Intraocular Lens surgery

[Physics Guy]

My apologies for a not strictly early retirement question.

I have horrible eyes. Refractive correction of -12 in my better eye plus congenital nystagmus. I'm also 52 and have some presbyopia but haven't been doing anything about it because between adjusting scaling on computers and my lifelong bad habit of reading over my glasses I haven't felt the need. The combination of problems means that I am not a candidate for LASIK. It is possible that I am a candidate for an IOL.

I'd love some feedback on the recovery from such surgery if there is anyone here who has had it. I would almost certainly get single vision set for distance and wear reading glasses for close work as I worry that increasing presbyopia would otherwise be a problem if I chose to get corrected for close work and use glasses for distance. From reading online it is unlikely that I could use an implanted bifocal lens.

 

[Red Badger]

I have IOC's in both eyes (cataracts). Love 'em. Yup, need readers for close up, but otherwise very happy.

Recovery was just a vented patch, eye drops, and normal post op care for a few days of care.

 

[Physics Guy]

A few days sounds good.

Online descriptions made it sound like prescription eye drops for a week and lubrication eye drops for multiple more weeks.

 

[mystang52]

I have IOC's in both eyes (cataracts). Love 'em. Yup, need readers for close up, but otherwise very happy.

Recovery was just a vented patch, eye drops, and normal post op care for a few days of care.

ditto for me, for my right eye. The twilight anesthesia literally made the surgery a fun experience for me! I never did illicit drugs, but I think I know what a psychedelic experience is, after my surgery. My night vision improved dramatically.

 

[erkevin]

Had left eye done in January, a toric IOL. Lost my good near vision, but I now see 20/15. No corrective lens needed (except readers)
Dropless surgery, so i was good to go in 24-48 hours.

 

[MRG]

Both done in 2015 because of cataracts. I choose monovision and am very happy. I need readers for heavy stuff but can manage without them for light reading.

Recovery was a breeze.

 

[Telly]

Recent experience, very nearsighted. As you are wearing glasses and very nearsighted, as was I, try to get the surgeries reasonably close together, like two weeks apart. When one eye has the IOL, and the other doesn't yet and is using glasses lens (one transparent blank for fixed eye, regular lens for not fixed eye), you may have a pretty hard time seeing to drive. Because the fixed eye now has internal correction, the unfixed eye has external (glasses) correction, and the brain has trouble merging images due to the in/out offset between the points of correction. An inability to lock, slowness to lock, or locking only in a narrow visual range side-to-side. I could not use my rearview mirrors very well, nor back up much. And quick head turns, not so good.

Surgery - Went with Versed via IV in hand, no worries.

After surgery - Came out with vented clear plastic shield taped over a patched-over eye. Next day, back for checkup where the shield and patch removed. They gave me back the shield plus a small roll of 3M clear perforated tape (can buy more tape in drug store if needed, under $2). For the next week, eyedrops three times a day: an antibiotic (Oflaxacin), and a steroid (first time was Durezol, I didn't know any better, incredibly expensive, second eye I said No, use the cheaper one, Prednisolone, a generic which was $3 instead of $180! The Prednisolone was 4 times a day rather than 3. For a savings of $177, no problem for me! The antibiotic went on for 7 or 8 days, the steroid till it ran out, or a month, whichever comes first.

For the first week after the patch was removed, taped on plastic shield right before bed, took off on waking up. Purpose is so you don't rub the eye while sleeping. A good idea, I woke up at least 3 times during nights rubbing the plastic shield! Also, no water in eye for the first week after surgery.

If you're an Engineer, you'll not be lazy nor screw up, you'll follow the directions and do fine. I made some simple helps, like drawing two parallel lines with a Sharpie on the shield on each side of where the tape should go. So to put on the shield at night, I applied the tape between the two guidelines, leaving about 3/4" sticking out of top and bottom, fold over a small edge on the bottom of tape as a pull-off tab for the next morning, the tape sticks really good. And then looking in a mirror placed the shield, and then pressed down the tape. Quick and easy.

 

[Bestwifeever]

The recovery time for me after cataract surgery and distance IOL was a couple of days mostly for the super-dilation to subside. I could drive right after the follow-up visit with the doc. And omg could read the street signs!!!! There was a weaning period off the steroid eyedrops prescribed before surgery. And hypermyopic eyeballs are still oddly shaped and more prone to retinal detachment, of course, even though the vision is corrected. My eyes were almost as bad as OPs—I saved one -10 contact lens from my better eye; the other was -13. Going on five or six years now and every day I still am amazed at how well I can see. Will your insurance pay for it?

