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Cataract surgery -- need to make a decision

Posted by dedtired (My Page) on
Wed, Nov 2, 11 at 14:05

I know we talked about this over the summer when Sooz was making a decision about cataract surgery, and now it's my turn.

I am going to have cataract surgery on both eyes in December. I knew it was coming and frankly my night vision has gotten bad, so I am glad to have it done.

I have to decide whether to have the standard intraocular lens (IOL) implanted or go with the Restor lens.

The standard lens is entirely covered by insurance and gives you good distance vision, but I'd need reading glasses for close up and possibly for mid distance. This means I'd need readers for reading, computer, price tags, call id, etc.

The Restor lenses give you vision without glasses at all (or barely ever). Downsides are possible "halos" at night, and needing more light in low light situations, like reading the menu at a candlelit table. They would also cost me $4500 out of pocket. That is not my biggest concern because I do believe in investing in quality of life, although it is still a consideration. If I were 84, I might not opt for the expensive choice, but I am 64 and I hope I have a lot of years of vision ahead. By the way, this is not monofocal lenses (one eye for distance and one for near).

I'd really like to hear from anyone who has had cataract surgery and find out what option you chose and why. Are you happy with your decision? Tell me anything and everything about your experience.

Sooz, how are you doing? Thanks all.


Follow-Up Postings:

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RE: Cataract surgery -- need to make a decision

I have a friend who had this done recently. I think he chose the standard lenses. He is younger than you at 58. I will forward your query to him.


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RE: Cataract surgery -- need to make a decision

Pam. I had cataract surgery in my 60's. My only options at that time, were far vision or up close and I chose far vision. I do use drug store readers and only recently I've found there are times, sporting events or reading road signs in the distance that I don't see as well. Just a year or so ago I got glasses only for distance but I rarely use them. I don't wear glasses (yet)when I'm on the computer. BTW my surgery was more than 15 years ago.

Good luck on your decision.

jude


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RE: Cataract surgery -- need to make a decision

Pam, I had cataract surgery in both eyes before I was 42. It went terrific & I've had no problems. I chose mono-vision & I still, some 20 years later, test 20/20 & need no glasses. It's only a problem when I go to take my driver's test & forget to tell the examiner that I've got mono-vision! :) He says, "Tell me what you see with your left eye, please." I say, "Nothing." Oops!

Hope your surgery goes as well as mine.

/tricia


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RE: Cataract surgery -- need to make a decision

I had both eyes done last year. I don't remember being offered a choice, just went along with my doctor. Medicare took care of the expense.I use cheapo readng glasses for up close although I can sorta see without them.I have prescription glasses for distance at night only. I'm glad I did this, makes so much difference.


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RE: Cataract surgery -- need to make a decision

I'll be "watching" you and your choice. My cataracts are advancing and after dealing with broken eyeglass issues this week -- only wearing sunglasses or reading glasses, I'm ready to be done with the glasses thing!


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RE: Cataract surgery -- need to make a decision

Question -- how far is "distance"? Can you see without glasses two feet away? More? Much more? At what point can you see distance without needing readers?

Thanks for all your responses. I can't tell you how much this helps and how encouraging it is. I am now leaning toward the standard lenses. The multifocals are still soooo tempting but I don't think they are tried and true just yet.


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RE: Cataract surgery -- need to make a decision

Just wanted to say good luck with this, Pam.


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RE: Cataract surgery -- need to make a decision

Can I come take care of you while you heal?


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RE: Cataract surgery -- need to make a decision

Oh thanks! Actually, I was told that I can go back to normal activities the next day! I even will drive into center city for my follow up appointment. That will be strange.

Jessy, I hope the next time you are out this way that we are not having any natural disasters and we can play!


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RE: Cataract surgery -- need to make a decision

Jessy, did DS get to enjoy the dark and cold along with so many of us last weekend?


