Cataract Surgery

[TromboneAl]

A friend is about to have cataract surgery. Here are her two questions:


1. Have surgery to correct for distance or near?
2. Have surgery to correct distance in one eye and near in the other?



Anyone have experience with this?

 

[bobandsherry]

A friend is about to have cataract surgery. Here are her two questions:


1. Have surgery to correct for distance or near?
2. Have surgery to correct distance in one eye and near in the other?



Anyone have experience with this?

There is a lens, multifocal, that will let you see far and near. I had my first eye done last week with a newer multifocal lens, Tecnis Symfony, and very happy with results. Can see clearly for distance and as near as about 12 inches. Can now see great for driving and using computer, tablet and phone without need for readers.

Second eye being done tomorrow.

 

[Bestwifeever]

I am hypermyopic and went with distance in both (although I did well previously with contacts corrected for one near, one far). I wanted to be able to drive without glasses with the depth perception of both eyes, and to easily get cheap-o reading glasses. Three years later and I'm happy with this decision.

My doc used Crystalens http://crystalens.com/Portals/14/Downloads/Patient-Brochure-2016.pdf

 

[Red Badger]

Both eyes done. Need readers, but driving and shooting are flawless (I do them at different times, mostly).

 

[W2R]

I went with the standard (cheapest) lenses and chose ones which give you good distance vision in each eye. Before surgery I was nearsighted; but I never minded using readers when wearing my contacts, so readers seemed like a good solution to me.

The improvement in vision has been wonderful. I love having good distance vision out of both eyes for driving, and the peripheral vision when driving is wonderful. However, it's such an individual thing. Your friend should choose according to what she feels most comfortable with.

Even more wonderful - - between Medicare and my insurance, the only thing I had to pay for was eyedrops, at $70/eye. Not one cent more for anything. But YMMV.

Make sure she has a ride home after the surgery, and someone to help her get inside the house and settled down. Frank did all that for me and it didn't take long, but was so very helpful.

 

[SheitlQueen]

A friend is about to have cataract surgery. Here are her two questions:


1. Have surgery to correct for distance or near?
2. Have surgery to correct distance in one eye and near in the other?



Anyone have experience with this?

I haven't had cataract surgery, but I would go with option #2 (monovision) if she doesn't go for multifocal implants. I wear monovision contacts and love them. However, if she has never had monovision I would suggest she try it for a few months with contacts before her surgery. Not every one likes it or can adapt to it.

 

[Moemg]

I haven't had cataract surgery, but I would go with option #2 (monovision) if she doesn't go for multifocal implants. I wear monovision contacts and love them. However, if she has never had monovision I would suggest she try it for a few months with contacts before her surgery. Not every one likes it or can adapt to it.

Great advice ! I had worn monovision contacts so I had monovision lenses implanted and I am so happy . I had the surgery over ten years ago and no problems .

 

[Rascal]

I had mono vision cataract surgery in both eyes about 9 years ago, done at the University of Washington eye clinic. The said they only did mono vision lenses. My good eye came out 20/20, but they could only correct my bad eye to 20/40. I can drive now without glasses and see street signs a block away and the big instruments on the dash without glasses but I have to us reading glasses or progressive lenses otherwise.

 

[braumeister]

Look around, Al. There have been several long threads on this in recent years.

 

[kaneohe]

I had mine done ages ago before the mono-vision lenses were available.
I was working then and most time was spent reading or in lab with microscopes or other work using near vision so I picked 1) for near vision. The side benefit is that you look gorgeous more of the time.

A caution about 2) ...one near eye and one far eye. I have heard that some folks do or did that but I wonder if that works for everyone......not quite the same but after I had the first eye done and corrected for near vision, I took out the lens in the eyeglasses for that eye,so I had one eye corrected for distance vision w/ the eyeglasses and one eye corrected for near vision when driving.
Brain went crazy trying to process 2 different images so I eventually had to cover the good (no cataract) eye while wearing the glasses and accelerated the cataract surgery on the second eye.

I would have similar concerns about the monovision lenses. Although most of the reports here are favorable , there seem to be some cautions that it may not be best for all.

 

[Amethyst]

I was just thinking, "Oh, good, maybe a new thread will uncover some new trends." My cataracts are not yet operable. I so hope that when it is time to have the surgery, the multi-focus lenses will be better than the last cataract thread made them out to be.

Sometimes (like when you're out shopping, hiking, in a museum) readers are kind of inconvenient.

Look around, Al. There have been several long threads on this in recent years.

 

[Alan]

My wife had cataract surgery yesterday on her left eye. She was advised that multifocal lenses with patients that have had RK surgery end up with halos around objects they try and focus on so she is having standard lenses. (She had RK surgery 30 years ago in both eyes).

