Another Cataract Surgery Thread

[Dreamer]

I had cataract surgery on 9/2/21 on my right eye. I had the basic lens put in. I had cataract surgery on 9/16/21 on my left eye. My doctor told me that I had greater astigmatism on my left eye. He said that if he put the basic lens in my left eye my vision would be about 20/30. He said that it should be fine and I would probably be okay to drive without glasses, but that there would be a slight difference between the two eyes. He recommended getting the Clarity lens in my left eye, if I hoped to be 20/20. I did get the Clarity lens in my left eye and paid $1400.00 for it. I used the three drops in my eyes and I only have two days of drops left.

I was at the eye doctor today and my vision is 20/20. He asked me if I wanted a prescription or was I just going to use readers. He said if I did get glasses, then the top part would just be plain glass. I did not get the prescription, but I think that I am going to call back and get it. I think that it would be a good thing to have these for certain times, such as at a museum or even watching tv and using my iPad at the same time. I have to keep taking off and putting my glasses on now. His assistant told me that I would probably need a +1.50 in readers. I would imagine that prescription glasses would be clearer, but I don't know that for sure. I can read most things without readers, but it is not as comfortable reading if I have the readers on. I bought a pair of +2.50 shortly after I had my surgeries and knew that they were overkill for me. I have not had any problems with light sensitivity. I always try to wear sunglasses though and did prior to surgery. I need to try driving at night and see if I have any problems.

My DH had LASIK surgery many years ago. He had worn thick glasses since childhood. He paid extra at the time of his surgery for some type of mapping of his eyes prior to surgery. He loved not wearing glasses. He had cataract surgery a few years back, but he got the prescription glasses. He likes to have them with him in case he is driving at night. They help him to see better. I notice that he wears them sometime when he is reading a book also.

 

[Katsmeow]

I was at the eye doctor today and my vision is 20/20. He asked me if I wanted a prescription or was I just going to use readers. He said if I did get glasses, then the top part would just be plain glass.

I don't really understand him saying that. I have prescription reading glasses. The top part isn't plain glass. That entire pair of glasses is reading glasses. I do have a pair of computer glasses that are progressive lenses where the top is for an intermediate prescription and the bottom are readers.

I've lots of prescription reading glasses over the years and none of them had plain glass at the top. I did buy a size of frames where I could look over them for distance vision if I didn't want to take them off.

With +1.5, though, you are probably fine in drugstore readers if your right and left eye need the same prescription. I did that for years when my need for reading glasses was mild like that.

I do think I will have a difficult week between the 2 eyes being done. Right now my left eye can't read well but sees better with no correction than with my prescription reading glasses. So I only use the right eye side of the glasses (I just close my left eye to read). After I have the Vivity lens put in, I expect my right eye will still need glasses to read but my existing glasses will be too strong. I guess I will go try to find a cheap pair of readers to get me through that week until the left eye gets done....

 

[harllee]

For those of you needing prescription reading glasses I highly recommend Zenni. I get mine for $8 per pair, work great and I have a bunch of pairs of them for all over the house.

 

[Golden sunsets]

I don't really understand him saying that. I have prescription reading glasses. The top part isn't plain glass. That entire pair of glasses is reading glasses. I do have a pair of computer glasses that are progressive lenses where the top is for an intermediate prescription and the bottom are readers.

I've lots of prescription reading glasses over the years and none of them had plain glass at the top. I did buy a size of frames where I could look over them for distance vision if I didn't want to take them off.

With +1.5, though, you are probably fine in drugstore readers if your right and left eye need the same prescription. I did that for years when my need for reading glasses was mild like that.

I do think I will have a difficult week between the 2 eyes being done. Right now my left eye can't read well but sees better with no correction than with my prescription reading glasses. So I only use the right eye side of the glasses (I just close my left eye to read). After I have the Vivity lens put in, I expect my right eye will still need glasses to read but my existing glasses will be too strong. I guess I will go try to find a cheap pair of readers to get me through that week until the left eye gets done....

Not sure I understand your thought process. When I get my prescription (see my cataract story above), I fully expect the distance portion of the new progressive glasses to be clear glass, as my post surgery distance vision is now 20/20 or better. In fact as I mention above, I bought a pair of "multifocal readers" as an interim fix, but they don't work well because the distance portion (upper) of the glasses still has some magnification and I can't see objects at a distance nearly as well as when I take the glasses off.

