Cataract surgery, IOL lens options and your age

[SimonaStefano]

Hello, this is the only forum I found with truly shared experiences from cataract surgery. I’m also huge Disney fan, so that must be fun. I’m 49 and two months ago the ophthalmologist told me I need to plan for cataract surgery in near future. I was so shocked by the news and when the doctor asked if I have questions I could not think straight. So, I did not ask anything. Now, I started to look into it and have so many questions... I would like to ask for your recent experience, choice of IOL lens and approximate age. Why I’m asking for age... I still don’ have presbyopia, I have myopia in power of 6 with mild astigmatism. I beleive my eyes would change and I would need reading glasses. How the doctor would determine what IOL lens to place , so I can be good for the next 10-20 -30 years? My understanding is that these IOL lens are for life. I still have good 10-15 years of work, I hope for less, but having kids lately in life moved the retirement for me so, for me to loose intermediate vision, or distance vision will not be desirable. My glasses/ contacts are monofocal at the moment and even though I’m severely nearsighted I can see close, intermediate and distance. I’ m willing to loose close distance and start using reading glasses, but how I would know this can be solved. In 2016 FDA approved Depth of focus IOL lens, I was wondering if anyone have any experience with these type of lens too?

 

[ronandannette]

Hello, this is the only forum I found with truly shared experiences from cataract surgery. I’m also huge Disney fan, so that must be fun. I’m 49 and two months ago the ophthalmologist told me I need to plan for cataract surgery in near future. I was so shocked by the news and when the doctor asked if I have questions I could not think straight. So, I did not ask anything. Now, I started to look into it and have so many questions... I would like to ask for your recent experience, choice of IOL lens and approximate age. Why I’m asking for age... I still don’ have presbyopia, I have myopia in power of 6 with mild astigmatism. I beleive my eyes would change and I would need reading glasses. How the doctor would determine what IOL lens to place , so I can be good for the next 10-20 -30 years? My understanding is that these IOL lens are for life. I still have good 10-15 years of work, I hope for less, but having kids lately in life moved the retirement for me so, for me to loose intermediate vision, or distance vision will not be desirable. My glasses/ contacts are monofocal at the moment and even though I’m severely nearsighted I can see close, intermediate and distance. I’ m willing to loose close distance and start using reading glasses, but how I would know this can be solved. In 2016 FDA approved Depth of focus IOL lens, I was wondering if anyone have any experience with these type of lens too?

Think this through extremely carefully and talk through every kind of lens that is available. Pay for an upgrade if you need to; your eyesight is priceless. I had artificial lens transplants to treat congenital cataracts when I was a little younger than you (about 5 years ago). I was also very myopic and had been my entire life. The standard lenses will change your vision - dramatically. You're optimum vision will likely be at about 12' and for a time you will have nothing but white fog up close. Even once your eyes have healed your near-vision will never return.

This is a big, big deal when you are used to being near-sighted and has far greater implications than just needing readers. Every fibre of your being will want to get closer to something to see it better and that habit was so strongly ingrained that I actually had to have occupational therapy to adjust. It's a much easier transition for older people who mostly have developed far-sightedness long before they have cataract surgery.

 

[Chickenlady]

I'm interested in hearing your replies. Aside from the fact that I'm a bit older, I have been told the same thing and sounds like your current vision correction is just like mine. I do an incredible amount of up close work (fine details) and manage just fine without any correction. I can't lose that!

 

[snappy]

The astigmatism may limit your choices, it did for me 4 years ago, although my astigmatism was pretty strong, along with bad far and near sightedness. Good luck.

 

[SimonaStefano]

Thank you RonandDannette! My thoughts are exactly on the same line as yours. I skipped in the story that for a month I was terrified. The month after I got over that the surgery must happen I started to read and looking for answers. I started to prepare a list of questions for the ophthalmologist and I decided if he decides not to answer or transfer me to so called sales team to leave and look for another doctor. I have appointment in February to really talk about scheduling surgery and I hope by this time to have all questions written down and almost a decision which way to go. I read in a lot of medical journals that severe myopia and some mild astigmatism may delay presbyopia. It has to be just the right numbers and they explained it in law of physics, but that is probably the reason I still don’t need bifocals or reading glasses. This article also is saying that all ophthalmologists are strive for perfect zero astigmatism, but in some cases is ok. Mine is considered mild .25 cyl. This bothers me a lot because it becomes really complicated calculation and I hope human error is eliminated to put all these factors into the lens choice.

