Re: Cataract surgery lens choice

BklynKinsey · ‎04-24-2011

I just went yesterday for a consultation with an ophthalmologist regarding my cataracts. I had Lasik surgery 18 years ago so that complicates things. This doctor was recommended because he has experience doing post-Lasik cataract surgery.

He asked what did I want from this surgery. I said that for the first time in my life I would like to see without glasses. Even with Lasik, I initially needed reading glasses. And, 6 years after Lasik, my vision regressed and I was back in progressive glasses full-time. So, he recommended a new trifocal lens call PanOptix.

I will also have the laser-assisted technologies available -- for the cataract removal and the surgery-monitoring system.

Medicare only pays for the basic lenses and not for the specialized lenses or the laser-assisted technologies. It will cost $4,000 per eye out-of-pocket.

I confess that I am absolutely terrified of doing this.

Silver Lining · ‎04-16-2010

@noodleann wrote:
Like others, I was not given a choice. Some eye doctors, IMO, have a deity complex, and mine was one. He decided that although I was just supposed to get plain simple lenses since I wasn't paying extra, he'd implant one for near vision in one eye and one for far vision in the other eye.

Thankfully, he shared this lunatic plan with me in the post-op exam after the first surgery, and I was shocked. I get migraines, icepick headaches, sick stomach headaches, etc., and I could just imagine the kind of headaches I'd get with such a distortion in vision. I told him absolutely not, and to implant an identical lens in the second eye so I'd have consistent vision, and he did.

The aftermath was rocky. I developed terrible dry eye, which is a well-known but little-mentioned side effect of the surgery. I hadn't had it before and didn't realize what it was. Eventually most people's dry eye resolves, and mine did, but I'd have bad attacks of dry eye after that. I finally saw a different eye doctor about it and he recommended liberal use of artificial tears and taking an Omega supplement, which I started that day. Five months and no attacks, and I'd have had at least one by now, so I swear by Omega 3>9 supplements.

I am very glad to have gotten the cataracts removed, and apart from the now-resolved dry eye issue, had no problems with the surgery. I had it done without sedation, so I was aware of everything happening, which was interesting. But my advice is to have a very granular discussion with the surgeon about exactly what he or she will be doing and why, and specifically what will be implanted in your eye. Research side effects and be prepared for dry eye. Follow all the post-surgery instructions and use the drops they give you as directed.

My last word on this is I've known several people in RL who've paid thousands of $ extra for having corrective lenses implanted when they had their cataracts done, and not one of them has been able to stop wearing eyeglasses. One of them got a partial refund on the surgery costs because the surgeon had promised a glasses-free life and didn't deliver. So just be aware that although people on this thread seem to have had great experiences from start to finish, some don't. Good luck.

I'm sorry you have had so much trouble with cataracts. I have dry eyes that are most likely caused by allergies, age, not enough sleep, and possibly too much computer surfing. I've had my share of eye problems. Amblyopia as a very young child, wore a patch over the "good" eye in order to strengthen my "weak" eye. It was very uncomfortable and embarrassing. Twenty years ago I had an iridectomy after the ophthalmologist tested the pressure in my eyeballs. Both of my eyes had to be done. A channel (tunnel) is lasered through the iris to prevent pressure building in the eye causing injury or blindness. I think optometrists also include the test as part of an eye exam.

I used to have excruciating migraine headaches with vomiting and so forth years and years before having cataracts. They were probably hormonal complicated by tension from my occupation and ex-husband. Anyway, the migraines stopped after all of that went away

For the sake of people reading this thread, I have to say I think most people are satisfied or happy with their cataract surgery. Yours was horrible. Mono-vision lenses are not "lunatic plans." Many people have mono-vision eye glasses, and mono-vision implants are very common. I have a nearsighted lense in one eye and a farsighted lense in the other. Your brain and eyes adapt to them. Because of that I can read without glasses (which I couldn't for years) and I can see long distance to drive, watch activities like baseball, football, basketball, tennis, etc.