He is waiting to see how well this new lens works out before doing the right eye which not only had radial cuts, but T cuts as well to correct astigmatism.

 

[donheff]

I would test the solution you want with contacts first to see how it goes. I have used monovision lenses for years and they work great for me. My distance vision has improved to the point that I ony use a single reading lens now. So I would lean toward a close up lens in my bad eye when the cataracts get to that point. But the multi-focal option is interesting. If multi-focal contact lenses that replicate the implant experience are available I would try them first to see if that was a better option.

 

[Amethyst]

I'm moderately nearsighted, have worn multi-focus contacts for many years, and love them.

My hope would be that a truly advanced multi-focal cataract lens, would more closely replicate "real-eye" vision than the contact lens is able to do.

The trouble is that as presbyopia worsens, I can actually see close-up better with the naked eye than with MF contacts (although not well enough to suit me).

My eye Dr. says that if she increases the "add" for close vision, it will diminish the contacts' ability to sharpen my distance vision. I insist on the best distance correction possible. So now it's multi-focal contacts, plus readers, for general use; and naked eye + readers for very close work.

(I know myself well enough to know that one "distance" lens and one "close-up" lens would drive me crazy).

I would test the solution you want with contacts first to see how it goes. I have used monovision lenses for years and they work great for me. My distance vision has improved to the point that I ony use a single reading lens now. So I would lean toward a close up lens in my bad eye when the cataracts get to that point. But the multi-focal option is interesting. If multi-focal contact lenses that replicate the implant experience are available I would try them first to see if that was a better option.

 

[kcowan]

Great advice ! I had worn monovision contacts so I had monovision lenses implanted and I am so happy . I had the surgery over ten years ago and no problems .

Yes me too. 20/30 in left eye in 1995 and 20/20 in right eye in 2000. Standard lens.

 

[Dash man]

My wife had cataract surgery yesterday on her left eye. She was advised that multifocal lenses with patients that have had RK surgery end up with halos around objects they try and focus on so she is having standard lenses. (She had RK surgery 30 years ago in both eyes).

He is waiting to see how well this new lens works out before doing the right eye which not only had radial cuts, but T cuts as well to correct astigmatism.

I am in the same situation as your wife, but not quite ready for surgery yet. I have the additional issue that my RK surgery didn’t heal perfectly and my cornea has bumps where fatty tissue filled the cuts rather than healing flat. It will make cataract surgery a bit more challenging.

 

[Alan]

I am in the same situation as your wife, but not quite ready for surgery yet. I have the additional issue that my RK surgery didn’t heal perfectly and my cornea has bumps where fatty tissue filled the cuts rather than healing flat. It will make cataract surgery a bit more challenging.

The consultant said that the generation that had RK surgery are just now at the stage of needing cataract replacements so the longer you manage to hold off the more data will be collected and the more accurate the equations for calculating new lens requirements.

For my he had 2 different sets of technicians take all the measurements at 2 different hospitals. With the left eye the readings were consistent, but the readings for the right eye were all over the place, so choosing a lens for that one is bigger challenge. He also said that the cuts continue to flatten the cornea for decades afterwards which is why she had 10 years with no glasses and then needed to wear glasses, though nothing like the really thick ones she used to have to wear. Because the corneas are still flattening he said he is aiming for -1 so that over the next x years the eye will move towards 0.

 

[friar1610]

I had my eyes done about 8 years ago so the technology might have improved. The hospital which did mine would NOT do the bifocal lenses. The doc also told me that the clinic did a nice business removing bifocal lenses which had been done elsewhere and replacing them with mono. I personally went for the distance lenses knowing I would have to use glasses for reading. That was the right decision for me.

 

[Teacher Terry]

I am so glad I never had RK surgery. I went with distance in both eyes when I had my surgery last year. I use readers. One eye is 20/20 and one 20/30.

 

[W2R]

I went with the standard (cheapest) lenses and chose ones which give you good distance vision in each eye. Before surgery I was nearsighted; but I never minded using readers when wearing my contacts, so readers seemed like a good solution to me.

The improvement in vision has been wonderful. I love having good distance vision out of both eyes for driving, and the peripheral vision when driving is wonderful. However, it's such an individual thing. Your friend should choose according to what she feels most comfortable with.

Even more wonderful - - between Medicare and my insurance, the only thing I had to pay for was eyedrops, at $70/eye. Not one cent more for anything. But YMMV.

Make sure she has a ride home after the surgery, and someone to help her get inside the house and settled down. Frank did all that for me and it didn't take long, but was so very helpful.

I didn't mention why I chose the distance lenses instead of multifocal or monovision or toric lenses.