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RE: Cataract surgery -- need to make a decision

Hi, Pam,

Here's the update. Cataract surgery was on Sept. 1. When I got home, the eye patch came off, and I started a regimen of eye drops that continued is decreasing amounts for the next month. For a week, I slept with the eye patch back on. I had some halos and could see my eyelashes and my pupil stayed dilated for a few days, which I didn't expect but what was totally normal. Weird. That went away within a couple of weeks.

During the next four weeks after the procedure, my vision in my right eye (the one that had the cataract and now has the intraocular lens) varied from 20/25 to 20/25 to 20/20. Finally, around week 4, my right eye vision settled down to...get this...20/20!

The specialist and my ophthalmologist both said I could just not wear any correction at all (I can see to read a book if I hold it up close like I do when I read before going to sleep) or I could wear reading glasses, or I could get a contact lens for my left eye, or I could get a contact lens and corrective glasses--depending on my needs and how I use my vision.

The cataract procedure was so easy and quick--the worst part was the IV needle they put in the back of my hand. I had an acrylic aspheric monofocal IOL put in that was set for distance vision, even though my right eye wasn't my dominant eye. The -0.25 IOL for distance is the thinnest IOL.

I had done lots of research and much worrying! Now, instead of a really thick lens on the left side of my glasses, and a clear lens on my right, I don't really wear glasses.

I wear a daily disposable contact lens in my left eye and I can use the computer, see the TV, and see around the house without any problems and can read most books and magazines too. If the print size is too small or if the lettering is, say, orange on a white background (apparently used seasonally for Autumn!), I put on my 99 cent readers. I tried on three different strengths of contact lenses and wore them for 2 weeks at a time to see what worked best for me.

Driving is fine with my contact lens except my range of clarity isn't what I want it to be for street signs and small details--I'll see just fine up to a certain point, but beyond that, it's a bit off until I get closer to within that specific range.

I decided I might as well get "driving" glasses and while the clarity issue wasn't that big of a problem, it's nice to see more like an eagle! I noticed sometimes I'll use them for TV when I want to read the scrolling TV Guide as it helps with the disparity in size of text on the TV screen (but no issues with using the computer--go figure!).

You might want to do a bit more research about Restor. The places I found most helpful when I was doing my research were the Eye Care Forum at http://www.medhelp.org/forums/Eye-Care/show/90 or http://www.medhelp.org/forums/Eye-Care/show/43

Another helpful site was the Eye and Vision Message Board at http://www.healthboards.com/boards/forumdisplay.php?f=54

You can also "Ask and Expert" after choosing which expert might be best suited to responding to your question: http://www.allexperts.com/el/Ophthalmology-Optometry/

Hope this helps! Let me know if you have any more questions as I'll be glad to share my experiences with you.

...and WOW, in the morning, I open my eyes and can SEE !

Smiles,
Sooz


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RE: Cataract surgery -- need to make a decision

Pam, good luck with whatever you decide is best for you. I just was at the ophthalmologist last week and distance is considered like across the room. I actually get two distances of 'reading' glasses. One for my computer which I keep at between 24" and 30". My closer reading glasses I use for reading and close art work and the distance is 12" for those. So, up to 30" is still considered close in the eye world. Hope this helps.


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RE: Cataract surgery -- need to make a decision

Sooz, thanks so much for that update. Very helpful. So you only had one eye done? Hmmm. Your situation sounds pretty good, if you can get away with wearing a soft contact lens. Wish that were an option for me. I am just so tempted by the ReSTOR multifocal so I can glance at the cell phone or ipod or whatever up close without having to wear glasses. I have an acquainatnce whose husband is a highly regarded ophthalmologist, and I may call her to ask her husband's unbiased opinion of those lenses. One side effect of this process if that I have learned to spell ophthalmologist.

I can't even imagine being able to see across the room in the morning!

