Cataract surgery lenses

[CRLLS]

With the other thread about age of giving up contact lenses, I thought of something regarding cataracts.

At some time in the future, I will likely need cataract surgery. Not right now. One thing that bothers me about the internal lens is that my distance vision has been constantly getting better. Over the years, my correction has dropped from ~ -3.5 to now ~ -1.0. I am curious, if I continue improving, at the time I actually need the cataracts removed, I may not need inter ocular lenses at all.

Is improving eyesight as you age, a normal thing? DW's eyesight is not improving. If yes, those who continue to have eyesight improve how do you deal with a fixed cataract lens? does eyesight continue to improve? Do you then start wearing glasses again? Just curious. I'll do what is necessary, for sure.

 

[Bamaman]

There are more dimensions to vision than just magnification.

When you need cataract surgery, your vision deteriorates around dark. And then you'll see stars around bright lights. It shows up especially when you are driving and keep pulling out in front of other drivers. My peripheral vision deteriorated.

When the doctor says it's time to take care of cataracts, it's time.

 

[CRLLS]

I got that. It is coming, just a matter of time. My question is more about the inter ocular lenses when vision acuity is constantly changing.

 

[Texas Proud]

My BIL had his eyesight improve as he was getting older until he passed in his early 70s... nobody else I know has improved.

 

[Souschef]

Right now I am at 20/40, but not quite deteriorated to nee the surgery. I do not drive at night any more.

 

[Telly]

The Spherical Power chosen for an IOL is determined by the depth of your eye. It is not based on your eyesight through your existing biologic lens. There are non-invasive optical and ultrasound machines that determine that depth. I think I mentioned one or two of them years ago here, that were used on me. I don't remember their maker nor model anymore. As an Engineer, at the time I looked them up on internet to see how they worked and what they were capable of.

EDIT: The longer your eye (more near-sited), the greater the chance that an IOL will not be "spot-on". I have long (deep) eyes, and was warned that I should not expect precision. I was fully prepared to have to continue to wear glasses, that was fine with me. And I did not push for Cylindrical Correction (Astigmatism) in an IOL. The Doc strongly suggested that I keep Astigmatism correction outside, as I have a lot. For those who need a lot of astigmatism correction (me!) messing up internally on astigmatism in an IOL, will be hard to try to un-correct externally with glasses.

 

[omni550]

I was just speaking with my 75-year-old cousin. She had cataract surgery a number of years ago (with interocular lenses installed). She has had laser correction (on her cornea) twice since then to improve her vision as it changed over time.


omni

 

[Texas Proud]

The Spherical Power chosen for an IOL is determined by the depth of your eye. It is not based on your eyesight through your existing biologic lens. There are non-invasive optical and ultrasound machines that determine that depth. I think I mentioned one or two of them years ago here, that were used on me. I don't remember their maker nor model anymore. As an Engineer, at the time I looked them up on internet to see how they worked and what they were capable of.

EDIT: The longer your eye (more near-sited), the greater the chance that an IOL will not be "spot-on". I have long (deep) eyes, and was warned that I should not expect precision. I was fully prepared to have to continue to wear glasses, that was fine with me. And I did not push for Cylindrical Correction (Astigmatism) in an IOL. The Doc strongly suggested that I keep Astigmatism correction outside, as I have a lot. For those who need a lot of astigmatism correction (me!) messing up internally on astigmatism in an IOL, will be hard to try to un-correct externally with glasses.

Interesting... not sure how much I have...


Can you undo cataract surgery? IOW, can you replace the lens with another one if your vision is not what you expected?

 

[RetMD21]

I am curious, if I continue improving, at the time I actually need the cataracts removed, I may not need inter ocular lenses at all.

The only problem with this is that your existing lens comes out

 

[Badger]

I had cataract surgery in May and July. Vision was getting fuzzy and darker to the point I finally had to do something about it. I had been wearing trifocal glasses for a couple of decades and had to deal with astigmatism along with the presbyopia.
I don't have eyes like I was 21 again but driving is much safer now and I only need "cheaters" when reading things like the ultra small print on a medicine bottle.
I was really scared to face the surgery (I even struggle with eye drops) but it wasn't bad at all.
My wife had hers done too by the same surgeon and is pleased with the results.

