OT cataract surgery choices

Kingfisher · #1 06-23-2021, 04:03 PM

I know this has been discussed here many times but today I met with ophthalmologist regarding needed cataract surgery.
What is confusing is the choices of lenses that insurance does not pay for.
I almost felt like I was purchasing a car.
My insurance will pay for monocular implants 100% but the other choices range from 5k to 7.5k over insurance. They promise you better near and far vision whereas the monocular I will need reading glasses for up close.
I opted for panoptyx multi focal for 5k but am now having second thoughts.
Any advice appreciated

unterhausen · #2 06-23-2021, 04:17 PM

I just had the monocular lenses done and I'm pretty happy about it. I'm going to be wearing glasses most of the time anyway for eye protection, so that's not a big deal. I guess my wife would be unhappy if I got expensive glasses though. Interestingly, some of my prescription reading glasses work fine. I was a bit far sighted, so that got corrected, so some of my prescription reading glasses are too strong now.

I'm typing this without glasses on, btw. My left eye still has a bit of an astigmatism, I would have had to be really lucky for that to have gone away.

My thought processes were: I'm cheap and I believe in simplicity. I would like to hear from other people that took the more expensive route just out of curiosity.

buddybikes · #3 06-23-2021, 04:36 PM

What if your vision changes in 2 years?

gdw · #4 06-23-2021, 04:47 PM

I had both my eyes done last year. I initially went to a much hyped local doctor who claimed to have performed over 10,000 cataract surgeries and was told that toric lenses would be required to fix my minor astigmatism. He then handed me a laminated sheet with a list of different options and their cost. All were well above what my insurance would cover and I would probably still require reading glasses afterwards. He did his best to upsell me and reminded me of a sleazy car salesman. I got a second opinion and was told that the toric lenses weren't necessary. I felt comfortable the the second doctor and had her perform the surgeries. I now have 20/20 vision in both eyes but require reading glasses for clear vision for anything within 3 feet. I can live with that.

djg21 · #5 06-23-2021, 05:54 PM

Quote:

Originally Posted by steveandbarb1

What if your vision changes in 2 years?

Once you have implants, your vision doesn’t change.

I had cataract surgery a few years back and chose monocular implants. Unfortunately, they don’t address my astigmatism, so my vision isn’t perfect for distance or reading and I wear still wear glasses full time. Granted, my new glasses don’t have to correct as much as my old ones (pre-cataract surgery) did, and I could get by and even drive without if need be. I do wish I had been provided with more information about correcting the astigmatism before I had the surgery.

eddief · #6 06-23-2021, 06:34 PM

the US healthcare system is still a ridiculous mess and this conversation is the perfect evidence.

gasman · #7 06-23-2021, 07:20 PM

I've seen a bunch of cataract surgery and seen patients who've had the surgery with many different lenses. I'd just get a mono vision as too many of these new, improved lenses aren't always able to do what they claim to do-give you clear vision at multiple distances. If the lens doesn't work that well for you it's very difficult and fraught with potential complications to change out the lens. I've had on cataract fixed years ago and have been happy with the mono vision. I need my other eye done and that's what I'll choose again.
I've also worn glasses since I was 16 so I'm used to them.

2LeftCleats · #8 06-23-2021, 07:34 PM

I had the adjustable type, Crystalens(?). One eye optimized for distance and the other for near. Works well. Don’t need readers but use glasses to improve distance vision with night driving. $4800 5 years ago, so not cheap. Had it done before I got Medicare. Not sure this is true, but my understanding was that Medicare covered everything if you got mono implants, but if you chose a premium lens, not only would it not cover cost of lens, but didn’t cover any of the surgeon’s fee.

thwart · #9 06-23-2021, 08:03 PM

Quote:

Originally Posted by eddief

the US healthcare system is still a ridiculous mess and this conversation is the perfect evidence.

True about the ‘ridiculous mess’ part and this conversation isn’t nearly as obscene or sad as some of the stuff I see.

But... Medicare probably has it about right here, at least IMO.

Pay for the ‘good’ solution that works well for most.

