Cataract Surgery...which type of lens?

[braumeister]

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]

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/honesty-ethics-professions.aspx

 

[JakeBrake]

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]

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

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]

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]

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]

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!

 

[TrvlBug]

Again, thank you all for relaying your and your friends' experiences with mono (near & far) as well as multi focal lenses. My doc says I'm a good candidate for either direction and it's just deciding what I want to do.

I have a call in to my optometrist to see about test driving both mono (in my bad eye only to simulate one near & one far) as well as multi focal contact lenses for a couple of months. I realize I won't have the best vision because of the cataract, but it should be close and with the multis, should provide a worst case night vision experience I think. I also talked last week to a former coworker who wears contacts and tried the one near/one far route for a year and absolutely hated it and now wears multi focal contacts and loves them. Decisions, decisions.

 

[JacquelineKimura]

I also had not done eye surgery. But my mom had a cataract surgury.She is a healthy 55 year old who has worn glasses since age 40 and have never had problems with eyes until she was told she had cataracts. Surgery was done on both eyes about 10 days apart 6 weeks ago. Result so far is problematical. Despite taking eye drops for dryness as prescribed, both eyes continue to burn and itch after reading for about 20 minutes or watching TV. Also have extreme sensitivity to sun light or bright rooms. She now wears double sun glasses outside and single sun glasses inside. Doctor says all is normal and will see her next march.

 

[TrvlBug]

I also had not done eye surgery. But my mom had a cataract surgury.She is a healthy 55 year old who has worn glasses since age 40 and have never had problems with eyes until she was told she had cataracts. Surgery was done on both eyes about 10 days apart 6 weeks ago. Result so far is problematical. Despite taking eye drops for dryness as prescribed, both eyes continue to burn and itch after reading for about 20 minutes or watching TV. Also have extreme sensitivity to sun light or bright rooms. She now wears double sun glasses outside and single sun glasses inside. Doctor says all is normal and will see her next march.

What type of lenses were implanted? I have heard of the extreme sun light sensitivity with accommodative lenses (Crystalens). Neither my doc nor the clinic, will implant these lenses any more due to the problems their patients have experienced.

 

[UtahSkier]

Despite taking eye drops for dryness as prescribed, both eyes continue to burn and itch after reading for about 20 minutes or watching TV. QUOTE]

Dry eyes -

I had elective Cataract surgery because my dry eye problem prevented me from wearing contacts. During one of the follow up appointments with the eye doc, I mentioned my dry eye pain and he said take fish oil. I have been taking fish oil for years, but apparently I was not taking enough. I now take enough fish oil daily to prevent all irritation.

I have been using Carlson's lemon fish oil. The doc recommended PRN DE Omega Benefits Fish Oil. The suggested dosing is 4 per day, but I need to take 6. Also, buying direct from PRN is much cheaper than this price on Amazon.

Amazon.com: Physician Recommended Nutriceuticals PRN Omega Benefits Fish Oil 120 Softgels: Health & Personal Care

 

[JakeBrake]

I also had not done eye surgery. But my mom had a cataract surgury.She is a healthy 55 year old who has worn glasses since age 40 and have never had problems with eyes until she was told she had cataracts. Surgery was done on both eyes about 10 days apart 6 weeks ago. Result so far is problematical. Despite taking eye drops for dryness as prescribed, both eyes continue to burn and itch after reading for about 20 minutes or watching TV. Also have extreme sensitivity to sun light or bright rooms. She now wears double sun glasses outside and single sun glasses inside. Doctor says all is normal and will see her next march.

My late FIL had similar problems after cataract surgery. He was in his 80's and had never worn glasses. It turned out that he was allergic to the prescription eye drops. Doc prescribed a different eye drop and he was soon OK. Incidentally, FIL had a type "A" personality and demanded that Doc do something immediately.

 

[nwsteve]

Also had cataract surgery, and doc gave similar recommendation, but also suggested Flaxseed oil as option if you have issue with fish, or prefer it.
nwsteve

 

[Tailgate]

bumping this older thread..

Just scheduled cataract surgery consultation in a couple of weeks.. the cataract in my right eye is on the move and growing larger. Correction to 20/40 in September and 4 months later it's slid to 20/60. Left eye is almost there but I will talk them into doing both. I'm 62 and retired 12/31...welcome to my first 'retirement surprise'....

