Cataract surgery... lense opinions.

[LARS]

Anyone recently have cataract surgery and use a multi-focal lense? Are you happy with the results? Would you go with the multi-focal again? Did you need subsequent laser tweaks to get eyesight optimal?

About to have surgery in one eye and would like to hear any experience with decisions about lense choice.

Thanks.

 

[nwsteve]

Lars
Had cataract surgery in both eyes a couple years. Second eye was about three weeks after the first but could have been done a week earlier but I changed lens strategy. Put a Rezoom in my dominant eye for distance and Restor for the other eye for improved mid/near vision.
Correction of a significant stigmatism was biggest uncertainty as one eye was almost too bad to be corrected with multi-focus. They did a small incision on the worst eye and it seems to have taken care of most of the issue. Last eye examine was 20/30 with some stigmatism still impacting. It was not bad enough to require correction so I have not gone back for any "tuning".
You may find the discussion here helpful in looking at mixing lens Review of Ophthalmology.
Some surgeons do not like to do them and I kinda had to nudge mine into it.
Having wore contacts for 40 years, I found any halos less than what I was used to with contacts and have no problems driving at night.
There are a couple threads on the Forum from others so look at those for some more insight. I definitely would do it again.
Nwsteve

 

[Moemg]

I had surgery five years ago and opted for the mono-vision lenses . I have one eye for distance and one eye for close . I have great vision and no corrections needed . I did not opt for the multi focal because it still was not perfected at that time . I never notice the difference in my eyes and I am 100% satisfied . I occasionally wear cheap readers if I am reading for hours but never on a daily basis . As surgery goes it was very easy .Eye drops , a little happy juice and voila it's over !

 

[chris2008]

My SIL had 2 multi focus and it took her a loooooong time to adapt, like 4-6 months.
Even now, she is not too happy with them.

 

[Rambler]

Surgery 5 years ago, ReStor multifocal implants. I also had astigmatism, both eyes. Doc did a lateral incision which largely corrected it. I am at about 20/20 in one eye, 20/25 in the other. I am REALLY pleased.

ReStor, for me, corrected distance and near vision. I do have minor problems with mid-range, like the GPS in the car, or price tags on the shelf in stores. To deal with this, I have a pair of progressive glasses that I keep in the car in order to be able to see with no correction in the top for the driving, and +1 to 1.25 in the midrange to +2.5 near. That allows me to see all distances with no problems. Note that in very dark restaurants, I also have difficulty reading the menu without the progressive glasses. For that, I use the very bottom, at +2.5.

I also have a pair of Silhouette Progressives to be able to read the teleprompter, since I give speeches quite often. They are so light and thin that you can hardly see them.

After about 4.5 years, I was getting a little cloudiness in both eyes. I expected this to happen, since I had studied this in depth before the surgery. This is caused by the pouch or capsule (that contains the natural lens) beginning to cloud or wrinkle after a while. I went in, the doc took a look, zapped it a few times with a YAG laser (YAG Laser posterior capsulotomy). This essentially burns/cuts away the rear of the lens capsule and allows the light to have clear access to your retina. I had a floater, a piece of the capsule, floating around for a few weeks or a months after that, but it was immediate relief. Floater soon evaporated. I saw better again.

Would I do it again? Absolutely!!! Does it take some getting used to? Absolutely. But the results are stunning if you have worn glasses all your life and have been suffering with cataracts for a few years, like I had. Just remember that the mid-range may take a bit of adjusting (get closer to the object if it is small, further away if large, or get a pair of progressives for the times that it is troublesome).

Final point: this was 5 years ago in just a few days, and the lens was still relatively new and expensive. I had to shell out some money that the insurance did not cover, a thousand or so, but it was THE BEST money I ever spent.

Final Final point: I wear my glasses maybe an hour a week, just when absolutely necessary. For the first couple of years, I just used a pair of OTC bifocal readers for the GPS in the car, and just adjusted my distance as necessary when grocery or hardware shopping. Got the progressives later when I figures out the insurance would pay for it.

R

 

[LARS]

Thanks for all the responses. All very helpful.

My particular situation is that I have one eye that needs surgery (cataract most likely caused by trauma).

What I think I'm going to do is go for the mono-lense. Assuming it all goes well, and I "see" how I'm seeing, then when I eventually get the left eye done I'll consider a multi-lense for the second eye. Though at the end of the day, wearing reading glasses seems a small price to pay to keep it simple. Plus, my Doctor has told me there is a higher % result of vision accuracy with the mono vs multi. He said mono he hits 20-20 approx 90-95% of the time while multi is around 85%.

 

[Texas Proud]

Just a question that might have to be answered by a doc...

Lets say you decide to go with the multi... but like the one poster about his sister... you do NOT like the results... can you get it 'fixed' I would think that whatever was done they could replace what was done with another lens... I am not worried about the cost... because I would be willing to pay out of pocket when it comes to my health... and I am hopefully not close to getting anything done... just curious at this time..

