Cataracts - Which lens?

[eytonxav]

I had floater problems, and after at least a year of online research decided to do the somewhat controversial laser treatment. In my case I was extremely satisfied with the results, but YMMV a lot with this. My floaters were the type with the highest success rate.

Happy to provide more details, either on here or PM me.

Larry

I have a rather large floater or flap that goes up and down in my right eye and has been bothering me for years now. The eye also has an epiretinal membrane problem. I have inquired several Drs about trying to use a laser on the floater and none thought it was a good idea, and claimed it would likely end in a bunch of smaller floaters that could be even worse. Their recommendation was to get a vitrectomy and suggested that is the best way to deal with the membrane and the floater.

 

[Dash man]

I had the old RK surgery to correct my nearsightedness back in 1996. I developed cataracts a few years ago and learned in an exam that my RK surgery didn't heal quite right and there are bumps in my cornea. Cataract surgery will be tricky when it's done and I'll definitely need glasses for near and far vision afterwards.

 

[ShokWaveRider]

I had floater problems, and after at least a year of online research decided to do the somewhat controversial laser treatment. In my case I was extremely satisfied with the results, but YMMV a lot with this. My floaters were the type with the highest success rate.

Happy to provide more details, either on here or PM me.

Larry

My floaters drive me scatty. Being an Engineer that like to do close up work and it can be very tedious. I do not really notice them for long distance and driving, just up close. My Eye Surgeon thinks I ought to have the aqueous humor replaced or partially replace with Saline. Problem is I am scared shitless on getting that done. I read WebMD too much. I do not know if he does the laser version or if I am even eligible.

 

[Bestwifeever]

The worst thing about the floaters I have had for decades (and I share everyone else's annoyance about them) was the ophthalmologist's tech cheerfully telling me to just move my head a little and they would go away. Right.

 

[Olbidness]

I've been having problems with my eyes for some time, pain, sensitivity to light and was diagnosed with Fuchs Dystrophy. I have surgery scheduled for the middle of July when they will do DSAEK /Cataract at the same time. My first official day of retirement is 7/1, not exactly how I planned to start my retirement.
Oh well, I'll take it as it comes like always.

 

[Ally]

I was terribly nearsighted all my life and chose distance vision and use readers. It was such a blessing to not have to wear thick glasses anymore! I was scared of the procedure, but it's so easy.

 

[Koolau]

My regular eye doc - the one who did my second cataract - advises me to do nothing about my floaters. The risks are significant compared to the problem (in his opinion.) For the most part, they just bother me for close work. I rarely notice them during driving, etc. Once in a while, I get the impression that a mouse just ran across the floor or something. I just figure it's the floaters. My DW will let me know if I'm wrong! YMMV

 

[explanade]

I just got diagnosed with it too. My vision, especially my right eye, has been changing a lot in the last year, going from -2.5 to -2.75 to -3.0.

The doctor sensed my wariness, said we could "watch" it for a year.

I don't know if my insurance would cover any of it. Doctor did say it was elective surgery. But as it turns out, I've met my deductible for the year and almost met my OOP max.

Even if it covered some of it, I don't know about having surgery earlier than necessary to save money.

 

[MichaelB]

I just got diagnosed with it too. My vision, especially my right eye, has been changing a lot in the last year, going from -2.5 to -2.75 to -3.0.

The doctor sensed my wariness, said we could "watch" it for a year.

I don't know if my insurance would cover any of it. Doctor did say it was elective surgery. But as it turns out, I've met my deductible for the year and almost met my OOP max.

Even if it covered some of it, I don't know about having surgery earlier than necessary to save money.

I agree with your doc. I was told years ago I had cataracts, and when the decline in my vision led to yearly changes in prescriptions the opthamologist said "wait until your changes in prescription don't do enough". I thought it was kind of pointless at the time, but it turned out to be good advice.

My insurance covered it without question, I did both eyes in the same year. I paid for the first one, the insurance paid the second.

 

[W2R]

My federal retiree BCBS insurance covered whatever Medicare didn't cover. I don't recall which paid most of it, but I know that I didn't have to pay a penny for the surgery or surgeon, but I did have to pay $71.25 per eye for the eyedrops.

Also for some unknown reason the instructions from the surgical facility specified that I was to wear a shirt that buttoned down the front. So, I bought a very cheap shirt like that since I didn't have any. I count that as a medical expense, not clothing, because I think it is ugly.

When you feel that your vision is getting bad, I'd encourage you to consider the surgery. It really improved my vision, so much.

After cataract surgery corrected my formerly nearsighted eyes, into far sighted eyes, I ordered the most gorgeous pair of Ray-ban sunglasses ever - - my first non-prescription sunglasses in half a century. I wear them when I drive, and feel like a movie star. I wear readers for the computer or for close up work.