FrostyBabe1 · ‎05-09-2016

I've had cataract surgery in one eye, and there's no sign that I'll need it in the other eye at any time - yet. I know that sounds odd, but I had a retinal detachment, and when they do the surgery to fix that, it's pretty much a guarantee that you'll get a cataract and that it'll grow like it's being fed Miracle-Gro. That was true for me, and I had my cataract surgery just about 2 years after the retinal detachment.

The surgery itself was a non-event for me, particularly after having 2 procedures for the retinal detachment. Technically, I could've driven myself there and back as the state of Michigan only requires that you have 20/40 vision in one eye to drive legally. I had no sedation ( I didn't see the point - it's a 10 minute procedure). We also had a challenge with numbing the eye as I'm highly allergic to all numbing agents in the "ester" family. That rules out all of the numbing eye drops that are used. We ended up using lidocaine to numb the eye, but it was still a bit uncomfortable.

I asked my opthamologist about a multi-focal lense, as the affected eye was the one that I had previously had good near vision in, while I had good distance vision in the other eye. He was adamant that he would not implant one for a number of reasons and I trust his judgement. Also, my insurance only covers the standard lense and I couldn't opt for a different lense and just pay the cost difference. I would've had to pay for the entire surgery out of pocket. Yes, that's right. The entire surgery. Because the lens wasn't covered, they wouldn't pay for the surgery to implant it.

I now wear multi-focal contact lenses. I have 20/20 distance vision in each eye, but need mid and near correction. Each of us has our own quirks, and mine is that I do not want to wear glasses. I went 50 years without them, and I'm not about to begin wearing them now.

~The more someone needs to brag about how wonderful, special, successful, wealthy or important they are, the greater the likelihood that it isn't true. ~

noodleann · ‎06-10-2015

@Puppy Lips wrote:
@noodleann wrote:
Like others, I was not given a choice. Some eye doctors, IMO, have a deity complex, and mine was one. He decided that although I was just supposed to get plain simple lenses since I wasn't paying extra, he'd implant one for near vision in one eye and one for far vision in the other eye.
. . .
@noodleann If my vision is not completely corrected, can I still wear contacts after having cataract surgery?

As far as I know you should be able to, unless you did have dry eye that didn't resolve and that caused problems. I would talk to the surgeon and your eye doctor about it. Perhaps people here will weigh in.

Hopefully, you'll have a very positive experience like the ones people posted about. I wanted to present a different experience, and one I'd like to have known could happen--and what to do if it did--before the operations. But I bet you'll have a smooth course and come out perfect.

Full disclosure, I have diabetes. It's well controlled, but I know it has a generally drying effect on me. That might be a big factor in how I healed.

Good luck.

noodleann · ‎06-10-2015

@Silver Lining wrote:
@noodleann wrote:
Like others, I was not given a choice. Some eye doctors, IMO, have a deity complex, and mine was one. He decided that although I was just supposed to get plain simple lenses since I wasn't paying extra, he'd implant one for near vision in one eye and one for far vision in the other eye.

...

I'm sorry you have had so much trouble with cataracts. I have dry eyes that are most likely caused by allergies, age, not enough sleep, and possibly too much computer surfing. I've had my share of eye problems. Amblyopia as a very young child, wore a patch over the "good" eye in order to strengthen my "weak" eye. It was very uncomfortable and embarrassing. Twenty years ago I had an iridectomy after the ophthalmologist tested the pressure in my eyeballs. Both of my eyes had to be done. A channel (tunnel) is lasered through the iris to prevent pressure building in the eye causing injury or blindness. I think optometrists also include the test as part of an eye exam.

I used to have excruciating migraine headaches with vomiting and so forth years and years before having cataracts. They were probably hormonal complicated by tension from my occupation and ex-husband. Anyway, the migraines stopped after all of that went away

For the sake of people reading this thread, I have to say I think most people are satisfied or happy with their cataract surgery. Yours was horrible. Mono-vision lenses are not "lunatic plans." Many people have mono-vision eye glasses, and mono-vision implants are very common. I have a nearsighted lense in one eye and a farsighted lense in the other. Your brain and eyes adapt to them. Because of that I can read without glasses (which I couldn't for years) and I can see long distance to drive, watch activities like baseball, football, basketball, tennis, etc.

