Crystalens® is an accommodating intraocular lens implant
which is used to provide a continuous range of vision for
far away, intermediate, close-up distances. It turns back
time by minimizing the eye's natural process of accommodation
and reducing or eliminating your dependence on contact lenses,
bifocals or reading glasses.
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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
Complimentary consultations are available to find out if Crystalens®
is right for you. 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. If you have already had cataract
surgery, you are not a candidate for the crystalens procedure.
Learn why thousands have trusted the Key-Whitman Eye and Laser
Center for caring service and excellent surgical results.
For more information about any of these life-changing services,
please email patientservices@keywhitman.com.
Or to schedule an appointment, you may call .
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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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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 implant put in both eyes?
Typically cataracts will develop in both eyes. If only one eye
has a cataract, only one implant is necessary. If both eyes have
cataracts and the vision in one eye is worse, the surgeon will elect
to implant that eye first. If both eyes are the same, the surgeon
usually starts with the ‘non-dominant’ eye.
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.
Complimentary consultations are available to find out if crystalens
is right for you. Learn why thousands have trusted the Key-Whitman
Eye and Laser Center for caring service and excellent surgical results.
For more information about any of these life-changing services,
please email patientservices@keywhitman.
To schedule an appointment, you may call or schedule
your consultation online.
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