 

[explanade]

Hmm, I'd always imagined the vision would be occluded, not as much light getting through because the lens had become more opaque.

Do the replacement lens have an effective service life?

 

[W2R]

Hmm, I'd always imagined the vision would be occluded, not as much light getting through because the lens had become more opaque.

Do the replacement lens have an effective service life?

Not as far as I know. You could ask your surgeon.

My optometrist told me forcefully that I needed to get my cataracts taken care of because he couldn't correct my eyes to any better than 20/40 or worse, even with glasses on. So I got a referral from him and scheduled the surgery immediately.

For years before that he had told me that I had cataracts starting to grow in each eye, and at that time he told me I would need the surgery at some time in the future but not yet.

I haven't seen this well since I was 5 years old. The colors are surprisingly intense, bright, and pleasing, and I love being able to walk and drive without any glasses at all. I was near-sighted before the surgery, and now I feel like a bionic woman when I can read signs so far away while driving. Extremely fine up-close work is more difficult for me (because I chose distance vision for each eye), but not bad enough for me to even order a magnifying glass. I am reading this web page with no problems and can see size 8 font easily but size 4 might be an issue.

Before the surgery, I didn't feel like I could see very well. I incorrectly attributed this to old age. I ran into things more, and tripped on stuff more too.

The surgery took 4 minutes. It's trivial but life changing.

 

[gcgang]

I just got a Tecnis 2.75 multi focal in my right eye. The right lens was totally clouded, needed to be done.

I can see! Not perfect, but better than I ever could on my own. There are night halo issues, but most interesting is the up close focus ability, or lack thereof.

I can't see well enough to comfortably read/do iPad stuff with the multi focal right now. This has been getting slightly better in the two weeks since surgery. I was told that changes will occur for up to a year, with 90%+ resolution after one month.

So here's where I'm at. I'm using "natural mono vision", haven't had the nearsighted left eye done. I'm so happy that I can see distance without glasses with the mf, and can see up close to not need readers. I'd be upset if I get the left eye done in a way that I'd have to find glasses anytime I wanted to read.

The cataracts will get worse in the left eye. But by the time I do that surgery, I'll have a better understanding of what the right eye can do. What I'm considering is a higher power mf, the 3.5, which should provide closer focus.

For now, when I drive I'm wearing old script glasses with the right lens taken out. In a couple more weeks I'll have sunglasses and driving glass prescriptions to tide me over until the next surgery, probably in the next 12-18 months.

 

[Likes_to_Lurk]

I had my cataract surgery when increases in my prescription no longer gave me good vision. For the last 2 years before the surgery, I had more frequent changes in my prescription than in prior years.

The lens are considered permanent. My mother had hers for over 30 years!

Medicare and many (most?) private insurance plans cover the procedure and usually pay for a new pair of glasses. Check with your carrier.

I'm so glad I had the the surgery. No reason to delay if your doctor says you are eligible.

 

[W2R]

I just got a Tecnis 2.75 multi focal in my right eye. The right lens was totally clouded, needed to be done.

I can see! Not perfect, but better than I ever could on my own. There are night halo issues, but most interesting is the up close focus ability, or lack thereof.

I can't see well enough to comfortably read/do iPad stuff with the multi focal right now. This has been getting slightly better in the two weeks since surgery. I was told that changes will occur for up to a year, with 90%+ resolution after one month.

So here's where I'm at. I'm using "natural mono vision", haven't had the nearsighted left eye done. I'm so happy that I can see distance without glasses with the mf, and can see up close to not need readers. I'd be upset if I get the left eye done in a way that I'd have to find glasses anytime I wanted to read.

The cataracts will get worse in the left eye. But by the time I do that surgery, I'll have a better understanding of what the right eye can do. What I'm considering is a higher power mf, the 3.5, which should provide closer focus.

For now, when I drive I'm wearing old script glasses with the right lens taken out. In a couple more weeks I'll have sunglasses and driving glass prescriptions to tide me over until the next surgery, probably in the next 12-18 months.

So glad that your mf lens is working out for you! I had my eyes done a week apart, since they both needed it at about the same time. Due to a stripped screw I couldn't get the lens out of my regular glasses after my first eye was done. So, I did not drive for a week and listened to podcasts and music for entertainment, napped a lot, and so on.

 

[MissMolly]

I just got a Tecnis 2.75 multi focal in my right eye. The right lens was totally clouded, needed to be done.

I can see! Not perfect, but better than I ever could on my own. There are night halo issues, but most interesting is the up close focus ability, or lack thereof.

I can't see well enough to comfortably read/do iPad stuff with the multi focal right now. This has been getting slightly better in the two weeks since surgery. I was told that changes will occur for up to a year, with 90%+ resolution after one month.