Multifocal: My surgeon and his office specialize in cataract surgery. They didn't push this option, and said that they had better results usually with other types of lenses. I had multifocal eyeglasses back in the 1970's and absolutely hated them; I have an unusually long neck, and I needed more fine muscle coordination in my neck than I have, in order to use exactly the right part of the multifocal lens to see whatever-it-is that I want to see. Since I hate multifocal glasses, it was easy for me to say "No!" to multifocal lens implants during cataract surgery.

Monovision: I have never tried this with contacts and I think this would have been disastrous (FOR ME), too. First, I don't think I would ever be able to get used to it because I am so set in my ways. And second, I often get a piece of dust or crud or something blown into my eyes, or stuck in my eyelashes, so when I am driving it would be safer for me to have two functional eyes with distance vision, not just one.

And besides, being so set in my ways, I kind of like using readers since I have always had glasses. They are cheap and I have pretty ones, so no problem. Mostly I just wanted to drive without glasses so that I could get the great peripheral vision on both sides. To me, that makes all the difference in the world. That said, I don't mind readers at all for reading, the computer, and so on.

Toric lenses for astigmatism: I really wanted these! I had even more astigmatism than nearsightedness. But my surgeon said that his tests showed my astigmatism was due to the cataracts themselves and would vanish once they were removed. I was skeptical since I have had really bad astigmatism since I was a teen or earlier, but reluctantly went for the regular lenses instead of toric because they were adamant about it.

 

[Walt34]

2. Have surgery to correct distance in one eye and near in the other?

Anyone have experience with this?

I've been this way naturally since about fourth grade - very nearsighted in the right eye but correctable to 20/15 (go figure) and until I was in my forties the left eye was 20/20, now I think 20/40.

So I only wear contact lenses or glasses when I have to drive somewhere, and I find this very convenient. I don't have to use reading glasses unless I'm wearing the contact lenses.

 

[bobandsherry]

Multifocal: I had multifocal eyeglasses back in the 1970's and absolutely hated them; I have an unusually long neck, and I needed more fine muscle coordination in my neck than I have, in order to use exactly the right part of the multifocal lens to see whatever-it-is that I want to see. Since I hate multifocal glasses, it was easy for me to say "No!" to multifocal lens implants during cataract surgery.

I've never heard of multifocal glasses. Are you talking about bi or tri focal?

I can't speak for all multifocal lens, but with the Tecnis Symfony lens it's nothing like what you describe. You don't have to do anything, the focal points are seamless. I'm typing this on my phone and look to TV, all one fluid motion, no movement in my head, neck or anything else.

I had LASIK 13 years ago and traded far sightedness for beibg nearsided, while it was ok I was ready to give up readers now with the multifocal. Going with Tecnis multifocal was right decision for me given my lifestyle. So much now is done on phone, laptop and tablet, not needing to grab a reader to use them is great. As is seeing a menu now when I go out to eat. But I understand everyone has different perspective on what works for them.

 

[W2R]

I've never heard of multifocal glasses. Are you talking about bi or tri focal?

I can't speak for all multifocal lens, but with the Tecnis Symfony lens it's nothing like what you describe. You don't have to do anything, the focal points are seamless. I'm typing this on my phone and look to TV, all one fluid motion, no movement in my head, neck or anything else.

I had LASIK 13 years ago and traded far sightedness for beibg nearsided, while it was ok I was ready to give up readers now with the multifocal. Going with Tecnis multifocal was right decision for me given my lifestyle. So much now is done on phone, laptop and tablet, not needing to grab a reader to use them is great. As is seeing a menu now when I go out to eat. But I understand everyone has different perspective on what works for them.

Glad you found an individual solution that worked for you!

That said, as I'm sure you must know, a substantial percentage of those who do just fine with bifocals do not ever successfully adjust to progressive/multifocal glasses. Many famous and wealthy people wear bifocals; even Bill Gates IIRC.

 

[bobandsherry]

Glad you found an individual solution that worked for you!

That said, as I'm sure you must know, a substantial percentage of those who do just fine with bifocals do not ever successfully adjust to progressive/multifocal glasses. Many famous and wealthy people wear bifocals; even Bill Gates IIRC.

A progressive lens in eyeglasses is nothing like the Tecnics IOL lens implanted for cataract surgery.

 

[MRG]

It's funny. I went with a monovision option after my first surgery. Doc said OK and my second eye was done for reading. I still use cheaters for heavy reading but go without them for every day stuff. I'd never heard of monovision before and definitely didn't try it.

Our brains are marvelous things that will adapt. When I was a kid getting glasses every year was horrible(I was very near sighted with astigmatism) for a couple weeks but eventually your brain adjusts. My brain adjusted in a day!