Coconut, thanks. I had no idea how far "distance" is. It's farther than I thought, darn it. Right now I take off my glasses to see the computer screen and just move my head closer as needed. I think my nose is about 12 inches from the screen now.

Why oh why do I have to research absolutely everything to death? Wish I could be one of those sheep-like people who always just do what the doctor suggests. Maybe I grew up around too many doctors and I know they are fallible for sure.


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one more thing

Sooz, I forgot to say THANKS for the links to those sites (ha, ha "sites" -- get it?). I had found one but not the others and I will definitely check them out.


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RE: Cataract surgery -- need to make a decision

I've had cataracts in both eyes; the operations were a year apart, at ages 55 and 56. I was not given an option with regard to the type of implant, so I assume that the Restor lens was not an option for me. One eye also developed a cloudy "capsule" about a year after surgery, so I underwent a laser treatment in the doctor's office.

The intraocular lens was *supposed* to give me near-perfect vision without other aids. I can see well enough to bumble around the house when I get up during the night; however, I needed contact lenses to get my vision up to 20/20 for general vision. I also need reading glasses for close work (like sewing or reading a book), but not for the computer, and I use distance glasses for driving. My optometrist said that, for most people, the contacts would be enough, but my eyes needed so much correction for both near and far vision that it would be impossible for a contact lens to do the job alone, without the glasses extending the vision at both ends. This doesn't bother me, because I have always worn glasses, and I've been wearing contacts for almost 50 years, and they're second nature to me.

Oh, one other thing: I now have a problem with driving at night if there are oncoming headlights. My doctor explained that light is reflected off the implant lens, and the artificial lens can't adjust to the change in brightness the way a natural lens would. I also can't see well on very dark roads. So, that's something I put up with. I do drive at night on well-lighted and familiar streets, but I'm leery of driving at night in unfamiliar places or on certain highways (divided highways are easier).

I've got to add that the purpose of the cataract operations, for me, wasn't to *improve* my visual acuity but mainly to remove those pesky "blobs" of cloudiness that impaired my ability to see at all. Overall, I'm glad that I had the operations. The Restor lens sounds like a worthwhile alternative to the type of implant I received, but I'm not sure I would have paid out of pocket for the higher cost.

Sue


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RE: Cataract surgery -- need to make a decision

Hi, Pam,

I'm a person who researches things to death as well. In fact, I emailed my cataract surgeon so many questions that she suggested I set up another visit so she could answer everything. Well, I ended up setting up TWO different appointments just so I could keep asking her questions. Yeah, I came in with pages of typed out questions from my research!

My uncorrected vision was 20/200. The cataract in my right eye developed as a result of my needing an vitrectomy epiretinal membrane peel procedure. This happened just before my 60th birthday. A cataract is a 100% for sure side effect that most folks get within a year of the vitrectomy procedure because the inside of the eye is exposed to oxygen. Yup, a little under a year later I had a cataract so the IOL procedure was just before my 61st birthday. Instant vision!

How well can I see with my IOL? Closing my left eye--the one with the contact lens-- and sitting about 18 inches from the computer, I can see the computer screen and webpages but cannot read them unless I click the little "plus" sign twice on my iMac. That enlarges the webpage. As for seeing things around the house (I'm closing my left eye for this info), my IOL vision sees things slightly blurry from right in front of my nose to about 18 inches from my face. After 18 inches, things like images are crisp and clear to infinity I guess, but reading text is not (depending on the size of the font).

If I can think of anything more to add, I'll post again. If you can think of any more questions for me or others, I know we'll all be glad to help!

Smiles,
Sooz


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RE: Cataract surgery -- need to make a decision

Thanks again, Sue and Sooz. Sounds like you both had extenuating circumstances beyond run-of-the-mill cataracts. Other than being nearsighted all my life, I have no other vision problems. I keep going back and forth in my mind between the standard lens and the Restor lens. I was looking closely at something on my face in the mirror tonight and realized I will have to wear reading glasses in order to do that in the future if I stick with the standard lens.