Thanks for the corrective to my getting the wrong end of the stick regarding these mono-vision lenses. But for me, I think they'd be dead wrong and am very glad I didn't get them. You had amblyopia as a child, so you know how that feels. I still have it, and the eye that wanders can get pulled off to the periphery if there are distracting lights or bright colors unless my eyes are tightly focused, either with glasses or an act of will. Enhancing the vision in that eye for distance could worsen that problem.

What this all goes back to is the failure of the doctor to inform me about his intentions prior to surgery. Some doctors seem to think "consultation" is defined as "Do what thou wilt shall be the whole of the law." Meh. But at least I can see!

Ceci · ‎03-11-2010

For the sake of people reading this thread, I have to say I think most people are satisfied or happy with their cataract surgery. Yours was horrible. Mono-vision lenses are not "lunatic plans." Many people have mono-vision eye glasses, and mono-vision implants are very common. I have a nearsighted lense in one eye and a farsighted lense in the other. Your brain and eyes adapt to them. Because of that I can read without glasses (which I couldn't for years) and I can see long distance to drive, watch activities like baseball, football, basketball, tennis, etc.

I am so grateful to read your post. I had cataract surgery on my right eye 6 months ago. At the time my eye doctor asked if I wanted a lens for near or far vision. I gave it some thought as I have worn glasses for distance for over 25 years. I've never needed reading glasses.

I felt since I have worn distance glass for so long, I'd continue to do that. I didn't like the idea of having to use readers as I've never had to. The doctor was suprised and said 99% of his patients wanted a lens for distance. I explained that I've always used distance glass for driving or watching tv/movies, but never did for reading and I didn't want to start. Decided I'd just leave things the way it was, distance glasses, no readers.

So, I had the lens implanted for reading. I'm very happy with it, I don't need glasses to read. But, I need my distance glasses for everything else.

Now, I'm planning to have my left eye done and am debating whether to have that lens for distance. I've worried about whether I'd find it disorienting having one eye for distance the other for reading.

My eye doctor mentioned that, but I thought it would be weird but now, reading your post, realize its doable! Thank you!

Silver Lining · ‎04-16-2010

@noodleann wrote:
@Silver Lining wrote:
@noodleann wrote:
Like others, I was not given a choice. Some eye doctors, IMO, have a deity complex, and mine was one. He decided that although I was just supposed to get plain simple lenses since I wasn't paying extra, he'd implant one for near vision in one eye and one for far vision in the other eye.

...

I'm sorry you have had so much trouble with cataracts. I have dry eyes that are most likely caused by allergies, age, not enough sleep, and possibly too much computer surfing. I've had my share of eye problems. Amblyopia as a very young child, wore a patch over the "good" eye in order to strengthen my "weak" eye. It was very uncomfortable and embarrassing. Twenty years ago I had an iridectomy after the ophthalmologist tested the pressure in my eyeballs. Both of my eyes had to be done. A channel (tunnel) is lasered through the iris to prevent pressure building in the eye causing injury or blindness. I think optometrists also include the test as part of an eye exam.

I used to have excruciating migraine headaches with vomiting and so forth years and years before having cataracts. They were probably hormonal complicated by tension from my occupation and ex-husband. Anyway, the migraines stopped after all of that went away

For the sake of people reading this thread, I have to say I think most people are satisfied or happy with their cataract surgery. Yours was horrible. Mono-vision lenses are not "lunatic plans." Many people have mono-vision eye glasses, and mono-vision implants are very common. I have a nearsighted lense in one eye and a farsighted lense in the other. Your brain and eyes adapt to them. Because of that I can read without glasses (which I couldn't for years) and I can see long distance to drive, watch activities like baseball, football, basketball, tennis, etc.

