Cataract Surgery...which type of lens?

[TrvlBug]

Due to rapidly deteriorating eyesight in my right eye, caused by a cataract, I will be having surgery as soon as I can schedule it...I have my initial appt. with the surgeon early next week.

Have been doing a lot of reading and it appears that multifocal is the way to go, even though it's considered a 'premium' lens and my insurance will most like not cover it. In my reading, people either love or hate the multis and I don't personally know anyone with these types of lenses.

Other than cataracts (the one in the left eye is tiny and stable), I have no other eye health issues and am considered an excellent candidate for the surgery. I'm currently (or was) nearsighted. I have worn progressives for a few years and love them. I'm in my 50s so these lenses will be with me a long, long, time and I plan on getting the best, no matter the cost!

I'm hoping for lots of input on the pros and cons of the various types of lenses, especially the multis. Thank you.

Edited to add: I'm looking forward to throwing away my glasses and understand that the multis can make that possible.

Ingrid

 

[W2R]

I have not yet had cataract surgery, although I do have cataracts and this surgery is in my future.

In my case - - I had multifocal glasses once back in the early 1990's, and hated them. My neck muscles aren't coordinated enough to be able to tilt my head at exactly the right angle for a particular focal length and as a result, I felt like I couldn't see much of anything very well. Right now I wear trifocal glasses and have no problem with seeing when there are only three focal lengths to choose from. When I wore contacts briefly, I was deliriously happy with just having distance vision and wearing reading glasses as necessary. To me that is perfectly fine so I will probably be pushing for that sort of correction if possible.

But anyway, back to you.... You said you have no problems with progressive lenses. It sounds to me like that would be perfect for you!

 

[TrvlBug]

I assumed that multifocals were like progressive lenses, however, one of the articles I came across implies that they are not...apparently the lens moves around allowing the eye to focus as needed. I'm putting together a list of questions for the surgeon and that's at the top of the list, right below, how many of these surgeries have you performed!

 

[Amethyst]

This thread is very timely, as I was just diagnosed with early cataracts. I don't have any issues yet during the day, but driving in the dark, facing headlights (which I do twice a day, every work day) is torture. My dr. will not even consider surgery - she says my cataracts aren't even on the "charts" yet - but I'd have it tomorrow if I could!

Amethyst

 

[W2R]

TrvlBug, I think that having the lens move around like that would drive me batty! But, when the time comes, I'll try to listen to the surgeon's recommendations with an open mind. (Edited to add: I just did an internet search and discovered that for those with significant astigmatism like me, multifocal lenses after cataract surgery are not an option. So, that settles that, for me, unless the surgeon tells me otherwise.)

Yes, by all means get a surgeon who has done this surgery a lot. I am pretty nervous about it myself, but it will be several years before I need this surgery so I have time to get used to the idea.

Amethyst, I almost never drive at night any more but I'll bet that if I did, I'd have the same difficulties.

 

[pb4uski]

DW had Crystalens done about 10 years ago. In theory, you are supposed to be able to learn to manipulate the lens for both near and far. DW wasn't as diligent about doing the exercises so she still uses readers for close work.

From what I understand the results are mixed - some people do well and need no glasses at all and others need readers. YMMV

 

[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.

 

[rescueme]

I've had both sides done, with about a 8-year interval between operations.

The only lens available for the first operation was monofocal. The second time around the multifocal was available, but my doctor (same one that did the first operation) said I would probably be better off with going with the standard lens - which I did.

It turned out that each eye is able to handle different tasks. My right (original operation) is good for close vision - the other (done in 2008) handles the duties for far vision.

The lenses were not set up to handle the two tasks, but probably just evolved as they were put in use after the respective operation.

In essence, I have bi-focal eyes - rather than bi-focal glasses (which I have not wore since the first operation).

- Ron

 

[Moemg]

I had cataract surgery done nine years ago and I opted for monovision lenses. The multivision were still being tested at the time . I have one eye for close & one eye for distance . I now have great vision and only wear reading glasses if I am reading for a long time . I had worn monovision contacts so I was a good candidate. The surgery was simple and it is great to not wear glasses .I had tried mutifocal contacts and I did not like them but I used to wear mutifocal glasses with no problem.

 

[Snow White]

My hubby is an ophthalmologist and he said that glare and decreased contrast are significant problems with the multifocal lens. He said some people never learn to tolerate them and end up having second surgeries to replace them. He did say a few people like them so maybe you will be one of those folks. I asked him if he'd consider getting one and he said, "hell no"! I always think a good test of newer medical procedures is to ask the surgeon if they or any of their family members have had it. I had LASIK surgery but not until the procedure had been around for many years and the techniques had matured.

 

[bssc]

I had it done last year for both eyes. Very easy surgery. What I did was have my left eye adjusted for distance and the right for close up.

Be aware that cataract removal makes you more susceptible for retinal detachment. If you doctor hasn't told you, ask them about it. It happened to me but I knew what to look for and it was fixed without any impact.

