OT-School me on cataract surgery please

[Len J]

I have really bas vision. My left eye, even w correction, allows ne to see the line below the big E, if I squint. My right eye currently requires a -12.8 correction to get me ok vision. I'm obviously right dominate, and my left is mainly for peripheral motion detection.



I've recently been diagnosed w cataracts in both eyes. The MD claims that replacing the lens will not only improve my vision on both eyes (giving me binocular vision for the first time in my life) but will also improve my perception of color. Sounds great, but, frankly the thought of putting my only functioning eye at risk scares the hell out of me.



Anyone have any experience or expertise on this!



Thanks in advance



Len





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[bargainguy]

No need to fear. This is one of the most common surgeries performed.

These days, they put you under, break up your old lens (phacoemulsification) and slurp it out, put the new lens in and that's about it.

The most common complication is leaving a few fragments in, and that's not a huge deal in most cases anyway.

You will be amazed at your new vision. Good luck!

[eddief]

Will they remove the old lens and replace with plain, clear. Or will they replace it with a prescription? I have been wearing glasses since I was 2 years old and have darn good vision with glasses. But, I am developing a cataract in my left eye. When I have it done, I get to decide to replace with plain or prescription lens. Since I have been doing glasses forever, will probably go for plain. And next year when I am medicare eligible, that service does plain for free and charges a chunk for prescription.

I posted a youtube of the 4 min operation a while back. Crazy simple and fast, but not without many stories of botches. Find a good surgeon.

If you pay cash here, it's about $5500 for 4 minutes.

[Len J]

Will they remove the old lens and replace with plain, clear. Or will they replace it with a prescription? I have been wearing glasses since I was 2 years old and have darn good vision with glasses. But, I am developing a cataract in my left eye. When I have it done, I get to decide to replace with plain or prescription lens. Since I have been doing glasses forever, will probably go for plain. And next year when I am medicare eligible, that service does plain for free and charges a chunk for prescription.



I posted a youtube of the 4 min operation a while back. Crazy simple and fast, but not without many stories of botches. Find a good surgeon.



If you pay cash here, it's about $5500 for 4 minutes.







In my case they will replace with corrective tori lenses, correcting both the astigmatism and the vision. No, more, contacts.



Len

[gasman]

Easy surgery done with some sedation and local anesthesia. I have a buddy in a situation similar to yours but corrective glasses didn't give him 20/20 vision. He had both eyes done with corrective lenses and he couldn't be happier. Just find a surgeon who has a lot of experience.

[soulspinner]

My father had it done recently. Do it.

[2LeftCleats]

Just had my left eye done 2 wk ago. As above, from the patient perspective there's hardly anything to it.

I'm right eye dominant so the surgeon's goal wasn't to get me eagle sharp at distance but to be decent in distance and really good close and midrange (computer and dashboard). I had a so-called premium lens. That part of it isn't covered by insurance and was $2400 cash up front. This particular lens uses the eye's own focusing mechanism to flex the lens allowing for a broad range of focus. In that eye I see 20/25 and can read very fine print (like the kind telling you of all the potential complications of the surgery).

It also gives me more true color. Looking at a white light with the operated eye, it actually looks white compared to the slightly yellowish view with the other eye, which isn't bad enough to do yet.

Prior to the surgery careful measurements are made and an algorithm calculates the prescription of the implant. In my case, previous LASIK surgery partly invalidated that. He had a device during surgery that took a new measurement. If there is some difference, the surgeon makes an educated guess about the right lens to install. In my case there was minimal difference.

I have some aberration from the previous LASIK surgery so I get some image distortion, especially at night, but it's better than before.

My guess is that OP may have more adjustment than most if he's not had binocular vision in a while.

[biker72]

I had both eyes done a couple of years ago.
I knew the colors would be more brilliant so that was no big deal for me.
The sharpness of everything has been rather life changing.

Totally painless and the procedure itself takes just a few minutes.
My out of pocket cost after insurance for both eyes was $425.
Don't go for the low bidder on this job.
Complications are rare.

[Ringleader]

I've sent you a PM regarding Improved Color Vision after Lens Replacement.
Cheers,

Richard...

[wc1934]

In my case they will replace with corrective tori lenses, correcting both the astigmatism and the vision. No, more, contacts.



Len

Might want to ask about the claim of "no more contacts". That claim is usually accurate, but as they correct for distance, your closeup vision may get compromised and you may need reading glasses. No big deal, but there may be a trade off. Best of luck.

[kramnnim]

My mother had it done...she had to go back a couple years later to have something removed, it was making the lens...cloudy? My optometrist said it was a little plastic pouch the lens sits in, and they would laser it out...?

[gasman]

My mother had it done...she had to go back a couple years later to have something removed, it was making the lens...cloudy? My optometrist said it was a little plastic pouch the lens sits in, and they would laser it out...?
You can develop a posterior capsular membrane-basically a membrane that forms on the back of the lens. It's lasered out in about 30 seconds.

