Cataract Surgery...which type of lens?

[TrvlBug]

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Originally Posted by donheff I'm in pretty much the same situation. I wasn't aware of any issues but my eye doc noted that I have a cataract in one eye. I currently wear monofocal contacts and like them so I would probably opt for staying with that approach with cataract surgery. Once you get into your 70's (still five years away) are there any issues with postponing too long? E.g., does it make sense to have the surgery while you are relatively young and healthy rather than waiting into your 80's?

This is one of the questions on my list. The cataract in my left eye is very small and stable, however, will need surgery at some point in time. Depending on the result of the surgery in my right eye and the cost, I may elect to give myself a b'day or Christmas present by covering the cost for the other eye! One of my concerns is surgery as I get older. In general, the younger your are, the better recovery is and I assume this also holds true for cataract surgery. I'll let you know what he says.

[rescueme]

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Originally Posted by Amethyst ...I could not see my road markings due to the oncoming glare.

That's what drove me to have my eyes checked, resulting in my first operation. Every oncoming car looked like they had their high beams on.

Of course, when I flicked my high beams on to tell them to turn their headlights onto low beam, they turned on their high beams and I could see nothing (of the road) ...

As far as your age when you get the operation? I don't think it matters since it's handled on an outpatient basis. The PIA portion is using the eye drops a few days before the operation and for a few weeks after (keep your lid colors straight! )...

[Amethyst]

Thanks, TrvlBug. I will see how it goes once I retire, and can night-drive during non-rush-periods. I don't have an issue (yet) when it's just a few cars, but during the madhouse hours, I'm definitely getting the "starburst" effect you mentioned. Painful.

Thanks to OP for starting the thread, and to everyone who's contributed.

Amethyst

[TrvlBug]

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Originally Posted by Gotadimple Some eye doctors have a special camera that takes digital pictures of the inside of the eye. My eye doctors uses something called Optimap. It is not covered by insurance, but the cost is reasonable - $39. It lets him see, and keep a record of the changes in your eyes. You also then don't have to have your eyes dialated so he can see the inside. -- Rita

My optometrist also uses this and he makes a big show of comparing last year's results to this year's. It is very limited in what it shows. The only reason I do this is so I don't have to have my eyes dilated. It does not show cataracts or other eye diseases. Only an ophthalmologist has the equipment and training to detect and diagnose cataracts.

In fact, I'll be looking for another optometrist. My hubby does not particularly like this one as he always pushes new glasses, most of the costs of which insurance doesn't cover. Additionally, there have been other instances where we have questioned his ethics, but as we've always thought he was competent, we've decided to stay with him. With my cataracts, we feel because of my complaints, he should have referred me to an ophthalmologist rather than 'waiting to see how my eyesight progresses.' I like being fashionable with my glasses and his office has always benefited to the tune of approx. $600/yr beyond what the insurance would cover... well, this CASH COW has left the barn.

But I digress, back to cataract discussions...

[TrvlBug]

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Originally Posted by braumeister Both eyes were done this year (Feb and March). Background: I've been extremely nearsighted all my life, so wearing glasses all day has been natural to me since age 6. My cataracts started about 15 years ago, and developed so slowly that they were merely an annoyance for most of that time. Then a little more than a year ago, they suddenly went into overdrive and I was having major difficulty reading highway exit signs. Off to the doc! My research made me apprehensive about the multifocal lenses, because so many people seemed to have night vision problems (rings/halos around lights) and other minor complaints. I opted for the straight monofocal lenses and am glad I did. Right out of the gate I had 20/20 vision for everything beyond my arm's reach. With my history, that has been an incredible treat! For closer distances, I can read many things if the print is big enough, but cheap drugstore readers do the job perfectly in all cases. I keep several pair around (different rooms of the house, car console, garage). It's a tough decision, because there isn't any way to "test" what your vision might be like with multifocal lenses, so you just have to go with your gut. FWIW, my ophthalmologist confided that he would do the same as I did, so he obviously wasn't trying to upsell me me on the expensive choice. Find a really good doc who specializes in this surgery and start looking forward to your new bionic eyeballs.

Braumeister, did you opt for one eye near and one far or both far? Initially, I was leaning to multis, but the more info I get, the more I think one far and one near (eventually) might be a better option for me. Like you stated, it's not something you can test drive and there are no do-overs, so I'm hoping for as much first hand info as possible.

[braumeister]

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Originally Posted by TrvlBug Braumeister, did you opt for one eye near and one far or both far?

I decided to have both eyes set for distance only. I'm very happy with my decision, but remember that I have always worn glasses so using the readers for close work doesn't bother me a bit.

As to when to get the surgery, my regular ophthalmologist always told me that the criterion was when the cataracts reached a point that I no longer had satisfactory vision, and I was the only person who could define "satisfactory."
When I began having trouble with highway signs in the daylight, that was the trigger for me.