Thanks for the corrective to my getting the wrong end of the stick regarding these mono-vision lenses. But for me, I think they'd be dead wrong and am very glad I didn't get them. You had amblyopia as a child, so you know how that feels. I still have it, and the eye that wanders can get pulled off to the periphery if there are distracting lights or bright colors unless my eyes are tightly focused, either with glasses or an act of will. Enhancing the vision in that eye for distance could worsen that problem.

What this all goes back to is the failure of the doctor to inform me about his intentions prior to surgery. Some doctors seem to think "consultation" is defined as "Do what thou wilt shall be the whole of the law." Meh. But at least I can see!

@noodleann, I shouldn't have written such a gung-ho post about my cataract surgery and what seemed like a miracle to me. It must be discouraging to those who've had unpleasant experieces and unsuccessful results. I had been terrified that something would go wrong considering each eye had its own complications, i.e., an iridectomy in each eye, one of which had astigmatism. I told the ophthalmologist I wanted "the best that money could buy" and he said you're getting what is best for you so trust me. He also said he was going to make me "a little nearsighted" to be able to read without glasses. Some people might have immediately run out then and there but he was the doctor who had found a serious condition years ago in both of my eyes and "fixed" them.

I realize now how lucky I am to have had an experienced doctor who really cared about me and didn't push or agree to "premium" lenses. He said that they have been proven to have more complications and outright failures than standard lenses. Some people don't realize that the standard lenses are digitally measured and carefully fitted to each eye.

Katcat1 · ‎07-21-2011

@shy bobcat When I had my surgery I did not have a choice. I have had both lenses replaced (not at the same time) and my vision is excellent.

kindness is strength

patbz · ‎03-10-2010

I had both eyes done about 18 mths ago and all in all I'm pleased. Dr. said the "standard" lens would work best for me. I did pay several hundred dollars out of pocket to have a test performed during surgery to get the best fit of the lens. I also had my drops during surgery (so I didn't need to administer repeatedly after surgery.

Silver Lining · ‎04-16-2010

@Ceci wrote:
For the sake of people reading this thread, I have to say I think most people are satisfied or happy with their cataract surgery. Yours was horrible. Mono-vision lenses are not "lunatic plans." Many people have mono-vision eye glasses, and mono-vision implants are very common. I have a nearsighted lense in one eye and a farsighted lense in the other. Your brain and eyes adapt to them. Because of that I can read without glasses (which I couldn't for years) and I can see long distance to drive, watch activities like baseball, football, basketball, tennis, etc.

I am so grateful to read your post. I had cataract surgery on my right eye 6 months ago. At the time my eye doctor asked if I wanted a lens for near or far vision. I gave it some thought as I have worn glasses for distance for over 25 years. I've never needed reading glasses.

I felt since I have worn distance glass for so long, I'd continue to do that. I didn't like the idea of having to use readers as I've never had to. The doctor was suprised and said 99% of his patients wanted a lens for distance. I explained that I've always used distance glass for driving or watching tv/movies, but never did for reading and I didn't want to start. Decided I'd just leave things the way it was, distance glasses, no readers.

So, I had the lens implanted for reading. I'm very happy with it, I don't need glasses to read. But, I need my distance glasses for everything else.

Now, I'm planning to have my left eye done and am debating whether to have that lens for distance. I've worried about whether I'd find it disorienting having one eye for distance the other for reading.

My eye doctor mentioned that, but I thought it would be weird but now, reading your post, realize its doable! Thank you!

@Ceci , you're welcome! Yes, you might feel comfortable getting the details from the doctor and going ahead with that choice. Another thing I should mention.... I don't know which one of my eyes has the lense that is making me able to see things up close and which eye has the lense to maintain good distance vision. They work together. I don't need to squint or close one eye to read. That's the most important thing for me. My ophthalmologist did say, though, that eventually, especially with aging in general, a prescription for glasses might be desired if I were to notice anything different. My mother passed away at age eighty-two and her vision never diminished. Her cataract surgery and mono-vision lenses were still great after many years. Everyone is different but it can't hurt to further explore the possibilities.