 

[LARS]

Just a question that might have to be answered by a doc...

Lets say you decide to go with the multi... but like the one poster about his sister... you do NOT like the results... can you get it 'fixed' I would think that whatever was done they could replace what was done with another lens... I am not worried about the cost... because I would be willing to pay out of pocket when it comes to my health... and I am hopefully not close to getting anything done... just curious at this time..

My understanding is that once the lense settles in (which I recall is a matter of a few short months) you really don't want to have to remove a lense. I thnk it can be done, but it is to be really avoided.

 

[nwsteve]

My understanding is that once the lense settles in (which I recall is a matter of a few short months) you really don't want to have to remove a lense. I thnk it can be done, but it is to be really avoided.

I also asked this question when I had my eyes done. The answer is "Yes" --the process is essentially the same as when they remove the original cataract. As I understand it, issue is often is the problem of a poor placement, patient not able to tolerate or just a need to "tune" the vision. If "tuning" is the issue, then they prefer to use laser surgery or keratomony to refine.
Not mentioned in my earlier post is the importance being sure your doc has lots and lots experience with multi-focus lens placement. Apparently there is as much art as science involved so HANDS ON EXPERIENCE is important to reliable results. To clarify level of experience, you want a surgeon who has 100's and 100's not dozens. The day I had my surgery, the clinic was doing 8-10 cataract replacements that day and they said it was a slow day. The clinic has offices all over the NW and their surgeons rotate through each clinic doing nothing but eye surgeries, mostly cataracts replacments.
Nwsteve

 

[Rambler]

LARS - my cataract situation was similar. I had only one, and it was "probably" caused by trauma some 30 years prior. However, my mother, grandmother, aunts and uncles all had them in their 50s. Doc just said "you are going to get them anyway, so we will just do both now". I was happy with that because I wore pretty strong glasses.

A couple points of caution:

1) be sure to ask your doc about mixing up the mono and the multi. I would worry about the balance. Some docs do make the near vision higher power in one eye, and lower power in the other, to balance mid-range and near vision, so it should work. But talk to your doc about it.
2) if you already know you will have to get the second done, and you wear glasses now, might be best to do them at the same time. I tried taking the lense out of my glasses between surgeries so I could see, correction with glasses on one eye, implant only in the other...it was HORRIBLE. I couldn't balance. I could not drive. Really weird sensation. If you don't wear glasses and you intend to get only one, mono, it may be best to get the implant adjusted to the same power as your un-altered eye. Talk to your doc about it.
3) I forgot to mention it, but with the ReStor, and probably the Rezoom, you will likely have halos around lights at night. This is because of the way the multifocal is constructed to allow both near and far vision, and how your pupil reacts to light and dark. I mention it now because I just remembered. It does take some getting used to, but after a while you don't notice them so much. You are not likely to get halos with the mono, because it is more like a single vision contact lens or eyeglass lens...smooth. Talk to your doc about it.

Over-riding theme here?? Talk to your doc about it.

R

 

[LARS]

1) 2) if you already know you will have to get the second done, and you wear glasses now, might be best to do them at the same time. I tried taking the lense out of my glasses between surgeries so I could see, correction with glasses on one eye, implant only in the other...it was HORRIBLE. I couldn't balance. I could not drive. Really weird sensation. If you don't wear glasses and you intend to get only one, mono, it may be best to get the implant adjusted to the same power as your un-altered eye. Talk to your doc about it.


R

I figure it can't be any worse than what I have now... i.e. one eye corrected with contact/glasses to 20-20 and eye with cataract basically useless.

With surgery it will be reversed, but when I wear my contact in non-operated eye with cataract removed eye I should see fine. And since I wear my contacts all the time I figure its only at night in the house when it will be glasses (I figure I'll get the eyeglass guy to put a clean blank in for the corrected eye).

My guess is that I will get the second eye done quickly AFTER I am convinced the first eye operation goes well.

 

[Rambler]

Yeah, you are probably right if you are using contacts. I did not use contacts, only glasses, so the visual distortion of having one lens in glasses and one implant was probably caused the problem for me.

Luckily enough for me, I had my second eye done only 48 hours after the first. I had them done by my US eye doc instead of in Japan where I am (still) living. I had to do it during brief vacation directly before flying off to Europe for meetings, so the doc decided to them that close together. Everyone I know who has had it done usually does it several weeks apart (Dad is most recent, about a year ago, mom 25 years ago, but 6 months apart, using an older method).

By the way, if you are wondering, there is no pain. You are sedated, your eye is numbed, but you are awake. After the sedation wears off you leave, with big wrap around sunglasses (use them!). Your pupil will be tightly constricted after the surgery is finished, for about 24-36 hours, so you will have difficulty seeing at night during the first night or possibly two. It can be a shock to wake up in the middle of the night and not be able to see anything out of the eye, but it is normal (due to medication to constrict the pupil for a while), and corrects itself in a day or so.