 

[nwsteve]

I had cataract surgery on both eyes about 4 years ago. I choose to go with multi-focal lens in both eyes but chose different lens manufacturers for each eye. Used ReZoom for primary eye because its slightly better distance correction and Restore in the other eye for its better mid-range and close correction. (keep in mind these lens advantages were 4 years ago and there may be better combinations now)
Even though I had wore glass since 13 for near sightedness and astigmatism, I had basically 20/20 as soon as both eyes were done. After the first lens was implanted and worn for a couple of weeks, we rechecked the correction on the other eye and changed the prescription before implanting the new lens. I rarely use a reader and then it is usually when light is low and print is a narrow font.
I think because I had worn contacts for over 40 years and often dealt with halos at night, I did not find halos to be an issue. In fact, if anything, halos have been a non-issue for me, especially compared to wearing contacts at the end of a long day.
Nwsteve

 

[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

 

[Amethyst]

Hmmm....I don't mean to thread-jack, and I do support getting a 2nd opinion... but wished to comment that while I haven't yet seen a picture of the insides of my eyes, my dentist has started using an oral camera and a screen to show me blown-up pictures of what's wrong with my teeth!

My eye dr. could probably do something similar, although it is harder to know exactly what you're seeing when it comes to the insides of your eyes. Tooth issues are pretty obvious, when you get a magnified look at them.

Amethyst

I think ophthalmologists are about as trustworthy as dentists....
So maybe get a second opinion.

Ha

 

[Rambler]

I had a bad cataract in my right eye and had the surgery done? I had convinced myself to go with the crystalens, but my doc talked me out of it, saying that the outcomes were not what he wanted to see. He suggested ReStor. I went with it. I do have halos now at night, and around highly reflective objects, but I'll tell you, I see better now than at any point in my life before the surgery. Doc suggested doing both eyes, since I had a long family history of cataracts. So I did. ReStor is multi focal. The only issue I have with it is that I can't read at say arms length to about 6 feet...so, for reading the navi in the car, or for shopping, I have some progressive glasses. Overall, I'm happy.

R

 

[Moemg]

I think ophthalmologists are about as trustworthy as dentists.

So maybe get a second opinion.

Ha

Ha , They only doctors that I have found that were full of sh** were Proctologists !

 

[donheff]

This thread is very timely, as I was just diagnosed with early cataracts. I don't have any issues yet during the day, but driving in the dark, facing headlights (which I do twice a day, every work day) is torture. My dr. will not even consider surgery - she says my cataracts aren't even on the "charts" yet - but I'd have it tomorrow if I could!

Amethyst

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?

 

[Amethyst]

I will ask my eye dr. next year when I get examined again. My 70's are a bit farther away than yours, and I don't see how I can wait that long. I almost had an accident on the BW-Parkway at 0545 - it was already heavily traveled, with dozens of vehicles pushing their way in at every exit, and I could not see my road markings due to the oncoming glare. If that's "not on the charts yet," I am terrified at the thought of what driving will be like when I'm "On the charts."

I do NOT want to turn into one of those helpless gals who can't drive at night, in certain situations, etc.

Amethyst

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?

 

[Gotadimple]

but wished to comment that while I haven't yet seen a picture of the insides of my eyes, my dentist has started using an oral camera and a screen to show me blown-up pictures of what's wrong with my teeth!

Amethyst

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

 

[TrvlBug]

I will ask my eye dr. next year when I get examined again. My 70's are a bit farther away than yours, and I don't see how I can wait that long. I almost had an accident on the BW-Parkway at 0545 - it was already heavily traveled, with dozens of vehicles pushing their way in at every exit, and I could not see my road markings due to the oncoming glare. If that's "not on the charts yet," I am terrified at the thought of what driving will be like when I'm "On the charts."

I do NOT want to turn into one of those helpless gals who can't drive at night, in certain situations, etc.

Amethyst

Amethyst, you might want to get a second opinion. My ophthalmologist's view is that if the cataract interferes enough with your everyday life, she would recommend the surgery. The other issue is insurance coverage. They have certain criteria that needs to be met, but that doesn't mean, depending on cost, that one couldn't self insure. 4 mos. ago, my symptoms were annoying, but really didn't interfere and I was afraid of surgery (in general, not cataract specifically). Now, it's interfering greatly, especially with my reading ability and I plan on scheduling the surgery the earliest time slot available! In fact, depending on the results and the cost, I may elect to self insure and have the left eye done before it gets bad enough for insurance to cover. It's not a matter of if I will need the surgery in that eye, but when.

I also have issues with night vision. I see halos around street lights and around the laser light during morning play time with the kitties! I don't drive at night, being retired and running errands, etc. during the day. Yesterday morning, dropping DH off at the airport, was the first time in months and months that I drove at night. Not halos, but starbursts; it was as if all the cars' headlights had a little fireworks show going. It was fascinating driving down the freeway with the concrete divider, but I'm not sure how 'fun' it would be driving down a marked two or 4 lane road at night during rush hour.

If I were in your situation, I would get a second opinion.

 

[TrvlBug]

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]

...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]

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]

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.