[Options]

Having had 20/20 vision for most of my life, I can remember exactly where I was and what I was doing when I had trouble reading. That was about 16 years ago. Since then, I progressed to reading glasses only at certain times to now something a foot away from me with large letters is blurry. In the last couple of years I've begun to notice that just about everything is not totally clear without reading glasses (people are much better looking without glasses on, too!).

Early next year, in preparation for FIRE, plan on seeing the ophthalmologist to learn what corrections need to be done.

[Gatordoc50]

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Originally Posted by haha I think ophthalmologists are about as trustworthy as dentists. 10 years ago one told me that I had small opacities in each lens. Since then I have been to two others, each says no sign of cataracts. So maybe get a second opinion. Ha

I think people are less trusting now than when I first started practicing. This poll still puts the medical/ dental professions at the top but we are slipping down with the rest of you, that's for sure.
http://www.gallup.com/poll/1654/hone...ofessions.aspx

[JakeBrake]

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Originally Posted by braumeister I decided to have both eyes set for distance only. I'm very happy with my decision, but remember that I have always worn glasses so using the readers for close work doesn't bother me a bit. As to when to get the surgery, my regular ophthalmologist always told me that the criterion was when the cataracts reached a point that I no longer had satisfactory vision, and I was the only person who could define "satisfactory." When I began having trouble with highway signs in the daylight, that was the trigger for me.

+1
My ophthalmologist says that everyone my age (68) has cataracts and only I can decide when to do something about them.

I've worn glasses as long as I can remember, but only when I want to see something. I know my glasses have saved my eyes several times from things like battery acid, hot anti-freeze, and airborne objects.

[UtahSkier]

I'm 51 and had elective cataract surgery just last May. I researched a lot of the available options and I think it is very important to know what you want and what you are willing to risk.

In the end, I decided I wanted the best possible distance vision even if I had to utilize reading glasses.

The other options offer hope that your vision will be good in all situations. But, I think that reality only happens for a few individuals. Correcting for really good distance vision is hard enough with a standard IOL. All the other options increase complexity and reduce your likely hood of being satisfied with the results.

In my case, I opted for distance vision correction for both eyes. My surgeon uses all the latest tools. For my right eye, I remember his dialog during the procedure stating that the pre-op lens selection was a 9.5, but the real time measurements after the natural lens was removed recommended a 10.0 lens. The DR stated he was inserting a 10.0 lens and my right eye is perfect.

My left eye is a bit different. Where as my right eye only required standard vision correction, the left eye required a toric lens to correct astigmatism. I went through the same procedure with the same surgeon. The result is not bad, but not perfect. The analysis is the eye is 1/2 diopter out of focus.

Why did this happen? Most likely the lens did not heal in the exact location where expected. My surgeon is willing to fix this with lasik for no charge, but I'm not going to pursue that option.

Driving and distance vision is fine. Around the house I need glasses for reading and computer work. The only problem I have is seeing menus and the bill at restaurants. I found a helpful magnifier for my android phone that solves that problem.

[TrvlBug]

Just got back from the doc's and am currently leaning towards mono, one near (my current 'good' eye) and one far (the one needing surgery). If my brain can't handle it, I'll have the 'good eye' also set for far. It has a small cataract and it's just a matter of time before it needs surgery.

This doc contradicted the other one in that he says there is no criterion that has to be met for insurance purposes. If he says it's needed, they'll cover. His view is the same as my other doc's, in that if it interferes with his patient's wellbeing, he would advise the surgery.

I also asked him about surgery at a later age. He stated no problems and recovery is the same. The only issue might be if surgery is delayed too long and the cataract gets too dense. He's performed surgeries on people in their 90s.

More thinking to do as I would really like the multis but am concerned with the cons.

[bssc]

As a followup, my Mom just had the same surgery at 81 since it wasn't as bad. It went well and six month latter is seeing much better.

Also, I just woke up earlier and started looking for my glasses even though I could see perfectly. Old habits are hardwired.

[Gatordoc50]

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Originally Posted by TrvlBug Just got back from the doc's and am currently leaning towards mono, one near (my current 'good' eye) and one far (the one needing surgery). If my brain can't handle it, I'll have the 'good eye' also set for far. It has a small cataract and it's just a matter of time before it needs surgery. This doc contradicted the other one in that he says there is no criterion that has to be met for insurance purposes. If he says it's needed, they'll cover. His view is the same as my other doc's, in that if it interferes with his patient's wellbeing, he would advise the surgery. I also asked him about surgery at a later age. He stated no problems and recovery is the same. The only issue might be if surgery is delayed too long and the cataract gets too dense. He's performed surgeries on people in their 90s. More thinking to do as I would really like the multis but am concerned with the cons.

I read your post to my Optometrist daughter and she feels you are getting good direction.One consideration would be the ability to get a multifocal for the good eye at a later date that works well with the current one. And you will need glasses in the interim. I think I got that right. She feels you should go with the monovision unless you can afford to do both eyes in multifocal right now. ( if the surgeon would even do it.)