Oh, what to do, what to do?!


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RE: Cataract surgery -- need to make a decision

Naw, you can get a magnifying mirror. I use a 5x mirror for putting on makeup (before I put on my contacts), and I've seen other strengths (4x, etc), too.

Sue


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RE: Cataract surgery -- need to make a decision

I love magnifying, lighted mirrors. For makeup only, though. Otherwise they brutally suck. ;)


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RE: Cataract surgery -- need to make a decision

The circumstances might have been beyond the normal aging process for me (although eventually I probably would have developed one anyway), but it was a run of the mill cataract. Yeah, boring! :O)

I really was bemoaning the fact that I would lose the close vision I had in my right eye if I opted for a distance IOL. My cataract specialist told me it was up to me whether I wanted the close or intermediate or distance IOL, but she recommended the distance IOL. It really bothered me that I would LOSE vision, no matter which IOL I chose! I wanted to be able to still read in bed without glasses and I wanted to be able to see to sew on my Kenmore and to thread a needle, and pick a splinter out of DH's finger, etc.

More research.

I finally calmed down and reasoned that I've worn glasses since 3rd grade, was myopic and had astigmatism, and had worn hard contacts, soft contacts, glasses with bifocals, etc etc.

If I needed to wear a contact or contacts again or wear a contact with "glasses" or wear glasses, well, I was still lucky because there are contacts and glasses out there to address any issues I had...but I worried up to the last second! I also asked other folks I know about their cataract surgery, and about their close, intermediate or distance IOL they had and what adjustments they had to make.

Mostly, they didn't know what IOL they had but I'm guessing it was distance. Also, the most "lifestyle change" anyone said happened to them was that they had to be sure to wear the appropriate sunglasses when outside. They already had bifocals or used readers, so no big changes there.

Smiles,
Sooz


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RE: Cataract surgery -- need to make a decision

Yes, I am probably over-thinking this to death. Last night I couldn't sleep for awhile so I reached for my handy ipod to listen to music. I can read the teensiest print on that screen and I suddenly felt sad that in a few weeks I will no longer be able to do that. Boo hoo. On the other hand, I will no longer bash into the bedroom door because I can't see it across the room.


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RE: Cataract surgery -- need to make a decision

Chiming in on my experience. Prior to cataracts, I was extremely nearsighted and went from thick glasses to wearing contacts with reading glasses. My left eye had the cataract and when I had the surgery, the only lens was the standard one which totally corrected my distance vision. It was like a new world! I then wore a contact in my right eye only but eventually went to no line bifocals. My right eye is still uncorrected even tho I have developed a cataract in that one.

I just came back from a recent visit and discussion with my ophthamologist. While she was ready to do the cataract surgery, I was not willing to give up the excellent close up vision I have with that right eye. When Dick, my husband, and I travel, there have often been times that even with his reading glasses he could not read the fine print. Me? just take my glasses off and I could.

The dr said that even with the bifocal implant (and we didn't even go into cost) it could never be as good as my natural nearsighted eye. She agreed that as long as everything was working for me as it is, there was no 'need' for surgery. I would be losing more than I would be gaining.

The computer is the bugaboo. I find as the day goes on, I sometimes have to hit that plus + button and I have a 24" iMac screen. I also find that by evening I need to spend some time looking at a tv screen because even reading is tiring. But I am 67 so I find I'm blessed to be able to do all the digital art work I do most of the day.

Hope this gives you another bit to think through. Unless you HAVE to have both eyes done, think about doing just one with only the lens that insurance covers.


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RE: Cataract surgery -- need to make a decision

Thanks Msazadi, and welcome back. I really do need to have both eyes done. I too just hate the idea of giving up my near vision, which is why I am considering the Restor lens. I just am still not convinced that they are really as good as they are advertised. I may end up with readers anyway.

Right now I have a hazy spot as I look at the computer screen. It's kind of hard to explain the sensation.

