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Cataract Experience

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@TGW asked in another topic for my experiences with cataract surgery. Rather than clutter the topic, I’ve created a new topic. Clearly this isn’t hearing related, so at least I’ve given people the ability to ignore the thread :slight_smile:

Toni, the process went very well for me. I’m a bit of an odd duck … I spent a LOT of the time before the procedure watching cataract surgeries on YouTube (you’d be amazed what you can find…), so I knew exactly what I was getting in to.

The good part: There was pretty much NO discomfort in either of my surgeries. The very slightest sting might occur when drops are first put in to your eye for initial anesthetic … not unlike having your eyes dilated (which is exactly what they are going to do next).

I can tell you without a doubt that unless you already know what implant you want to go with (like for budgetary reasons you might choose whatever insurance will cover), choosing from among all the different options will be the hardest, most stressful part (I should qualify, most stressful if you don’t stress out about the procedure).

What kind of lens to get depends on so many things, I can’t generalize at all. Your surgeon will help you determine your options. The basic choices are, monofocal (only one insurance might cover), Extended Depth of Focus, and Multifocal. Each of those also can be ordered in toric form to correct astigmatism, but your surgeon may also be able to address some astigmatism without a toric lens. I have (had?) astigmatism in both eyes, but only one IOL is toric.

My initial plan was EDOF lenses, undercorrecting one eye by .5 diopter (to increase my ability read without reading glasses), correcting the other eye to “plano” (optimal). But I have high myopia, so I knew going in that the correction may end up different … and it did. I ended up with both eyes undercorrected. I can read great, but distance is about 20/50. My surgeon was not happy with this, and is paying to have PRK done to fix one of the eyes (I’ll then have good vision at all distances). In fact I go to see that surgeon Wednesday.

The procedure is quick. You spend most of the time beforehand while they prepare your eye (dilating, and if a toric lens is used, marking the correct axis). Then you go in to the surgical suite and lie on your back. The procedure is done through a microscope, and you’ll basically be staring at a bright light the whole time. 10-20 minutes later, you’re done. You’ll have a clear cover over your eye for the rest of that day, and you’re going to use it while asleep for a week.

I had zero discomfort, itch, whatever, post surgery. Oh, you’ll be putting drops in your eyes for weeks post-surgery (4 weeks, if I remember correctly).

I could go in to detail about the whole procedure based on what I’ve watched, but there will be people here that really don’t want to accidentally see any of that…

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Thank you, Kevin. My husband (who will be having the surgery) might avail himself of the YouTube videos, but I’m content with non-visual generalities, lol : )) He was originally going to have the cataract surgery in spring of 2020, and well . . . 2020. Like you said, insurance covered only the basic surgery, and we were going to pay the additional cost. I don’t recall the 2-3 options he had, but I’m pretty sure toric was the way we were going, and also not mono. Definitely appreciate your description of the experience and how it all played out. Did you have both eyes done at one time? I think the recommendation was to do one eye followed by a 2-3 week period, then the second eye. We learned so much about the process here on this forum that helped guide the decision-making process and he’s quite happy with his new KS-10s, but still using the forum to understand issues and tweaks to discuss at follow up visits.

I suspect there’s some varieties in experience. I wore a patch post procedure overnight and then was done with it. The striking thing for me was how bright colors were. I went with monofocal lenses and am thrilled. I have 20/20 vision now and surgeon “undercorrected” one eye by 1/2 diopter to give me reasonable middle distance vision. I choose to wear progressive lenses as I got tired of getting poked in the eye by branches. (I’d learned to rely on glasses to protect eyes) I really like not having to worry about putting on reading glasses. I actually take glasses off for TV.

In reply to @TGW

One eye, then the other. There’s a non zero chance of complications, even though very rare. Some will do both eyes but most are one at a time.

Uday Devgan has s yt channel showing cataract surgeries. VERY GRAPHIC! Anyone squeamish about the eye at all should not even look at his channel page, lol.

In another life I could have been a surgeon. Sights and smells don’t get to me. (There are no unusual smells during cataract surgery … some sounds from different machines, but nothing starling).

