Cataract Surgery...which type of lens?

[kcowan]

I had a lens implant in 1995. It corrected my vision to 20/30. Then in 2000, I had the other (right) lens done, this time correcting to 20/20. Because I had always had monovision contacts, I adjusted immediately. In 2007, the right cataract had regrown and I had outpatient laser surgery to remove it.

Now for my question: The 1995 surgery used an unfolded lens whereas the 2000 surgery was done with a foldable lens. Now the 2 lower brackets that hold the lens in place have come loose. This causes me to see the upper edge of the lens at night (or looking up during the day). This is very irritating considering that I have been problem-free for 18 years.

Has anyone had experience with this problem and what are the possible remedies? Thanks.

 

[Amethyst]

I'm afraid I don't have anything to add except empathy, and that it is most surprising that an artificial implanted lens can develop a cataract. I did think a cataract is a thickening of the biological lens.

Amethyst

I had a lens implant in 1995. It corrected my vision to 20/30. Then in 2000, I had the other (right) lens done, this time correcting to 20/20. Because I had always had monovision contacts, I adjusted immediately. In 2007, the right cataract had regrown and I had outpatient laser surgery to remove it.

 

[Moemg]

I had cataract surgery ten years ago and many of my friends have had it . All have had monovision without any problems adjusting .The only problem I had was they did my first eye in January and the second three months later . During that time I had my newly done eye for distance and my regular nearsighted eye .The difference was too extreme and it actually made me nauseated .The minute the other implant was in I was fine and adjusted immediately . I love not wearing glasses and buying cheap sunglasses .

 

[kcowan]

I'm afraid I don't have anything to add except empathy, and that it is most surprising that an artificial implanted lens can develop a cataract. I did think a cataract is a thickening of the biological lens.

Amethyst

The original cataract grows on the original lens, bonding to it. The regrowth cannot bond to the plastic lens so the laser surgery just cuts it back out of the way and it falls harmlessly inside the eye. It is a 10 minute outpatient procedure.

 

[Amethyst]

Oh, OK, I thought the cataract-y biological lens had to be removed and replaced with the synthetic lens. I didn't know they left the real one in there.
Aha! Here is the relevant info, from Wikipedia:
"Some people can develop a posterior capsular opacification (PCO, also called an after-cataract). As a physiological change expected after cataract surgery, the posterior capsular cells undergo hyperplasia and cellular migration, showing up as a thickening, opacification and clouding of the posterior lens capsule (which is left behind when the cataract was removed, for placement of the IOL). This may compromise visual acuity and the ophthalmologist can use a device to correct this situation. It can be safely and painlessly corrected using a laser device to make small holes in the posterior lens capsule of the crystalline. It usually is a quick outpatient procedure that uses a Nd-YAG laser (neodymium-yttrium-aluminum-garnet) to disrupt and clear the central portion of the opacified posterior lens capsule (posterior capsulotomy). This creates a clear central visual axis for improving visual acuity.[19] In very thick opacified posterior capsules, a surgical (manual) capsulectomy is the surgical procedure performed. A YAG capsulotomy is, however, a factor which must be taken in consideration in the event of IOL replacement as vitreous can migrate toward the anterior chamber through the opening hitherto occluded by the IOL."

The original cataract grows on the original lens, bonding to it. The regrowth cannot bond to the plastic lens so the laser surgery just cuts it back out of the way and it falls harmlessly inside the eye. It is a 10 minute outpatient procedure.

 

[Tailgate]

ok, bumping again...

Just got back from initial cataract consultation with the opthamologist (eyes are still dilated).. She said I was a good candidate for the multi lens at 2k an eye and not covered by insurance.... the standard mono lens is taken care of by insurance after deductible is met... although I liked her a lot, it did sound a teeny bit like a sales pitch.

Anyway, I'm back there on the 18th for measurements and to make the decision about the lens. She said they (not sure who 'they' are) would offer the multi lenses at that time and I could go that way or turn them down in favor of the mono distance lens, so I'm guessing the real sales pitch is coming. We didn't discuss going with one far/one near like later posts on this thread brought up, so I guess I'll discuss that at the next consultation.

At this point for me, looks like the standard mono lenses are the tried and true way to go. Readers won't bother me a bit since I've worn glasses pretty much for 55 years.

