Cataracts and choices

[Jim Becker]

I honestly don't know what process my surgeon used to do the lens implant when I got my right eye done last year...it was absolutely necessary because the macular hole surgery I had to have the previous year accelerated the cataract growth very quickly. My surgeon had a little bit of a challenge because I had had LASIK back in 2003 and no records were available from that surgery for her to know for sure what changes were made. They had been destroyed years ago. She came close, however...20/25 in that eye uncorrected. I believe I have a single focal lens as I still absolutely require correction for reading and other close work. I'm actually fine with that.

I really, really, really can't wait to get my left eye done someday. Why? Color. There's a "yuge" and noticeable difference in color rendering between my "old" 65+ year old left lens and the spanking new synthetic lens in my right eye. Let's just say it's like comparing a soft white lamp next to a full spectrum lamp. I kid you not!!!

[Maurice Mcmurry]

Maurice, it sounds like yours were corrected for distance as well.

Again, thanks for the discussion and kind words!

My new Inter ocular lenses have no correction. I am back to 20 20 when looking at an eye chart. Before the procedure the cataracts distorted my 58 year old lenses and turned them into magnifiers. I could see sixteenths on the tape if I got very close but I could not drive safely at night or see the highway signs in time. I opted for no correction based on an acquaintances bad experience. I can see sixteenths now but only at stretched arms length which is too far from a saw to be useful. It is weird.

We lived on the Mercy Ship and were onboard during procedures. The operations were shown live on CCTV. I could not look.
The Caribbean Mercy | Mercy Ships

[Kev Williams]

I couldn't in a million years have a different focal length lens inside each eye. I did that accidentally when ordering a set of "computer" glasses from Zenni, because I did the math wrong on my left eye, so when I got the glasses the right side was in perfect focus at arms-length+about 6", great to see the monitor, but the left lens was perfect at about 12", great to see the keyboard... But it was ridiculously annoying trying to see either one with both eyes open, and almost as annoying closing one eye! I've been wearing glasses since I was 12 years old, and no-line bifocals since I was 20... so far, at 68 I still see great with the right glasses, but IF I ever get cataract surgery I'll just go for mid-range focus and let no-liners do the rest

[Scott Winners]

While I have never had cataract surgery, I have been wearing glasses since elementary school. I have never regretted splurging a (relative) few bucks on lens upgrades.

[Alan Lightstone]

OK. Saying this as a human, not a doctor.

I'll need cataract surgery some day. Welcome to living in Florida. The small personal point I wanted to bring up here is about seeing halos at night.

I'm one of the first persons in the US to have gotten LASIK. I flew to Toronto to have it done about a year before it was FDA approved in the US. I'm 26 years out from it.

A consequence of the procedure was that I do see halos at night from lights. But the nice thing is that you brain tunes them out very effectively. At least mine does. If you asked me about driving at night and seeing a halo, I would think for a few seconds and say, yeah I guess I do. But I really haven't noticed them consciously in decades.

I live near a location of a practice that does a monumental number of cataract surgeries a year. I always wanted to visit their facility just to see it. My OR experience can't fathom doing that many cases in a day. They are very well thought of, and you really hear very, very few complaints from patients.

In surgery, volume does matter. And higher volume practices in many procedures have been consistently shown to produce better results.

My best friend is an OD. Would I ask his advice before having the surgery - absolutely. Would he have the final say. No, that's a decision that will be between the ophthalmologist and myself. As it should be. Doctors don't do residencies for fun. They do it to learn like mad. Which they do.

As far as single vs multiple focal lengths. I've worn progressive lenses for years (my ophthalmologist when he did my LASIK said I'd be good for about 10 years then need reading glasses. 10 years later, like clockwork, came the reading glasses.) Many people have trouble with progressives. I couldn't have worked without them with the multiple focal lengths I needed to focus on in the OR. But they're not for everyone, as I assume multi-focal length lenses aren't. In my case, they'll probably be a great thing.

[Jack Frederick]

Curious on the cost of this surgery. I’ll be 74 tomorrow and have worn specs since five. Rt handed, left eyed which was a tid-bit I was unaware of until at about 26 i was on pistol range and the range master walking behind me said, “what are you doing?” He gave me the dominant eye check and I learned a lot about myself that day. for instance as a kid I was a left handed batter but a dead left field hitter. I didn’t see the ball until late. I am somewhat ambidexterous. I am heavily astigmatic in the left eye and where my prescription didn’t change for years the last three I have had to upgrade my specs annually and they are about $700+ for the lenses. Minimum cataracts, no macular. You compensate for life’s changes as you go along, but improved vision would be…wonderful!

[Jim Becker]

Jack, I believe the largest cost for cataract surgery is covered by Medicare which is nice for "mature" folks who largely are the ones that need it. But the one I got done prior to age 65 for medical reasons was nearly fully covered by our private group insurance from Professor Dr. SWMBO's employer. The out of pocket was only a few hundred dollars once I got things straightened out around a "non-network" anesthesiologist that was trying to bill a couple of grand for their services in the OR. The hospital and my surgeon were participating but the happy drug doctor (a contractor, apparently) wasn't. This was before the new "surprise billing" legislation was passed and went into effect, but our insurance carrier dealt with it on our behalf.

Specific to your situation, you'd need your doctor to find a way to medically find a way to justify the surgery given you state you don't actually have cataracts.