Good luck!

R

 

[LARS]

R,

Thanks for the input. I'm sure it will go well, but I have an irrational fear of blindness. I guess it comes from having bad eyes (very nearsighted) since I was a kid. Hence, my hesitation to make absolutely certain the first eye goes well before considering the other. The "good" eye is fine with contacts so no rush to do it other than convenience. And I figure eyesight that works (even corrected) is better than no eyesight.

I'm sure the op will go fine, but fears are fears no matter how illogical you know them to be!

 

[ls99]

I had cataract surgery last Nov, and the second in Dec.. I had a very rational fear of blindness, since I have one lazy eye. If that eye got screwed up it would take years to learn to see with the lazy eye. Driving would be out of question. Doc did the lazy eye first, all went well and then the primary one next month, which went well also.

I chose single focus lenses for both eyes. As of today my vision is better than ever. Though both eyes could use a - 0.5 diopter lens with a 15 degree cylinder for distance. (a result of slight corneal deformation) I don't use that correction. For reading + 1.25 correction is needed. If necessary I can read newsprint with great effort without corrective lenses.

 

[NeverBored]

This is so relevant - I'm still in my 50's and will probably be having cataract surgery in one eye soon. I'm nervous - can't stand the idea of someone cutting into my eye, but the fogginess and blur is driving me crazy.

Glad to hear so many are happy with the results.

 

[Moemg]

The one thing no one mentioned to me was the light show . I was pretty awake for the procedure and I saw a blast of colors . It reminded me of a laser show . It was not frightening just totally unexpected .

 

[Nords]

The one thing no one mentioned to me was the light show . I was pretty awake for the procedure and I saw a blast of colors . It reminded me of a laser show . It was not frightening just totally unexpected .

Just don't blink!

 

[ls99]

Gee, I missed out on the light show. Versed at work. No memory of the procedure at all. DW said as I was regaining consciousness I was babbling on about something. She could not understand the language. Something to be grateful for.

 

[LARS]

To close the loop I had the surgery about a week and a half ago and all I can say is "Wow"! For the first time in too many years I can see well without glasses/contacts. It is amazing!

I did go with the mono lense set for distance.

Thanks for all the input.

 

[Texas Proud]

To close the loop I had the surgery about a week and a half ago and all I can say is "Wow"! For the first time in too many years I can see well without glasses/contacts. It is amazing!

I did go with the mono lense set for distance.

Thanks for all the input.

So does that mean you need reading glasses

Glad to hear that you can now SEE!!!

 

[LARS]

So does that mean you need reading glasses

Glad to hear that you can now SEE!!!

For now I do need reading glasses. When I eventually get the second eye done the Doctor said if I wanted I could set the next eye more for reading than distance.

I'll make a decision then, but for now reading glasses is a very, very minor inconvenience compared to being able to wake up in the morning and not have to grab my glasses to see!

Cateract surgery really is amazing!

The doctor did tell me, however, given I was so near sighted I have to continue to be careful about retinal detachments as they can materialize later on due to the changes in the eyeball due to cataract surgery.

 

[Moemg]

For now I do need reading glasses. When I eventually get the second eye done the Doctor said if I wanted I could set the next eye more for reading than distance.

.

Congratulations on the successful surgery !
I had one set for reading and it works great . The only time I use readers is if I am reading for long periods of time . I also do not notice the difference in the eyes at all . I would highly recommend it .

 

[LARS]

Congratulations on the successful surgery !
I had one set for reading and it works great . The only time I use readers is if I am reading for long periods of time . I also do not notice the difference in the eyes at all . I would highly recommend it .

Thanks for the input.

 

[NeverBored]

I got preliminary information about my upcoming cataract surgery and they are recommending either the Tecnis or the Crystalens for a multifocal IOL. It looks like the Tecnis is the latest of this kind. Has anyone had any experience with either of these lenses? I am in my late 50s and was not really prepared to make this decision, but the vision in my right eye has deteriorated to the point where I am ready to do it. Just trying to choose the right lens is driving me nuts.

I don't mind wearing glasses for driving or for extended reading, but I don't want to wear them around the house and for hobbies, travel, etc. I spend a lot of time on a computer (don't we all) and have always loved to read, until the last year when reading has become difficult because of the cataract.

 

[LARS]

Everyone is different, but in my case I went with mono focus. I didn't want to chance something I couldn't test before hand.

In the end, I'd say my eye (with mono) turned out to be a reasonable compromise. I can see very clearly from about 1 1/2 feet to thirty or forty feet. For dedicated reading I still feel more comfortable with readers, which given a life of glasses/contacts is no big deal.

As far as distance, I see more than well enough (uncorrected) and so I'm pleased with the compromise the mono lense has made.

YMMV...

EDIT: I should have added that as far as the mono, around the house, everyday living I do not feel the need for any glasses (other than reading).