Of course, tough decisions can go back and forth like a windshield wiper until it comes down to crunch time.

 

[TrvlBug]

ok, bumping again...

Just got back from initial cataract consultation with the opthamologist (eyes are still dilated).. She said I was a good candidate for the multi lens at 2k an eye and not covered by insurance.... the standard mono lens is taken care of by insurance after deductible is met... although I liked her a lot, it did sound a teeny bit like a sales pitch.

Anyway, I'm back there on the 18th for measurements and to make the decision about the lens. She said they (not sure who 'they' are) would offer the multi lenses at that time and I could go that way or turn them down in favor of the mono distance lens, so I'm guessing the real sales pitch is coming. We didn't discuss going with one far/one near like later posts on this thread brought up, so I guess I'll discuss that at the next consultation.

At this point for me, looks like the standard mono lenses are the tried and true way to go. Readers won't bother me a bit since I've worn glasses pretty much for 55 years.

Of course, tough decisions can go back and forth like a windshield wiper until it comes down to crunch time.

Just got back from my measurements appt, and wouldn't you know it, my astigmatism is worse than was visible to the dr. and I'm NOT a good candidate for the multis after all...why, oh why, didn't I make the measurements appt sooner...I would have my 'bionic' eye by now .

The technician stated that the measurement appt also lets the dr. know if there are issues with certain lenses. It assists the dr. and you in making the final decision as to which lenses are best for you. In my case, toric far for my bad eye. This leaves me with slight nearsighted in my left eye. Dr. says my brain should have no problem with the near/far combination, but if it does, I'll go with all far when the right one goes bad.

Good luck with your decision.

 

[bssc]

I have the near / far combination and haven't had any problems. After all, your brain also inverts the image which is much more complex.

 

[TrvlBug]

I have the near / far combination and haven't had any problems. After all, your brain also inverts the image which is much more complex.

Is your far in your dominant eye? This may be my problem in that I'm left eye dominant, however, the far is not going there. My former optometrist states most people who do this (backwards) cannot make the adjustment.

My surgery is set for the end of March and I'm going with the 'backwards' near/far combo, hoping I'll adjust. Time will tell.

 

[friar1610]

I had both eyes done last winter at a hospital in Vermont. When I inquired about the multifocal lenses the doctor said that the opthalmology department there strongly recommended against them. He said they did a very nice business replacing multifocal lenses that had been done elsewhere with monofocals. I took their advice and went with the lenses that are optimized for distance. I have to wear reading glasses but that is no big deal for me. I can't believe how much better I can see while driving, particularly at night. I can read road signs! I can read the crawler with the college basketball scores at the bottom of my TV screen!

 

[Bestwifeever]

I am hoping to have this done in a couple of months. I have been wearing mono vision contacts forever but I have been so nearsighted for so long that I am ready to just have both for distance and wear reading glasses.

 

[Moemg]

I am hoping to have this done in a couple of months. I have been wearing mono vision contacts forever but I have been so nearsighted for so long that I am ready to just have both for distance and wear reading glasses.

If you have had a good experience with monovision contacts you would do great with the monovision implants . I tried just distance contacts thinking that reading glasses would not bother me . They drove me nuts because I needed them all the time . Could not read menus or read anything without them .I always had to have them with me . The monovision implants that I have give me great distance but also enough close vision that I only need reading glasses if I am reading for a very long time .

 

[TrvlBug]

If you have had a good experience with monovision contacts you would do great with the monovision implants . I tried just distance contacts thinking that reading glasses would not bother me . They drove me nuts because I needed them all the time . Could not read menus or read anything without them .I always had to have them with me . The monovision implants that I have give me great distance but also enough close vision that I only need reading glasses if I am reading for a very long time .

This is the result I'm hoping for. I'll know in about a month .

 

[braumeister]

If you have had a good experience with monovision contacts you would do great with the monovision implants.

That's just what my ophthalmologist told me, too.
Best of luck with it!

 

[Ally]

Cataract surgery is a miracle, especially if you were extremely nearsighted before. I have the near/far lenses now and can function without glasses. I only use readers when I read a book with smaller type, otherwise my eyes get tired. After wearing thick glasses for most of my life, I'm in heaven.