[palincss]

I've recently been diagnosed w cataracts in both eyes. The MD claims that replacing the lens will not only improve my vision on both eyes (giving me binocular vision for the first time in my life) but will also improve my perception of color. Sounds great, but, frankly the thought of putting my only functioning eye at risk scares the hell out of me.

Anyone have any experience or expertise on this!


I had it done in both eyes (one at a time is how they do it, not both together) and in my considered opinion it's the closest thing to a medical miracle most of us are ever going to experience. Really, aside from a couple of days wearing a protective cover over your eye, about the only hassle is the eye drop regimen: several different meds, at different intervals.

[palincss]

Will they remove the old lens and replace with plain, clear. Or will they replace it with a prescription?


If you need vision correction they replace with the appropriate prescription. There are 3 possibilities: single focus; single focus plus astigmatism correction at a modest upcharge not covered by insurance; or a bifocal lens plus I believe radial keratotomy (what my doctor called "The Mac Daddy") at a very large upcharge.

You'll get to choose what sort of vision you have. Some decide to have one eye for distance, one for reading, and go through life with basically monovision thereafter; I chose to have one eye set for long distance, one for medium close distance. Without any glasses I can see from cue sheet and computer out to infinity, and need drug store 1.75 reading lenses for computer and reading books.

[palincss]

Prior to the surgery careful measurements are made and an algorithm calculates the prescription of the implant.


In my case, multiple careful measurements done with several different techniques carried out over several visits.

[PaMtbRider]

My wife had lens replacement as elective surgery about 3 years ago. Her vision since a child was poor. Her weak eye correction if I remember correctly was +10.5 The surgeon told her she was near the limit of what they felt they could correct 100% with lens replacement. She went with the bifocal lens. She now has 20/20 vision and doesn't need glasses for anything. No follow up Lasik was required.

As others mentioned, 1 eye is done at a time. They typically correct the weak eye first, and the dominant eye about 2 weeks later.

She didn't have cataracts so the total cost was out of pocket. Best money she ever spent.

[Len J]

They won't do my dead eye first because the eyelid doesn't close. This would make healing more problematic.

[fogrider]

yeah, this is an older person thing, but my wife needed it done and she was the youngest patient at all the appointments. the way they do it here it's like a mill, the doctor does all the surgeries a few days a week but he must crank through half a dozen an hour!!! the one weird thing is that the new lens are not smooth, they're segmented.

[bironi]

Len,
Thanks for asking this question. I'll be doing the surgery in a couple years when I turn 65.
Byron

[DfCas]

I had both eyes done about 3 years ago. They waited 3 weeks between eyes. I chose not to have my distance vision fully corrected. This means I can read/work close with no glasses but I use glasses for distance vision.

Mine were routine and minor and I was back on the bike in about 10 days after the surgery.

[itchyjoe]

I can add a couple things to an already complete discussion:
1-The anesthesia trend today is preop numbing drops and light IV sedation during the actual procedure. The surgeon wants you responsive in the OR because he/she may want you to move your eye or tilt your head, etc. And too much sedation is bad cause you may snore or have a startle response, both of which give unwanted (and dangerous) movements. In the 1990's all cataracts got retrobulbar blocks which entails sticking a needle behind the eye from just inside the lower lid to numb up the eye muscle nerves--and sensory too. It gives perfect anesthesia but the type and risk of complications is scary! If I interviewed a surgeon and he/she uses only RBBBs I'd find someone else.

2-Your surgeon may wanna use a laser machine preop--and that's another upcharge ($600 where I am). It makes the incisions in your cornea which is perfect every time. Plus it fractures your cataract into quarters making it easier to remove. Some of the older docs don't like the laser and prefer to make their own corneal incisions. So if you're offered, inquire about comfort level and # of cats done that way. I'm a gaspasser so don't ask me about lens till after I get mine done someday, lol!

[gasman]

They won't do my dead eye first because the eyelid doesn't close. This would make healing more problematic.

If you see someone with 10 years or more of experience this shouldn't be an issue. In general with experience comes good judgement.

[Birddog]

This is very timely indeed as I will likely be having it done in a couple of months. Doc appt is in 2 weeks then I'll know more. I have cataracts in both eyes and they said I can't improve my vision with RX specs any longer. It's starting to drive me nuts.

[Len J]

Thanks to all for the info.



Still nervous as hell, but I'll probably schedule for January.



Thanks



Len



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[biker72]

Thanks to all for the info.



Still nervous as hell, but I'll probably schedule for January.



Thanks



Len

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Nervous is normal. I was just as apprehensive with the second eye even tho the first one went incredibly smoothly....:)

[Len J]

Right eye vision (left eye is -22.5)



2.5 years ago -9.0

8 weeks ago -12.5

4 weeks ago -12.9

This week -13.4



I don't think I'm going to have a choice here. Sigh.



Len