I chose EDOF because multifocal lenses have a high rate of nighttime visual disturbances (like while driving) and can present a challenge to some brains … they have an adoption proof not unlike hearing aids, though not everyone has issues.

EDOF lenses general provide excellent far and intermediate vision, less excels reading, though you can do what I did and show one eye towards reading.

EDOF lenses also have less impact on contrast. The technical reasoning here is that premium iol’s create the ability to see better across different distance by sharing the amount of light coming in. So with a multifocal lens your dividing the light among 3 different focal distance, but at each of the 3 distance your getting less overall light. That’s also where the brain accommodation comes in, because there are 3 images and your brain has to select. It’s a fantastic organ!

There are some good descriptions of the different designs online.

I have the Acrysof vivity lens in both eyes.

In reply to @MDB

Definitely, different surgeons have different preferably.

@TGW , @MDB’s experience with vivid colors is a direct outcome of his decision to use monocular lenses. A pro of that is, as I said, increased contrast, and that equals vivid colors.

Everything is a personal preference, no easy decisions here!

Interesting. I wasn’t aware increased contrast was an advantage of monos. I knew sharpness was. One surgeon actually encouraged me to remain nearsighted because that’s what he would do for himself as a surgeon.

Thank you both, great info! I did not remember the Acrysof Vivity lens from our previous visits, but I do recall that his doctor (with Key Whitman, Dallas, TX) mentioned another option that was not yet available - Acrysof may have been the one. I see it is now listed on their site as an option, and that although it was approved in Feb 2020 (when we were contemplating the surgery), it was not available in wide distribution for several months. That will go on my question list when he goes back for reevaluation :+1:

In reply to @MDB

Here’s a good link about the different lens options, but it’s the same surgeon I mentioned earlier and this page does have closeups of an eye just before surgery…

Extended Depth of Focus: Alcon Vivity26

We all want to be young again, at least when it comes to vision: visual quality, range of vision, and freedom from glasses is best when we are in our 20s (or even younger). With age comes presbyopi…

A friend of my parents had cataract surgery I guess in the late 60s. He had to wear glasses that were thick like the bottom of coke bottles for the rest of his life. Times have certainly changed. Maybe you don’t even know what I mean when I say the bottom of coke bottles. I’m getting old

My experience was terrific. I wore glasses my whole life, now, just for reading, and I buy them at the dollar store (now $1.25).

Great help… I work on my computer and wonder how easy or hard it will be for me to read the screen when I’m waiting for my 2nd eye to be done. Should I get a lens removed from my glasses?

Still deciding.

Thanks
Nancy

It is definitely an awkward time while waiting for the second surgery. Many people (I know I did) experiment with removing a lense from glasses. There is no great solution.

In reply to @Nancydrew

I had cataract surgery on both eyes, way back in 2009.
I was persuaded that both eyes should be done, and the worst eye was done first. That then meant that my worst eye became my best eye and my brain had trouble coping with that until the surgery for the second eye, a few weeks later, and then back to normal (my better eye had been very much better)
I was told not to get new glasses for 4-6 weeks after the 2nd eye surgery, as my eye would still be settling down.
The only solution in my case, was to purchase some cheap reading glasses to keep me going.
So you could remove a lens from your current glasses. There is still a chance that you might need glasses later as although they will try their best, perfection is not guaranteed.
In my case, I was short sighted beforehand and used to that, but because my surgeon was long sighted, he erred on the side of my new lenses being long sighted.

In reply to @Nancydrew

Hard answer. Even if you remove the lens, your eyes will not function the way you want because the one eye still has the focal effect of a lens far from the eye while the other is literally in the eye. The result is widely different sized images on the retina, and it takes time for the brain to adjust to that. About as much time as you likely have between appointments.

I use(d) contact lens, and this was much more doable because they aren’t that distant from each other. It’s also obviously easy to just use one of them.

Very helpful, not sure about contact but will ask. Tried them once and not good but may be better now, Had not thought about the distance to the lens in glasses.

Appreciate the information,

Nancy

Even if you get glasses that have no prescription, there is protection behind the lens – you can get anti-glare& UV coatings and the ability to shade in sunlight to protect your eyes beyond the physical protection.

WH

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