And then the free market offers several complex and difficult to sort out options available for those who want to pay for the benefits (maybe...) of the higher priced spread.

Louis · #10 06-23-2021, 08:40 PM

I would suggest that you do lots of research if you're considering something other than the basic monocular lenses, and find peer-reviewed, published studies with statistics on likely outcomes done by people who don't have a vested interest in showing a particular type good or bad. I'm sure the manufacturers can provide plenty of glossy information sheets and fancy web presentations touting thier products, but do you really want to trust them?

Good Luck

buddybikes · #11 06-23-2021, 09:08 PM

And talk intensely to your surgeon, some eyes don't make it challenging for these fancy lenses. My diabetic eyes surgeon said good thing I didn't spring for them as he had difficult time just getting regular ones situated. I did have macular swelling afterwards for about 4-6 months which sucked.

DHallerman · #12 06-23-2021, 09:19 PM

I have (had?) astigmatism in both eyes, worse on left than right. So that’s why I had my doc put in the toric lens for both eyes, and so far I’ve been very happy. Excellent distance and mid range, much better than before, and now I need reading glasses, something I never needed before.

I say “so far” since I had my left-eye surgery the beginning of May and the right eye just in early June. In fact, since my doc wanted me to wait 3 weeks before cycling, I rode today for the first time since my completed surgery. And because I could see more clearly, especially in dappled light and on rutted roads, I felt far more confident again on my bike. Yay!

My out of pocket was the cost of a good bike, $3K or $1.5K per.

Somebody earlier in the thread said he wished he had gotten more info about astigmatism related lens choices, and I believe somebody else said they have astigmatism and the regular, no-extra-cost lens was fine for them. And so far, with eyes not perfectly healed yet, I’m super happy. I s’pose one idea here is if you have astigmatism, do a bunch of research before cataract surgery.

Dave, who has discovered the joys of various Rudy Project Rydon lens tints

DfCas · #13 06-23-2021, 09:58 PM

I'm diabetic and have some eye issues. The doc said that most likely I would need glasses to make a small correction for me to have my best distance vision, and I would also need reading glasses. I decided not to to fully correct my distance vision as I would need a pair of glasses anyway.

So, I wear glasses for distance correction and need no glasses to read. I find it easier to wear glasses than to carry glasses. Cyclist need to wear glasses anyway and I like having the ability to read without glasses.

Pastashop · #14 06-23-2021, 10:12 PM

The torics work, from what I hear, but it depends a bit on your specific case. I can ask for more details as I know several great eye docs well.

As to the whole medical system in general… The general part of the issue is that the legal landscape (including frivolous lawsuits) requires that docs leave it up to the patient to decide the course of action, but often in matters in which they really have no knowledge, and with uncertainties in outcomes that often depend on patients’ (non)adherence to the prescribed regimens, etc. As to cataract surgery in particular, it is perhaps the most widely performed and the most successful type of surgery in the history of medical practice, restoring vision so profoundly in most cases that it’s like getting a fresh pair of eyes. And the level of tech and training it requires is truly mind-blowing — I know some of the folks that were involved… Is that worth the price of a bike frame or a high zoom wheelset?… Perspective…

Louis · #15 06-23-2021, 10:17 PM

Quote:

Originally Posted by Pastashop

As to the whole medical system in general… The general part of the issue is that the legal landscape (including frivolous lawsuits) requires that docs leave it up to the patient to decide the course of action, but often in matters in which they really have no knowledge, and with uncertainties in outcomes that often depend on patients’ (non)adherence to the prescribed regimens, etc. As to cataract surgery in particular, it is perhaps the most widely performed and the most successful type of surgery in the history of medical practice, restoring vision so profoundly in most cases that it’s like getting a fresh pair of eyes. And the level of tech and training it requires is truly mind-blowing — I know some of the folks that were involved… Is that worth the price of a bike frame or a high zoom wheelset?… Perspective…

No one's doubting the quality of care one can get in the US in the great majority of cases, but you have to either be quite wealthy or employed with a good job that offers good benefits. In that regard the US is an outlier compared to practically every other developed country on the face of the earth.