 

[ronandannette]

Thank you RonandDannette! My thoughts are exactly on the same line as yours. I skipped in the story that for a month I was terrified. The month after I got over that the surgery must happen I started to read and looking for answers. I started to prepare a list of questions for the ophthalmologist and I decided if he decides not to answer or transfer me to so called sales team to leave and look for another doctor. I have appointment in February to really talk about scheduling surgery and I hope by this time to have all questions written down and almost a decision which way to go. I read in a lot of medical journals that severe myopia and some mild astigmatism may delay presbyopia. It has to be just the right numbers and they explained it in law of physics, but that is probably the reason I still don’t need bifocals or reading glasses. This article also is saying that all ophthalmologists are strive for perfect zero astigmatism, but in some cases is ok. Mine is considered mild .25 cyl. This bothers me a lot because it becomes really complicated calculation and I hope human error is eliminated to put all these factors into the lens choice.

I hope you fare better than I did but you're already ahead of the game with awareness of what some of the pitfalls might be. Honestly, even though I was on a wait-list for the surgery for over two years (yay Canadian public health care - it's not complete utopia) I really had no clue what I was in for. Not once during consultation did the surgeon or anybody else explain what would happen to my near-vision. I'm sure there are options and I really encourage you do do as much research as you need to feel completely confident.

 

[SimonaStefano]

I don’t think we can claim it on Canadian public care Surgeons, or specialists that I met never had any time to explain what really is going on unless I pressed them in and some of them still did not want to “waste” their time.

 

[goofyernmost]

Wow, I don't know what to say. I had my left eye done in 2016 and my right eye done in 2019. I don't recall any discussion about lenses other then did I want to have one eye see up close and the other see normal or both normal which meant using readers (I was old enough for that already) I tried that with contact lenses once and it nearly drove me insane. All I had to do to fix that was to take one of them out. Life is better when your sight is balanced. Other then that I don't know what the differences might be. My vision was not bad really. I wore glasses when I had the surgery but have not needed them since then. For the first time since I was 21 I no longer needed glasses written on my drivers license. I was in my 60/70's when I had it done and the degree that it fixed everything, made colors brighter, vastly improved my night vision and so on. It is like a miracle. I had a couple of problems that others don't have because of an inherited family cornea problem. But once we worked through those all was wonderful. I'd be interested in knowing what other things are optional.

 

[SueInBoston]

I just had cataract surgery in Sept & Oct. I asked about the multi focal lenses but I was not a good candidate due to family glaucoma history. Now I have 2 pairs of glasses, one progressive that corrects slight astigmatism and allows me to read if I tilt my chin up...lol. Then I have a pair of reading glasses for when I work at my computer (up to 10 hours/day) and cheap readers all over the house.

No complications.

 

[antmaril]

I had laser cataract surgery about three years ago (three weeks apart). I was not a candidate for the multi-focus lenses. I have a Toric lens in my left eye because of severe astigmatism. I have worn glasses since I was a little girl (I am 69 years old). I can see (distance) without my glasses for the first time in decades. However, I cannot read anything up close. This was very strange at first because I was always used to bringing something closer to read it. Readers are required for EVERYTHING. Because I don’t really feel like myself without glasses, I have chosen to wear progressives. This way I don’t have to have readers handy. That was driving me crazy.

I am very happy with the results of my cataract surgery.

Good luck!

 

[snappy]

I had laser cataract surgery about three years ago (three weeks apart). I was not a candidate for the multi-focus lenses. I have a Toric lens in my left eye because of severe astigmatism. I have worn glasses since I was a little girl (I am 69 years old). I can see (distance) without my glasses for the first time in decades. However, I cannot read anything up close. This was very strange at first because I was always used to bringing something closer to read it. Readers are required for EVERYTHING. Because I don’t really feel like myself without glasses, I have chosen to wear progressives. This way I don’t have to have readers handy. That was driving me crazy.

I am very happy with the results of my cataract surgery.

Good luck!

My experience mirrors yours. Surgery was 4 years ago.

 

[Mango7100]

I had the Toric lens in both eyes done at the age of 40. Yup, 40. I had a cataract in one eye, so insurance paid for that (minus the upgrade lens) and the other eye was out of pocket. I had it done because I was severely myopic. I was at a -13 in both eyes (and one wasn’t even corrected completely with that). -13! I was not a candidate for LASIK with that severity, and I had been talking about lens replacement for years with my ophtho. Retinal tears and detachment are a risk of any intraocular procedure, and severe myopic are more at risk. I am so happy I did it. I am now at a -1.

Losing my near vision was a very big adjustment and was a trade off. I wear progressive glasses all the time and different cheap readers if I’m working at my desktop computer because I can’t see with my progressives due to the distance of the screen. It is strange to have to raise my head and look down to see my phone, watch, etc. I used to do surgery as part of my job, and that would actually have been quite difficult with losing my near vision—thankfully I quit surgery years prior. But I can see things far away now! It’s amazing. As my ophtho said, “Your vision won’t be perfect after this, but at least you would be able to get out of a burning building without needing your glasses”.