 

[footenote]

Same experience as everyone else: easy peasy. Both eyes for cataracts, very near-sighted, so surgeries were done within about two weeks. Since the pre- and post-surgery eye drop periods overlapped, I made a spreadsheet to keep track of which drops in which eye by day.

(Versa and other twilight drugs are, as mystang52 noted, fun. Nurse warned me "Sometimes it's less effective for the second procedure." Indeed: I was relaxed enough to let them dig around in my eye, but could hear and remember their conversation during surgery.)

 

[MRG]

Recent experience, very nearsighted. As you are wearing glasses and very nearsighted, as was I, try to get the surgeries reasonably close together, like two weeks apart. When one eye has the IOL, and the other doesn't yet and is using glasses lens (one transparent blank for fixed eye, regular lens for not fixed eye), you may have a pretty hard time seeing to drive. Because the fixed eye now has internal correction, the unfixed eye has external (glasses) correction, and the brain has trouble merging images....

Good point. I was extremely nearsighted and unable to wear my old glasses at all! I can only close one eye independent of the other too. I walked around with one eye closed for three weeks. Why three weeks? I was scheduled for 2 weeks and showed up, got fully my other eye fully dialiated...The surgeon was too sick to operate on me. So another week of one-eye.

 

[braumeister]

There was a good long thread a couple of years ago about IOLs.
http://www.early-retirement.org/forums/f38/cataracts-which-lens-87109-5.html

Incidentally, maybe a mod could correct the title of this thread for future searching -- it's "intraocular" not interocular.

 

[TrvlBug]

... ...Since the pre- and post-surgery eye drop periods overlapped, I made a spreadsheet to keep track of which drops in which eye by day. ... ...

Also by time of day so they are properly spaced . For 2-3 weeks post surgery IIRC.

 

[oldphd]

It's been just over a month since I had my cataracts done.

First, I had the "no drop" procedure. Walked out with no patch, no drops, etc. How do they do this, you ask? Well, let's just say marketing got involved to pick the name, because the original designation by the doc was "the old shot in the eyeball" procedure. They give you a single shot with antibiotics, steroids, etc., at the end of the procedure. Took 24 hours+ for dilation to go down, so things were blurry most of the first day, fine after that.

I've got astigmatism, had mild eye done with LRI (limbal relaxing incisions), worse eye got a toric. Both procedures utilized laser. As far as recovery, not sure how much the laser helped since that's all I experienced, but it was slick. Eye done with LRI had no astigmatism at 3 weeks, one with toric still had some at a week but haven't gotten out far enough to know for sure what the long term holds. Prior to surgery doc said to expect to need a little astigmatism correction.

Near, far, or combo. I went with good near vision. Doc said he felt that I'd be able to read without correction, but that if he tried distance correction I still might want/need correction. I had 20/15 corrected and was having trouble at 20/25 with lots of double vision and night glare.

Side note: while researching multi-focal lenses, I found an article in a review mag for opthalmologists that said if you have a patient who is an engineer and asks how the multi-focal work, they are not likely to be a good candidate for them. I'm an engineer who was looking into how the multi-focals work.
What I did learn is that they focus multiple images on the macula and you have to adapt your brain to picking out the right one for what you're doing. Given what I was seeing with my cataracts (which were mild), the doc said I'm picky/sensitive/whatever, and sent me down that road.

At this point, happy with the result, though looking forward to getting a final set of glasses since right now I am test driving a temporary set.

 

[Amethyst]

That just sounds like an engineer joke
Curiosity = better understanding = a better patient.

I asked a lot of questions about my multi-focal, toric contact lenses, which my Dr. was happy to answer. The CL's have concentric rings of correction, and your brain learns to "pick" which rings to see through for near, far, or middle distance. Sounds very like the multi-focal cataract lenses.

I
Side note: while researching multi-focal lenses, I found an article in a review mag for opthalmologists that said if you have a patient who is an engineer and asks how the multi-focal work, they are not likely to be a good candidate for them. I'm an engineer who was looking into how the multi-focals work.
What I did learn is that they focus multiple images on the macula and you have to adapt your brain to picking out the right one for what you're doing. .

 

[Telly]

Same experience as everyone else: easy peasy. Both eyes for cataracts, very near-sighted, so surgeries were done within about two weeks. Since the pre- and post-surgery eye drop periods overlapped, I made a spreadsheet to keep track of which drops in which eye by day.

(Versa and other twilight drugs are, as mystang52 noted, fun. Nurse warned me "Sometimes it's less effective for the second procedure." Indeed: I was relaxed enough to let them dig around in my eye, but could hear and remember their conversation during surgery.)

I had not heard of "pre-surgery" drops before.