I am so grateful to hear of anyone's experiences with cataract surgery and their outcome.


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RE: Cataract surgery -- need to make a decision

I'm almost 65 years old, wore contacts for 40+ years, had lasic surgery done on both eyes in 2002 (with stellar results, although I suffered from presbyopia, so wore the small, over-the-nose reading glasses when necessary), and in 2008 and 2009 I had cataract surgery performed, one eye each year.

Because clarity of vision is exceedingly important to me, because I absolutely did not want anything to do with the mono-vision approach, and because I'm physically active, with lots of outdoor activities, I decided it was worth the money to purchase the special lenses that would allow me to see long distance as well as read.

In 2008, I had the ReZoom lense inserted into my right eye. Here's its link: http://www.rezoomiol.com/

In 2009, I had the ReStore lense inserted into the left eye. I think you must have information on this lense, so I've not included a link.

With both lenses, there was a "learning curve" while the brain adjusted to the different "readings" on the lense, and learned where to go on the lense to view things in the distance or read.

I rarely use "reading" glasses, except in situations where the light is very low or the print is very small. Reading the newspaper or books without my glasses, reading recipes without glasses are just some of the pleasures of using these lenses.

Similarly, I can easily see the computer and engage in other mid-range tasks, without using glasses.

And my distance vision is very good. I golf, and can easily see the golf balls. When I'm outside, I often am the first to spot a deer or some other sight, and have been frequently complimented on my vision.

When I do drive at night, I do so without any qualms. I don't detect any halos around on-coming lights, but I confess I never had this problem with either my contacts or the post-lasic surgery, so maybe my eyes aren't sensitive to lights???

For me, the better reading lense is the ReStore lense, which is why my doctor recommended that lense instead of the ReZoom lense when it came time for the second surgery. But this is really a matter of personal adjustment. As my right eye adjusted to the ReZoom lense, I kept complaining about the reading print being a bit blurry -- I am VERY picky about clarity of vision. So, when it came time to select the lense for the other eye's cataract surgery, we went with the ReStore lense. I think my eye dominance switches between the right and the left eye. Normally, I'm right-eye dominant, and I think this applies for long distance vision. When I'm reading, I think I become left-eye dominant, because I see with excellent clarity...it's like the left eye's ReStore lense over-rides the right eye's ReZoom lense.

I can tell you that I have never regretted spending the extra money for these lenses, and that the quality of my vision is very, very good. Each year I test out at 20-20 at my eye exam.

Also, in my own case, I'm very glad I had each eye done 12 months apart because that gave me an excellent opportunity to determine how well the first lense was working. I would not have been happy had both eyes had the ReZoom lense, with its less-than-perfect clarity for reading. But I want to emphasize that these are my results, only, and every patient is bound to have her own unique
experience.

The final point is the importance of a thorough and skilled surgeon. My surgeon obtained many, many readings from the opthomologist that did my lasic surgery in Virginia. In fact, he would not schedule the surgery until he had those readings to ensure he was ordering the correct readings for the implanted lense. And this was on top of the lengthy and many measurements performed on my eyes during the pre-surgery sessions in the office.

I hope this information helps.


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RE: Cataract surgery -- need to make a decision

Wow, Beth. That is such terrific information. The Restor sure sounds like something anyone would want -- why not choose good vision at all lengths rather than just at a distance? I suppose that anyone choosing Restor has the chance of being one of the few unlucky ones who end up with glare and halos.

All I have been able to find on the internet are horror stories or "patient testimonials" that are obviously chosen because of their success. I have been hoping to find a first hand report and you surely have given me that.

I do have confidence in my surgeon. I am lucky enough to live near Philadelphia, which has an excellent medical community. My doc is at Wills Eye Hospital and his CV is impressive, including an internship at Harvard Medical.

Thank you, thank you , thank you for taking the time to give me so much info!! It helps tremendously.


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