I had the surgery on the second eye on a Tuesday and went to Disney 5 days later. Got some cheap readers since they wanted to give me a month before deciding a lens prescription for progressives.

 

[mrsstats]

I had both eyes done over the summer. Never really discussed any other lens then the one covered by Medicare. I was using reading glasses already but could see some things close up without. Now I can not see anything close up without the readers. Plus floaters have gotten worse.

 

[ronandannette]

I don’t think we can claim it on Canadian public care Surgeons, or specialists that I met never had any time to explain what really is going on unless I pressed them in and some of them still did not want to “waste” their time.

Ah, that part was solely referring to the two+ year wait list to get the surgery, not the quality of the care. Sorry I didn't make that clearer.

 

[bcla]

My mom got her cataract surgery done years ago, but still wears glasses. I think even with the overall correction from the artificial lens, it wasn't perfect and progressively changes anyways.

 

[NotUrsula]

Are you planning to pay OOP for the treatment? I have small cataracts that are (IMO) severely impacting my night vision, but my opthalmologist informs me that they are nowhere near bad enough for my vision insurance to pay for surgery. It's not just mine, either; most insurance plans pretty tightly define what they will pay for when it comes to cataract treatment.

I'm about to bite the bullet and get it done anyway, because my work commute in wintertime is starting to feel a bit too hazardous for comfort.

 

[SimonaStefano]

Thank you all for you responses!
NotUrsula, the doctor told me last time you are ready for surgery, I don’t see you how you can survive winter driving. I’m from Seattle, so if it doesn’t rain or it is gray foggy it is dark pretty early. Somehow I got used to having bad vision, halos and it doesn’t bother me a lot. So , for me surgery and monofocal lens will be covered by insurance. I expect to be offered so called dropless surgery, which probably will cost me OOP. So far what I see droplets surgery 1000 per eye out of pocket and if I go premium lens 3000-3500 per eye OOP. I‘m fortunate and I can afford it, so I don’t think about the money right now, I’m still terrified about the surgery and the the outcome. I never knew before this that we have intermediate vision. I was so nearsighted that my intermediate vision is part if the nearsightedness, but now I hope for the best.

 

[ronandannette]

Thank you all for you responses!
NotUrsula, the doctor told me last time you are ready for surgery, I don’t see you how you can survive winter driving. I’m from Seattle, so if it doesn’t rain or it is gray foggy it is dark pretty early. Somehow I got used to having bad vision, halos and it doesn’t bother me a lot. So , for me surgery and monofocal lens will be covered by insurance. I expect to be offered so called dropless surgery, which probably will cost me OOP. So far what I see droplets surgery 1000 per eye out of pocket and if I go premium lens 3000-3500 per eye OOP. I‘m fortunate and I can afford it, so I don’t think about the money right now, I’m still terrified about the surgery and the the outcome. I never knew before this that we have intermediate vision. I was so nearsighted that my intermediate vision is part if the nearsightedness, but now I hope for the best.

Yes - we definitely do, especially on a functional basis. Those of us with progressive glasses have "zones" in the lenses that are set at roughly 1' (for reading), 3' (for things beyond arms-reach) and 10' or so for distance. You must move your head or your eyes around inside your glasses to find the "zone". It's a bit tiring even when you're used to it and many of us have a specific pair of glasses for computer work. Mine are called computer-bifocals. They only have 2 zones - 1' for reading and 3'ish feet for looking at the screen.

 

[SimonaStefano]

No one have experience with extended depth of focus lens?

 

[SimonaStefano]

After a lot of thought, I did my right eye last Thursday. My left eye is coming a week later -this Thursday. I read a lot about the options for IOL and got to the same choice that the doctors recommended for me. The doctor said because of my age if I decided on monofocal he will try to convince me to postpone as much as I can because I will loose my intermediate and close vision and I will be needing glasses for this. He suggested multi focal extended depth of focus on one eye and multi focal in the other eye. This way I can have as much vision in all ranges once both eyes are done. So, I have multi focal EOB for 5 days now. Immediately the day after surgery it was complete haze, the day after it was a new world and 20/20 vision. The eye is still healing so The far vision is not as sharp as the first day but still good, intermediate vision good, close vision maybe reading glasses with .5 power. That is for now. I can write more once the other eye is done and the healing is complete. Now that I have the model number I found this simple e plantation about IOL and cataract that I would like to share. It was really difficult to find information like this before I had the serial number.