Having read this thread, it seems that the mono lenses are a safer bet than the multi. I have no problem using readers since I've worn glasses since I was 9.

My optometrist (whom I like a lot) says the industry is another generation or two away from a superior multi lens and he's highly recommend the monos.
Even though I like him a lot, I did get a second opinion from an ophthamologist who confirmed the cataract. Since, at that time I thought I was a year or two away from getting them done, we didn't discuss lenses.

Any new thoughts on which way to go? Thanks advance for replies...

 

[TrvlBug]

Uncanny timing for resurrection of this thread as I've been debating back and forth...multi vs. mono vs. multi vs.........In the meantime, the vision in my right eye has deteriorated more to the point where I am now having trouble with daytime driving in my neighborhood. And reading in anything but bright light is just about impossible now.

Even though I'm a risk taker, I decided just the other day that the multis have simply not been around long enough for my comfort. I've decided to go with the monos. I would still like to toss my glasses and am going to go with a farsighted mono lens in the bad eye and when the other eye's cataract grows, will go with a nearsighted lens in that eye, allowing me to hopefully toss my glasses most of the time. Unfortunately, I'm left eye dominant and that eye should have the far sighted lens implanted. I will be doing it backwards and the odds are not with me. Worst case is I'll still be wearing glasses until the left eye goes bad and I have another far sighted lens implanted, thereby needing readers only. On the other hand, I could have both eyes done now (couple of weeks apart) the 'right' way, but then what if I can't get used to it.

Decisions, decisions... That's the problem when you have too many options.

 

[braumeister]

It's a tough decision, alright.
I had both eyes done about a year ago -- one in February and one in March.

I found it interesting that my ophthalmologist, who did the surgery, recommended against the multifocal lenses even though it would have been far more profit for him.

The only remaining question was whether to go strictly distance, strictly near, or one eye distance and one eye near focus. I was really wavering about this.

Again, my doc's comment was that the one and one (distance/near) combination seemed to work well for people who were already comfortable with that combination of contact lenses. But he said that he had tried that contact combination himself at one time and could never get used to it. He gave it a decent try (about four months), but he quit due to his brain's inability to accommodate.

I've been extremely nearsighted all my life, so I decided on both eyes set for distance. It has been nearly a year now, and I'm very happy with my decision. Being able to see my surroundings clearly immediately on waking in the morning had always been foreign to me, and I absolutely love it.

The slight nuisance of having to grab a pair of reading glasses (which now reside permanently in my shirt pocket) from time to time is so minor that it really doesn't bother me.

OTOH, I know several people who got the one and one combination and seem perfectly happy with it.

Bottom line: there is no universal answer.

 

[TrvlBug]

It's a tough decision, alright.
I had both eyes done about a year ago -- one in February and one in March.

I found it interesting that my ophthalmologist, who did the surgery, recommended against the multifocal lenses even though it would have been far more profit for him.

The only remaining question was whether to go strictly distance, strictly near, or one eye distance and one eye near focus. I was really wavering about this.

Again, my doc's comment was that the one and one (distance/near) combination seemed to work well for people who were already comfortable with that combination of contact lenses. But he said that he had tried that contact combination himself at one time and could never get used to it. He gave it a decent try (about four months), but he quit due to his brain's inability to accommodate.

I've been extremely nearsighted all my life, so I decided on both eyes set for distance. It has been nearly a year now, and I'm very happy with my decision. Being able to see my surroundings clearly immediately on waking in the morning had always been foreign to me, and I absolutely love it.

The slight nuisance of having to grab a pair of reading glasses (which now reside permanently in my shirt pocket) from time to time is so minor that it really doesn't bother me.

OTOH, I know several people who got the one and one combination and seem perfectly happy with it.

Bottom line: there is no universal answer.

Thanks, Brau, this helps in making my decision. Your post confirms that my one near/one far makes sense even though I will be doing it backwards. If it doesn't work, I have the option of going all far, which is preferable to continuing with the all near. My second option, of one near/one far with the correct dominant eye would not allow for do-overs so I would be stuck with that decision even if it did not work out.