 

[Kwirk]

My cataract surgery was about 1.5 years ago. Both eyes were myopic. The plan was for multifocal lenses in both eyes with an expectation that focus at computer distance would be acceptable. The interval between surgeries was to be ~6 weeks.

After the first eye was done I was not happy with the multifocal lens. Distance vision was improved but was not great (compared to 25/20 during my youth). This did give me the chance to try monovision with far vision in the treated eye and near vision in the untreated eye. I tolerated the monovision quite well and opted to have a simple near vision lens in my second eye.

I've been generally pleased with the mono vision outcome but wish I'd had a simple far-vision lens for the first eye. I fear there may be something of a profit motive with recommendations for special lenses.

 

[mn54]

of course there is a profit motive for using the premium lenses instead of the monofocal lenses. the insurance, or medicare, reimbursement for the standard monofocal lenses is going to be miniscule compared to the 4K for the premium lenses.

 

[braumeister]

of course there is a profit motive for using the premium lenses instead of the monofocal lenses. the insurance, or medicare, reimbursement for the standard monofocal lenses is going to be miniscule compared to the 4K for the premium lenses.

In theory, yes. But my surgeon talked me out of multifocal lenses when I asked about them. He said that in most cases it was impossible to predict who would tolerate them well vs who would find them a poor solution.

I think he was right, because I'm very happy with my distance-only lenses and happily grab a pair of readers when needed. OTOH, DW got the multifocal ones and says that overall she's sorry she didn't do what I did.

 

[Katsmeow]

Not sure I understand your thought process. When I get my prescription (see my cataract story above), I fully expect the distance portion of the new progressive glasses to be clear glass, as my post surgery distance vision is now 20/20 or better.

If all you need are reading glasses then you don't need progressive glasses. People wear progressive lenses either when they want distance (or intermediate) correction on the top and reading on the bottom. If you don't need distance or intermediate correction then you don't need progressive lenses. In that case, you just get glasses with reading only. I have a pair of prescription reading glasses that only have reading correction in them. They don't have anything for distance or intermediate. I do have a pair of computer glasses that have intermediate on the top and reading on the bottom. Pre-cataract I didn't need distance correction at all. (You could get progressive glasses with clear glass on top if you wanted, but I am just pointing out that it is not required).

If I have my reading glasses on and want to look at something at a distance I just look over them. You can buy reading glasses that aren't very tall where this is easy to do. Of course, when driving and such I just take them off.

I've been generally pleased with the mono vision outcome but wish I'd had a simple far-vision lens for the first eye. I fear there may be something of a profit motive with recommendations for special lenses.

I think it is more that the premium lenses offer options to people. Not everyone, for example, can tolerate monovision. DH tried monovision contacts some years ago and he couldn't not tolerate it at all. In fact, many surgeons will not do monovision cataract surgery on people unless they have had monovision contacts in the past demonstrating an ability to tolerate it.

Some people want to have good vision in both eyes with no reduced or reduced need to wear glasses and choose to get multifocal lenses in both eyes and it works out great for them.

I do think it is important for doctors to manage expectations. In the questionnaires and forms I filled out for my cataract evaluation, the documentation was clear that they can't guarantee that I won't need glasses post-cataract surgery.

There was no push for a premium lens. I was asked what was important to me. Where did I want to have clearest vision? How did I feel about having to wear glasses? Between distance, intermediate and near, where was it most important to me to see the best. Based upon my answers to those questions and my personal vision constraints (prior LASIK and prior vitrectomy in my left eye), they recommended particular lenses (different for each eye). That is what I expect them to do.

Now, if I had said I was perfectly fine with good distance vision and having to wear glasses for intermediate and near then a simple monofocal lens would have been fine, but that wasn't want I preferred. As a practical matter, if that was the lens I wanted, I wouldn't have gone to the surgeon I am going to and is wouldn't be worth traveling out of town.

 

[Time2]

I talked to my sister yesterday, found she was going in for cataract surgery at 6:30 am this morning. It was late in the evening and she was changing sheets and following instructions to minimize dust when she got home. I didn't get to ask any questions about the type of lens. She did say the second eye was scheduled two weeks later.

 

[RonBoyd]

Has anyone here had (or considered) this procedure?

New implantable trifocal lens sharpens world view

 

[Katsmeow]

Has anyone here had (or considered) this procedure?

