skills, credentials and training. You will feel the warmth and concern of health care providers who will make your experience pleasant and rewarding.

Q: So how do some clinics charge as little as $299/eye for LASIK? Typically, you get what you pay for. Comparing LASIK vision correction technology, LASIK eye surgeon experience and LASIK surgery outcomes (patient results), you will understand why Dr Whitman was honored in D-Magazine as 'Best in Dallas' for 11 straight years. Our competitive pricing most often meets or is less than any reputable competitor in this market with all-laser blade-free matching technology and we offer a Lifetime Enhancement Guarantee. Vision Correction Costs - a price will be quoted to you following your in-office exam & consultation that is payable in full or in part via credit card (airline miles!?), cash and/or through financing. Insurance? Call us to see if your vision plan offers discounts on LASIK (some offer 15% discount off our price). For cataract surgery, our doctors and surgery center participate in most major medical insurance networks. Payment Plans - We offer payment plans through Care Credit that can help you pay for your vision correction procedure with options for interest free up to 2 years or in smaller payments in up to 60 months. Medicare? Yes - we take assignment with Medicare - Key-Whitman will file your cataract surgery procedure with Medicare. Flex Spending Accounts? Have vision correction and submit your claim through your pre-paid Flex Spending account. Most programs will reimburse you immediately (up to your designated commitment level), giving you an entire year to pay (one paycheck at a time) but more time to enjoy your vision! Check with your benefits coordinator with your employer for more details. Tax Refund? Yes - save your refund or apply your refund to your laser vision correction! We cannot think of a better way to invest in your future. Why wait? Invest in yourself now. Call or schedule your consultation online today!

D-Magazine Best in Dallas (pdf)

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FAQ

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.

Should I have the Crystalens®HD® implant put in both eyes?

Your doctor will look at a number of factors in deciding which eye to implant first and when, if necessary, 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 will 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 you may be administered medications 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 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 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. You may need to wear reading glasses to help you read during this time.

After about 2 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 cataract 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 can be done if my implant does not provide sufficient focusing power?

There are various reasons why the power of your implant may not be sufficient to provide you with a continuous range of vision, including, but not limited to, measurement error, prior refractive surgery, e.g., LASIK, RK. In these cases, your doctor will decide the best course of treatment, which may include additional surgeries, such as removal and replacement of the Crystalens® implant.

What about glare, problems driving at night and sensitivity to light? Can implant surgery create these problems?

These symptoms are much less likely to occur with Crystalens® than any other presbyopia-correcting lens. These symptoms can be produced or exacerbated by cataract surgery. Many people report these problems before cataract 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.

Will I have to have cataract surgery again?

Once your cataracts are removed and replaced with an implantable lens, you will never have to have cataract surgery again. 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 cataract 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 caused the original 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 cataracts will be required.

I have dry eyes. Will lens implantation help this condition or will I still have to use artificial tears?

Implant surgery typically will have very little influence on chronic dry eyes. This condition is related to a variety of internal and external medical conditions and is sometime associated with aging. You should consult your doctor on a therapy that is most suited to the cause and severity of your condition as well as your lifestyle.

What will the Crystalens® procedure cost? Will insurance cover any of it?

Since each patient's vision is different and unique, the cost for the Crystalens® procedure will vary. Insurance coverage varies greatly from policy to policy and state to state. Generally speaking, private insurance may cover the cataract surgical procedure and anesthesia 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. (Some patients are completely responsible for payment - not all insurance companies will cover some of the patient cost).

Payment for conventional IOLs furnished in an outpatient setting is covered by Medicare. However, providers have generally not offered beneficiaries presbyopia-correcting IOLs because the costs for this advanced technology substantially exceed Medicare's payment.

A Medicare beneficiary may request insertion of a presbyopia-correcting IOL in place of a conventional IOL following cataract surgery. In this case, the presbyopia-correcting IOL device and associated services for fitting one lens are considered partially covered by Medicare. The beneficiary is responsible for payment of that portion of the charge for the presbyopia-correcting IOL and associated services that exceed the charge for insertion of a conventional IOL following cataract surgery.

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The Key-Whitman Advantage

We uniquely offer the convenience of the Doctor's office, the Outpatient Surgery Center and Optical Shop all under one roof. To better serve your needs, we have offices in Dallas, Plano and Arlington and accept Medicare, Medicaid and most insurance plans.

The Key-Whitman Eye Center provides free parking near the front door. Special facilities, parking spaces and wheelchairs are available for the disabled.

Contact us for more information about our life-changing services or to schedule an appointment, you may call .

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To consult with our laser eye doctors & surgeons, please contact Key-Whitman Eye Center.