So here's where I'm at. I'm using "natural mono vision", haven't had the nearsighted left eye done. I'm so happy that I can see distance without glasses with the mf, and can see up close to not need readers. I'd be upset if I get the left eye done in a way that I'd have to find glasses anytime I wanted to read.

The cataracts will get worse in the left eye. But by the time I do that surgery, I'll have a better understanding of what the right eye can do. What I'm considering is a higher power mf, the 3.5, which should provide closer focus.

For now, when I drive I'm wearing old script glasses with the right lens taken out. In a couple more weeks I'll have sunglasses and driving glass prescriptions to tide me over until the next surgery, probably in the next 12-18 months.

This is what I am leaning towards (no, I have still not gone for the surgery). I like the idea of my eyes being able to focus near or far like normal eyes. I am now to the point where when watching TV with the captioning on, I wear both pairs of my glasses (I have 2 of same prescription is case one gets broken) in order to be able to read the lettering. And my eyes were bad before the cataracts so my eyeglass prescriptions are relatively strong.

I have gone from watching TV with normal sized captioning to medium sized to super large (letters are almost 2" tall) and still having problems reading. The two pairs of glasses will work for awhile and then I will have to give in and get the surgery. I'm hoping to put it off until next year since I have had no medical bills so far this year. If I wait until next year, it will take care of some of my deductible/MOOP in case I end up with any other medical issues.

So, your success thus far is encouraging to me. I hope it continues to improve for you. Keep us updated.

 

[jebmke]

Not as far as I know. You could ask your surgeon.

My optometrist told me forcefully that I needed to get my cataracts taken care of because he couldn't correct my eyes to any better than 20/40 or worse, even with glasses on. So I got a referral from him and scheduled the surgery immediately.

For years before that he had told me that I had cataracts starting to grow in each eye, and at that time he told me I would need the surgery at some time in the future but not yet.

I haven't seen this well since I was 5 years old. The colors are surprisingly intense, bright, and pleasing, and I love being able to walk and drive without any glasses at all. I was near-sighted before the surgery, and now I feel like a bionic woman when I can read signs so far away while driving. Extremely fine up-close work is more difficult for me (because I chose distance vision for each eye), but not bad enough for me to even order a magnifying glass. I am reading this web page with no problems and can see size 8 font easily but size 4 might be an issue.

Before the surgery, I didn't feel like I could see very well. I incorrectly attributed this to old age. I ran into things more, and tripped on stuff more too.

The surgery took 4 minutes. It's trivial but life changing.

This was the same with me. I had toric lenses to correct for a very severe astigmatism. I am now 20/20 with almost no astigmatism since the spring of 2016.

 

[explanade]

One thing he didn't tell me is that the surgery could by itself correct my vision.

I'm -3.0 and -2.25 so not too bad. He checked my Lasik said the flaps are in good condition.

It never occurred to me that vision deterioration about 10 years after the Lasik could be due to cataracts. For awhile the correction needed was mild but in the last year, one eye has changed almost every half year.

My initial reaction was that cataracts would be to stop the change in vision while I wear some low correction glasses.

The ophthalmologist is part of a practice which heavily promotes Lasik. In fact I was leery of seeing them because I didn't want to be sold on doing Lasik again.

Well he didn't try to sell me on doing Lasik again but I didn't connect that cataracts could correct the vision and potentially eliminate the need for distance correction at least.

That is until reading this thread with people reporting that the surgery not only cleared up the vision but eliminated the need for glasses.

 

[W2R]

One thing he didn't tell me is that the surgery could by itself correct my vision.

I'm -3.0 and -2.25 so not too bad. He checked my Lasik said the flaps are in good condition.

It never occurred to me that vision deterioration about 10 years after the Lasik could be due to cataracts. For awhile the correction needed was mild but in the last year, one eye has changed almost every half year.

My initial reaction was that cataracts would be to stop the change in vision while I wear some low correction glasses.

The ophthalmologist is part of a practice which heavily promotes Lasik. In fact I was leery of seeing them because I didn't want to be sold on doing Lasik again.

Well he didn't try to sell me on doing Lasik again but I didn't connect that cataracts could correct the vision and potentially eliminate the need for distance correction at least.

That is until reading this thread with people reporting that the surgery not only cleared up the vision but eliminated the need for glasses.

I think of it as sort of like getting free or cut-rate Lasik courtesy of Medicare and/or your insurance. The cataract is removed, and a lens to correct your vision is put in there in place of it.

My cataract surgeon is the #2 guy at a big "Lasik mill" here in the New Orleans area. So, he does tons of Lasik and tons of cataract surgeries. I think they are pretty similar (although I don't actually KNOW that).

 

[Teacher Terry]

I have needed cataract surgery for a few years but kept putting it off. I have not been able to drive at night for a year. The end of Sept. I will get the right eye done which is 20/100. He wanted to do the next eye with 20/40 the next week and I said no. I will see how this goes. If it goes well I will do before new deductible time. I would never choose having one eye different then the other.