New implantable trifocal lens sharpens world view

That is the PanOptix multifocal lens. It isn't a different procedure. It is the same cataract surgery as anyone gets, just a different lens.

From my understanding, the PanOptix lens is a great choice for people who fit the profile to use it and who don't mind the tradeoff.

That is, you need eyes that are "good" eyes. I was told before I had my vitrectomy that I would not be able to have a multifocal lens in that eye afterwards. Also, most doctors either won't use it on people who have had refractive surgery such as LASIK or are very picky on who they will use it on. So, lots of people are not good candidates for the lens.

The tradeoff is that the lens increases greatly the risks of halos and starbursts. Many people don't want to tolerate that. This is one reason why people who have had certain eye surgeries or procedures are not good candidates for the lens since they already have a higher risk of those kinds of things.

 

[mn54]

Has anyone here had (or considered) this procedure?

New implantable trifocal lens sharpens world view

the panoptix is a multifocal lens made by alcon. it is a very good lens for distant, intermediate and near vision. the lens I had implanted is the newest multifocal approved by the FDA. it is called the synergy lens made by J&J. it is supposed to be even better than the panoptix. I am very satisfied with it.

 

[braumeister]

I find these cataract threads interesting because we all have lots of trepidation when it's our turn.

I don't think I've ever been so afraid of something in my life.
"You're going to cut into my eyeball?"
NONONONONONO !!!

But after the first one I saw that it was really a very routine thing, and I had a great surgeon who inspired confidence. The second one was a real no-brainer.

Still, a most memorable adventure.

 

[Katsmeow]

I find these cataract threads interesting because we all have lots of trepidation when it's our turn.

I don't think I've ever been so afraid of something in my life.
"You're going to cut into my eyeball?"
NONONONONONO !!!

But after the first one I saw that it was really a very routine thing, and I had a great surgeon who inspired confidence. The second one was a real no-brainer.

Still, a most memorable adventure.

I had LASIK in 2 eyes in the 1990s and had a vitrectomy in July. Each time just the idea was scary. But, after the first it wasn't scary during it. So, just thinking about the cataract surgery is scary to me although I think I will be fine during it.

 

[tuckeverlasting]

Following with great interest as I expect to have cataract surgery sometime next year. Am severely nearsighted and have worn monovision contacts for at least 15 years. I spend many hours per day reading on my computer, and also books. The freedom from glasses is wonderful and I would hate to give that up, am apprehensive about my surgeon getting the lens power right. My evaluation appointment is some months off yet so will continue reading all I can find on the topic meantime.

 

[braumeister]

Am severely nearsighted and have worn monovision contacts for at least 15 years.

According to my surgeon, that makes you an excellent candidate for monovision IOLs when you get your cataract surgery, since you already know that your brain can comfortably accommodate them.

 

[Katsmeow]

I did a notice from my doctor's office that before going to the surgery center the day of surgery that I will go to the office first. They had told me back in June when I was evaluated that when I came back they would probably do this so they can recheck a few of the measurements.

The surgery center is only 2 minutes away. (The doctors in my surgeon's office are the only ones who use the center).

Following with great interest as I expect to have cataract surgery sometime next year. Am severely nearsighted and have worn monovision contacts for at least 15 years. I spend many hours per day reading on my computer, and also books. The freedom from glasses is wonderful and I would hate to give that up, am apprehensive about my surgeon getting the lens power right. My evaluation appointment is some months off yet so will continue reading all I can find on the topic meantime.

Look for a surgeon who does the Light Adjustable Lens if you are concerned about power. That lens is a monofocal lens but you can do monovision. The beauty of it is that you can adjust the power of the lens after surgery so you can fine tune the power for each exactly as you want. It can be hard to find surgeons who do that lens as it requires specific equipment which is used after surgery to adjust the power of the lens. But it is a great choice to be certain to get the power right. I am going to have that lens in my left eye. The primary downside that I see for the Light Adjustable Lens as opposed to a monofocal lens is that the Light Adjustable Lens is a premium lens and will cost out of pocket money as compared to a standard monofocal lens. The other downside is that you have to wear UV blocking glasses until the final prescription is chosen and locked in. To me, that is a minor factor and the ability to change the power after surgery well outweighs that.

 

[tuckeverlasting]

Yes, thank you braumeister and Katsmeow, much good info and advice! Forewarned is forearmed, great thread from everyone.