[Andrew Joiner]

Yes, it's a big decision and I put it off for a long time. I got to trust my doctor more as time went on and he got to know me and my needs for vision. I also tried prescription progressive lenses again in my glasses for the second time. I tried them 20 years ago and hated them both times. In fact I can't believe people can wear them. This helped me decide on monofocal implants. Once they're implanted lenses are hard to change. Ordering glasses online is easy and cheap now. My doctor agreed that I would probably like monofocals better!



Ier had both eyes done a week apart in December of 2021. I put it off for a long time and talked about it he:
https://sawmillcreek.org/showthread....ses&highlight=
I finally went with non laser assisted. My research indicated laser assisted didn't provide better results and fewer surgeons in my area did laser assisted.


I chose monofocal lenses. I did a lot of research on the pros and cons of all the land's choices. The con with monofocal is I'd have to wear glasses. The cons list for other lenses was longer.


In my case I prefer to wear glasses all the time like I have all my life. Many times over the years my eyes have been saved by my glasses taking the impact of a stray object. I also dislike reading glasses as I found out after my cataract surgery. I could see fine in the distance with no glasses for the first time in 60 years,but I had to wait 6 weeks for my RX bifocals. So I got an assortment of reading glasses. It drove me nuts to not have them on all the time to read. I made an adjustment to have them hang around my neck. That was convenient but still a hassle. I also found that even expensive reading glasses had less quality optics than my new prescription bifocals.


When I got my new bifocal prescription glasses it was like a miracle. I could see further than 20 ft slightly better than through my monofocal implants alone( glasses off). Vision from 3 ft to 20 ft was vastly improved looking through my prescription glasses. Reading took some getting used to because before cataract surgery I could see up close really good without glasses . To take out a Splinter or see details I'd always take my glasses off . My old bifocals were set for computer reading distance. Right after cataract surgery up close is permanently blurry unless I put on a pair of 3.00 reading glasses. I did adjust to this and can now remove splinters at computer reading distance with RX bifocals on.
Strangely now 10 months after cataract surgery I need a new prescription for glasses. I remove my RX bifocals to see sharply in the distance. My opthamologist says that happens occasionally but new RX bifocals are $31 shipped from Zenni. I'm so used to ordering glasses online now it's a no-brainer.
I'm happy with my cataract surgery. One big downside is I have big cloudy floaters. My Dr says I had them long before the surgery but now with the overall cloud of the cataracts gone the floaters are more obvious.

[Ron Selzer]

Curious on the cost of this surgery.

$6000 extra 3 years ago for my wife to get progressive lenses versus standard lens.
Top eye Doctor in Ohio
Insurance covered complete operation, I paid for the better lens.
Ron

[Edward Weber]

I just wanted to say thanks to the OP and everyone, this has been a great discussion

[Maurice Mcmurry]

I learned a lot too. During the cataract procedure I also had a stint put in my right eye to reduce the risk of glaucoma. I have had 3 checkups since and my pressures are good.

[glenn bradley]

Several people have told me about the option to have one eye focus closer than the other to give a better range of vision without glasses. I would think the simple lenses could be selected to focus at any distance desired - whether that's a good idea or not. Are you saying that's not done?

A coworker was talked into this by his lasik guy and has been unhappy ever since. It is not unusual to see him with his hand over one eye or the other depending on what he is looking at. If you are lucky you can have your lasik tweaked after a decade or so. Not so much with implants.

I'm not a doctor either but I thought the decline in vision was from a loss of elasticity in the lens with age making it more difficult to focus up close. Also cataracts of course, but with implants they're permanently gone. If that's correct about the reason for decline in vision I don't see why the correction of a lens implant at 65 would be a mistake by 80. (I crossed that bridge years ago, but I still want to understand what's going on.)

Lens degeneration certainly contributes to our declining eyesight. An implant removes this decline. If only that were the only thing that started to show the effects of father time . If you are unfortunate enough to have blood sugar issues retinopathy can be problematic. Macular degeneration, muscle atrophy, macular edema, and pressure (glaucoma) are some common issues for the rest of us as time goes on. Your inter-ocular implant does nothing for these.

My point is that an aggressively corrective implant can become problematic as we age. Trying to correct the previously mentioned issues if they come along is bad enough. Trying to prescribe glasses that you have to wear over what are essentially permanent glasses just makes things more tricky.

I'm not trying to convince anyone to do or not to do anything. I just have a knee-jerk reaction to some things growing up the son of an eye doc. Your reliable medical professional is still your best option for answers to these questions. The sales clerk at Ernie's 1-hour LASIK . .. not so much.

[Lawrence Duckworth]

I learned a lot too. During the cataract procedure I also had a stint put in my right eye to reduce the risk of glaucoma. I have had 3 checkups since and my pressures are good.

I thought I had cataracts...but I'll be going in for more glaucoma tests this week.

[Maurice Mcmurry]

I thought I had cataracts...but I'll be going in for more glaucoma tests this week.

I hope you get good news. Dad and B.I.L. are both on drops for glaucoma Its inconvenient but effective.

[Eduard Nemirovsky]

Speaking as a doctor - I don't have cataract yet, but did hundreds of anesthesia for cataract surgeries. Could be done with light sedation or without it, ophthalmologists choice mostly and availability of anesthesiologists. It is not painful procedure, but could be very scary. Somebody working in your eye!!
Laser just help to destroy old lens, ophthalmologist still needs to make small incision and pieces of old lenses needs to be remove. A new one coming thru same very small incision.
My recommendation - choose your eye doctor very carefully, ask hundreds questions and don't afraid of procedure - in last 20 or more years it's done millions time with much improved technology and technics.
Ed.