[Amethyst]

TrvlBug, I'm not sure I follow you. Wouldn't this involve a second surgery to replace the first artificial lens with another one? I didn't know there were do-overs in lens replacement.

Amethyst

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Originally Posted by TrvlBug Just got back from the doc's and am currently leaning towards mono, one near (my current 'good' eye) and one far (the one needing surgery). If my brain can't handle it, I'll have the 'good eye' also set for far. .

[TrvlBug]

Quote:

Originally Posted by Amethyst TrvlBug, I'm not sure I follow you. Wouldn't this involve a second surgery to replace the first artificial lens with another one? I didn't know there were do-overs in lens replacement. Amethyst

Sorry for the confusion...currently I am nearsighted, requiring glasses only when driving. I see well enough to do without glasses around the house, having bought 60" TVs so that I can watch TV w/o glasses . My right eye, the one with the cataract needing surgery, is causing me nothing but problems, especially with reading, which I do a lot of. I am currently leaning towards mono far vision for that eye. This would hopefully result in my brain making the adjustment and allowing me to go without glasses, using my current nearsightedness in my left eye to read and the 'new' farsightedness in the right (surgery) eye to see distances, thereby allowing me to effectively toss my glasses. Hope this makes sense.

Although now I'm leaning towards multis . Just got back from a short vacation and need to do some more thinking. Just before my doc appt, I freaked out reading a lot of negative info on the internet from people who got the multis and had nothing but problems with them. But the info I'm receiving here, from another forum, as well as the surgeon, indicate that people are happy with the multis. This past week I really paid attention to the halos, rings, and starburst I am currently experiencing with the cataract, both during the day and night (with DH driving). They generally don't bother me that much. What really bothers me is the degradation in vision I am experiencing when I read, which I something I love to do and do a lot of.

Fortunately, I don't have to make the decision tomorrow, but I do want to do so ASAP.

[braumeister]

Although I'm quite happy with my monofocal lenses, I saw my family doctor the other day and he commented that he got the multifocal ones last year. He's happy with them, despite a little trouble with driving at night.

As someone mentioned above, everyone has their own level of tolerance for accommodation.

[TrvlBug]

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Originally Posted by Gatordoc50 I read your post to my Optometrist daughter and she feels you are getting good direction.One consideration would be the ability to get a multifocal for the good eye at a later date that works well with the current one. And you will need glasses in the interim. I think I got that right. She feels you should go with the monovision unless you can afford to do both eyes in multifocal right now. ( if the surgeon would even do it.)

Gatordoc, Why does your daughter think I should go with the multis? I'm leaning in that direction now and frankly, have been since day one. $ is not the issue, only making the best medical decision for my needs. I've been wearing glasses since my early teens and would love to throw them away, knowing I would still need readers in low light and very small print situations.

My doc says that whatever I decide to do for the 'bad' eye, if after that point, I don't have optimal results, he is comfortable with performing surgery in my 'good' (the one with the teeny cataract). As I stated earlier, it's not a matter of if, but when for that eye. Given that the 'bad' eye's cataract went into overdrive from Jan. to now to the point where I can't see with my new prescription, the same could easily happen with the 'good' eye.

[Amethyst]

Don't know how relevant this is to our discussion, but I have multi-focus rigid-gas-permeable contact lenses, and I love them. Had no problems adapting to them, so I wonder if that may translate to being able to adapt to multi-focus artificial lenses. Next time I see my ophthalmologist, I'll ask her opinion.

I am moderately nearsighted, and the lenses correct well for distance and astigmatism. They are less effective for close-up; indeed, I see better close-up with my natural vision; but at some point, everything about aging is, at bes, a compromise.

Amethyst

[nwsteve]

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Originally Posted by Amethyst Don't know how relevant this is to our discussion, but I have multi-focus rigid-gas-permeable contact lenses, and I love them. Had no problems adapting to them, so I wonder if that may translate to being able to adapt to multi-focus artificial lenses. Next time I see my ophthalmologist, I'll ask her opinion. I am moderately nearsighted, and the lenses correct well for distance and astigmatism. They are less effective for close-up; indeed, I see better close-up with my natural vision; but at some point, everything about aging is, at bes, a compromise. Amethyst

Your situation is very similar to my situation when I got my multi-focal cataract correction, except my nearsightedness was worst as well as the astigmatism.
I do encourage you wait to have your second eye correction delayed until your primary eye is stablized-say two weeks, but your Doc will know when.
I think long term contact wearers have an easier transition as we have long been accustomed to accommodating the imperfection of corrections.
FWIW, my multi-focal correction has far exceeded anything I was ever able to get with contacts.
Nwsteve

[scrinch]

TrvlBug, sorry I'm late to the party. No eye surgery yet for me, but I've had two close friends in their 50's go the monovision one-for-near/one-for-far route following cataract removal. Both are very happy with the results. Best of luck to you in your upcoming operation!