Cheers!

 

[CRLLS]

Thanks for the replies, all. It sounds like when the time comes to have cataract surgery, getting interocular lenses my not be the end-all solution for me. I would likely have good vision for a short while but then need some corrective glasses soon afterwards.

 

[erkevin]

I had a traumatic cataract that pretty much obliterated my vision in one eye (legally blind). I have an astigmatism in that eye. I went for the toric lens to be implanted without any guarantee that I would not need a corrective lens as the result. The result; I see better than 20/20 in that eye. An excellent result. I have great far and intermediate (computer) vision, but it caused my near-vision to go to hell. Need reading glasses.

 

[Telly]

.....Can you undo cataract surgery? IOW, can you replace the lens with another one if your vision is not what you expected?

From what I have read, it CAN be done, but the level of risk is much higher than original cataract surgery. Really, to be avoided except in serious situations. And I think having PCO laser work later after IOL implantation, makes putting in a replacement IOL even riskier. And most who have had cataract surgery will need the simple PCO laser procedure in time, as I found out!

Medicare pays 100% for Spherical IOLs. Fancier IOLS like Toric, etc. etc. the patient will pay the difference, as I understand.
Spherical IOLs are easy to unfold and place into position. Any IOL that requires precise rotational positioning (Toric, and many new wonder lenses), well, require very precise positioning! Increasing the chances of error or unforeseen issues that require subsequent removal and replacement.

Personally, I don't like risk in eye surgery. As they say, YEMV (Your Eyes May Vary)

 

[braumeister]

From what I have read, it CAN be done, but the level of risk is much higher than original cataract surgery. Really, to be avoided except in serious situations. And I think having PCO laser work later after IOL implantation, makes putting in a replacement IOL even riskier. And most who have had cataract surgery will need the simple PCO laser procedure in time, as I found out!

Medicare pays 100% for Spherical IOLs. Fancier IOLS like Toric, etc. etc. the patient will pay the difference, as I understand.
Spherical IOLs are easy to unfold and place into position. Any IOL that requires precise rotational positioning (Toric, and many new wonder lenses), well, require very precise positioning! Increasing the chances of error or unforeseen issues that require subsequent removal and replacement.

Personally, I don't like risk in eye surgery. As they say, YEMV (Your Eyes May Vary)

This is a very good answer. I would just add one more item.
The basic premise of standard cataract surgery is that the original (natural) lens is zapped with ultrasound to shatter it into myriad bits. Those bits are then vacuumed out and the new IOL (artificial plastic intraocular lens) is put in its place.

If you want to do it over, the plastic IOL is obviously not subject to the same procedure, so grabbing hold of it and removing it through the tiny slit is quite a different procedure. Not something I would want to risk either.

Just find a good surgeon who does a lot of these procedures every month and you should be fine.

 

[Texas Proud]

From what I have read, it CAN be done, but the level of risk is much higher than original cataract surgery. Really, to be avoided except in serious situations. And I think having PCO laser work later after IOL implantation, makes putting in a replacement IOL even riskier. And most who have had cataract surgery will need the simple PCO laser procedure in time, as I found out!

Medicare pays 100% for Spherical IOLs. Fancier IOLS like Toric, etc. etc. the patient will pay the difference, as I understand.
Spherical IOLs are easy to unfold and place into position. Any IOL that requires precise rotational positioning (Toric, and many new wonder lenses), well, require very precise positioning! Increasing the chances of error or unforeseen issues that require subsequent removal and replacement.

Personally, I don't like risk in eye surgery. As they say, YEMV (Your Eyes May Vary)

I have been told that medicare will not pay anything if you do not get the lens they will pay for...

 

[RetMD21]

I have been told that medicare will not pay anything if you do not get the lens they will pay for...

That's wrong

 

[VungTau]

My vision has continued to mildly improve over the years. I don't know the numerical correction that has occurred but I can see distances better and read signs that were too blurry in the past. It started to improve in my late 40's and now I'm 63.