 

[W2R]

I have needed cataract surgery for a few years but kept putting it off. I have not been able to drive at night for a year. The end of Sept. I will get the right eye done which is 20/100. He wanted to do the next eye with 20/40 the next week and I said no. I will see how this goes. If it goes well I will do before new deductible time. I would never choose having one eye different then the other.

If your experience is like mine, then believe me, you will be SO HAPPY to have had this done. I felt like I was getting the eyes of a five year old back; brilliant colors, lots of light, and great distance vision.

I had no problems getting my eyes done a week apart, although I wouldn't have wanted the second one done any sooner; it took me about a week to be able to see well after surgery.

I still don't feel comfortable driving at night, although apparently most people do after cataract surgery. Driving in the afternoon is sheer joy.

 

[gcgang]

I have needed cataract surgery for a few years but kept putting it off. I have not been able to drive at night for a year. The end of Sept. I will get the right eye done which is 20/100. He wanted to do the next eye with 20/40 the next week and I said no. I will see how this goes. If it goes well I will do before new deductible time. I would never choose having one eye different then the other.

They cautioned against "monovision (one eye different than other)" unless you'd done it before with contacts, but it seems to be working for me.

The doctor did a lot of consultations about my "personality type". Was I exacting, detail oriented, or more easygoing? In retrospect, I'm noticing my distance vision isn't exacting, and neither is my close up. But, my "easy going " type still is happy with being functionable with both distance and closeup without glasses. To me, it's worth it. An exacting personality would probably be better off with another choice of lens.

 

[eytonxav]

Had some laser scar tissue removed the other day from my right eye and a definite improvement. Had the left eye done earlier in the year. Such scar tissue can develop some period of time after cataract surgery. My cataract surgery took place in first half of 2016. It's totally painless, and out the door with no restrictions, although they do recommend using preservative free lubricants to alleviate any scratchiness.

 

[explanade]

I did the surgery yesterday on my right eye and I go for a followup this afternoon.

My ophthalmologist recommended simple lens for either distance or close correction because I had astimatism. Didn't really try to push me towards the other lens options at all so I agreed on distance correction, hoping my close vision would still be okay for reading, including reading phones or the computer screen.

When I got Lasik 15 years ago, they told me I would probably need reading glasses as I reached my mid 40s and later but didn't turn out to be the case as my near distance vision was always good even as my distance vision began to deteriorate over the past 5 years or so.

I thought the Lasik was wearing off and had figured I'd need some light distance correction, which is what I've done for 4 years. But in the last 1 to year and a half, I needed more correction, especially in my right eye. So I went to the ophthalmologist to see if there was some other problem than the Lasik correction losing its effect.

He told me in August that the Lasik flaps were in good condition and that it was cataracts which was causing the deterioration in vision. He said we could check back in another year to see if it deteriorated even more but this month, I decided to do it because I had met my OOP maximum for this year and figured I might as well get it paid for.

They recommended an ORA measurement for more precise measurements to determine the IOL they would use. It wasn't covered by insurance and would cost $600. I agreed to it since the surgery itself was covered.

Yesterday, vision was foggy, like Vasoline on glass. This morning, I would see that the right eye had better distance vision than my left eye but it wasn't sharp. If I put on my glasses, my corrected left eye was sharper than my right eye with the IOL.

But my right eye is so far sensitive to light and saw halos around artificial light sources. Incandescent bulbs in my bathrooms were almost white to my surgically corrected right eye.

They told me my vision would improve from second day on so I guess I have to wait.

I had hoped my right eye wouldn't need near distance correction but right now I can't read well with it. Then again, my distance vision is better than it was before but still need to sharpen up and it's sensitive to light.

I've removed the right lens from my glasses, including prescription sunglasses. The difference in the two eyes is tough to deal with. Often the image on the computer screen diverges since there's a difference. My left eye prescription is about -1.75.

I guess I'll have to just wait to see how my right eye vision settles.

 

[W2R]

Explanade, congratulations! When I had mine done, I got lenses for distance vision in each eye. I wear readers up close. Although some of the fogginess disappeared on the first day after surgery, it probably took a week before it was all cleared up for me.

I wasn't asked about the ORA thing to get a more precise idea of what lens needed to be inserted. But I would have gladly paid $600 for it. What you get, is what you are stuck with forever so why not.

I didn't ever have Lasik before my cataract surgeries.

For me, Medicare and/or BCBS paid for every last cent, other than the cost of the eyedrops.

So, I treated myself to the most fabulous pair of non-prescription Ray-Ban sunglasses. They are my first Ray-Bans and they are polarized gray wrap-arounds, and were expensive but wow, my favorite sunglasses EVER. I wear them almost every day when I drive.