Before surgery, I was very concerned about seeing tools going at my eye, thus I opted for Versed. With Versed, it never happened. For the first eye, I became vaguely aware right near the end, and all I perceived was a small pleasing light blue light, with some occasional black squiggles on it, sort of like being down in a well and looking up at the sky. No concern or worries at all. For second eye, I was more aware, but aware as far as time, it seemed to be taking longer, not that anything was different than the first time. Still no worries. Success!


BTW, "Versa" is a subcompact car made by Renault - Nissan. I am certain that Medicare would not have paid for that, had I chosen it

 

[Physics Guy]

OP here - a name change on the thread would be great. I knew I'd messed it up but not before I hit Post. Thanks for the continuing flow of info. I'm especially glad to hear the results from others who done IOL as elective surgery for myopia.

 

[MBAustin]

That just sounds like an engineer joke
Curiosity = better understanding = a better patient.

I asked a lot of questions about my multi-focal, toric contact lenses, which my Dr. was happy to answer. The CL's have concentric rings of correction, and your brain learns to "pick" which rings to see through for near, far, or middle distance. Sounds very like the multi-focal cataract lenses.

Could you share the brand info of your multi-focal toric contacts? I have astigmatism in both eyes and an odd prescription (anisometropia) and am increasingly unhappy with my monovision contacts. My doctor doesn't think there's a good multifocal toric out there for my situation, but I like to keep up with what's out there. TIA!

 

[bobandsherry]

I'd love some feedback on the recovery from such surgery if there is anyone here who has had it. I would almost certainly get single vision set for distance and wear reading glasses for close work as I worry that increasing presbyopia would otherwise be a problem if I chose to get corrected for close work and use glasses for distance. From reading online it is unlikely that I could use an implanted bifocal lens.

My experience.... I had Lasik many years ago. That made my prescription a bit trickier. I did pre-op drops for a week before the procedure. I opted for bladeless (laser) surgery. I watched TV later that evening. Day after procedure I was seeing well, no discomfort. Did second eye two weeks later. Same outcome.

For me, I went with Tenics Symphony Extended Range lens. Yes, cost considerably more but worth it to me. In my mid-50's, I hope to have many years left to enjoy my improved vision and doing without readers. I now have vision, near and far. There is no "bi-focal" type of vision effect, the vision is clear regardless of the focal point. Nothing you need to train your eye or brain. It just works.

I had my procedure done last September and no longer need readers for about 99.5% of my vision. Since having the procedure I've put on readers 5 times, for extremely close up or really, really, tiny print. Other than that I can read, use the computer, drive, etc without needing any readers or glasses. I can see at night including driving. There is some haloing from headlights or streetlights, but as I've described what I see to my wife she has very similar vision with her contacts. So that's a point of reference. For those who say readers are fine, they haven't had the freedom of going without them.

Good luck.

 

[swakyaby]

I asked a lot of questions about my multi-focal, toric contact lenses, which my Dr. was happy to answer. The CL's have concentric rings of correction, and your brain learns to "pick" which rings to see through for near, far, or middle distance. Sounds very like the multi-focal cataract lenses.

I also asked my optometrist about multi-focal toric contacts lens on my last visit 3 months ago. I had been using toric monovision contacts in each eye for w*ork, then reverted back to toric binocular vision contacts coupled with reading glasses after retirement. He told me that the multifocal toric lenses were "not quite there yet" in his opinion, that they were getting close to getting it right, and to keep asking about them. And he would then let me know when they were suitable for my case.

 

[yakers]

Both done in 2015 because of cataracts. I choose monovision and am very happy. I need readers for heavy stuff but can manage without them for light reading.

Recovery was a breeze.

I'm half way through. Got the inplant on distance eye and its great. Using a contact lens for other eye right now, surgery scheduled for a couple more months. The 'monovision' with lens inplant and contact lens is very workable but now I can tell how bad my bad eye is and can't wait for new lens.

 

[Amethyst]

My eye dr. in MD contracted them out to a lab, so I don't have a brand name. I had to order them through this eye dr. and pick them up at the office. Since we've moved, I guess I'd better ask them to forward the information to a new dr. (when I find one).

The original Rx took some tweaking, as I recall.

Could you share the brand info of your multi-focal toric contacts? I have astigmatism in both eyes and an odd prescription (anisometropia) and am increasingly unhappy with my monovision contacts. My doctor doesn't think there's a good multifocal toric out there for my situation, but I like to keep up with what's out there. TIA!

 

[Teacher Terry]

My husband had these in his contacts and couldn’t adjust. I chose the regular cataract lenses and use reading glasses.