 

[Turbo29]

What are the opinions here on conventional vs laser? I have surgery scheduled next month for my right eye and the surgeon said that with laser, relaxing incisions could be made in my cornea at the same time to eliminate my astigmatism. With a monofocal lens I should have good distance vision and only need glasses for reading.


Vision in my left eye is still correctable to 20/25 but the surgeon is of the opinion that I will need surgery on that eye within the year although he didn't even mention the "two weeks apart plan" that everyone seems to be on in this thread. Now I am wondering if I should schedule the left eye as soon as the right eye settles in from the surgery.

 

[Katsmeow]

What are the opinions here on conventional vs laser? I have surgery scheduled next month for my right eye and the surgeon said that with laser, relaxing incisions could be made in my cornea at the same time to eliminate my astigmatism. With a monofocal lens I should have good distance vision and only need glasses for reading.


Vision in my left eye is still correctable to 20/25 but the surgeon is of the opinion that I will need surgery on that eye within the year although he didn't even mention the "two weeks apart plan" that everyone seems to be on in this thread. Now I am wondering if I should schedule the left eye as soon as the right eye settles in from the surgery.

My understanding is that laser has fewer complications. However, both have good outcomes. Also, the additional cost for laser is not covered by insurance/Medicare and is an extra cost.

On the eye that is 20/25 now, I would say it depends. Visual acuity isn't everything. Cataracts can cause problems that don't really show up on visual acuity such as halos and starburst, impaired depth perception, fading of color, etc.

The main argument for having surgery sooner rather than later it is that it is easier to do cataract surgery earlier in the process and the cataract will continue to progress. Surgery can be more difficult if you wait too long. On the other hand, if you want/need a specific time of premium lens that is not yet available in the US then you might want to wait a reasonable amount of time for the lens. Lenses have to be FDA approved so if there was one that you might want to use that is likely to be approved 6 months from now then that might be a reason to wait. On the other hand, if your needs are met by a monofocal lens or an existing available lens then that doesn't apply.

 

[RetMD21]

What are the opinions here on conventional vs laser? I have surgery scheduled next month for my right eye and the surgeon said that with laser, relaxing incisions could be made in my cornea at the same time to eliminate my astigmatism. .

Why not have a toric lens to correct for the astigmatism?

 

[braumeister]

I think some folks may think the laser is a better option because it's somehow "more modern" but I'm skeptical.

The incision made into your eye with the standard method is unbelievably tiny and extremely well established.

I once had the pleasure of meeting the guy who invented most of the instruments used for this procedure and he explained it in some detail. Everything he said was confirmed by my surgeon when it was my turn, so I would advise anyone not to obsess about this aspect.

 

[Katsmeow]

So tomorrow (Tuesday) I am off to Houston for my cataract surgery on my right eye. DH is driving of course (4.5 hour drive).

I must admit I feel a little bit of anxiety about it. In a way, that is sort of ridiculous. After all, this summer I had a vitrectomy with peel of macular pucker which from what I understand is a longer, more complex surgery. And, years ago, I had LASIK in both eyes. So, I am used to eye surgery. Still, there is just something about eye surgery, that causes me have that little bit of anxiety.

The surgery center called today to go over medical history and wanted to know all previous surgeries. While I am in good health I've had a lot of not terribly serious surgeries. So, when I'm asked, I have a habit to just think about my body and move head to toe naming each surgery. I finished and we were on to the next question when I realized I need to mention something from my vitrectomy (which was in July). I realized I had totally failed to mention it in my history.

Of course, the vitrectomy is the surgery that is really relevant for them to know about (of course, I've talked about it already with my doctor's office) and I just totally forgot it! I think what was going on is that since it is so recent I haven't yet internalized it as part of my spiel about prior surgeries.

Anyway, I will hopefully be able to post by at least the day after surgery. I'm not sure what near vision I will have after surgery and I may need to get some readers.

My current reading glasses will likely be way too strong after surgery. But, I will need readers for that eye. Lens is Vivity extended depth of focus lens which should give good distance and intermediate distance but I will need readers.

Most people could probably rely on the unoperated eye to read. But, that is the eye that currently can't read at all and my reading glasses don't help it at all. So -- we'll see (at least I hope so).

 

[harllee]

Kat, all the best. I am sure your surgery will go great!

 

[TrvlBug]

After the vitrectomy, the cataract surgery will be a breeze!