Anyone have cataract surgery in last few years?

[OTW]

Judy-- Just before leaving for my trip I had an eye exam and found that I'm in the same boat as you are, and with the same decisions. I can't justify $2500 or 2x that or whatever it is for the progressive/bifocal implant lenses so am very likely to go with the standard lenses that Medicare covers. So true -- one choice is have the implant lenses made for distance and use reading glasses (seems that would be a constant hassle to me because I'd have to wear them on a chain around my neck). BUT another choice, and what I will most likely do, is to just get a regular pair of glasses with progressive lenses (what I wear now anyway and you may also), but the new pair would have zero correction on the distance part of the lens (that gets taken care of by the implanted lenses) while they would continue to have the reading prescription on the closeup part of the glasses' lenses. That way you can wear glasses, as normal, and not have to constantly be putting on and taking off reading glasses. Just wanted to add that alternative to consider.

[Birdie]

I had the lasik surgery to fix my far vision primarily. I did have cataracts but not yet qualifying. Back then, 2005-2006, the choices were much less. I am hoping things change to the point I can have my lenses changed! Technology is so fantastic. The changes in just year to year can blow your mind! I so hope, Judy, that you give full consideration to a second opinion at a well known organization with a doctor who does 10 a day! Also, study the newer lens as it will save you a bundle on down the road AND no glasses! With what Medicare and your supplement pays, it won't be that much.

I was a computer nerd when I had mine done. I took two days off, one for surgery and next for follow up. Could not lift, bend, strain, etc for a week. So my co workers got to lift the pc's on to desk. But everything else was good. I doubt that much has changed in that regard. I had mine done in Tucson, home of the retired millions. My doctor there did surgery two days a week. Another doctor there did his a different two days. Lots of cataracts on us older folks. Good luck and keep us posted.

[FinallyTime]

Here is a very long comment about cataracts, surgery, and my experience.

I went through cataract surgery a year and a half ago. Before the surgery I was extremely near sighted (could see close objects clearly, distant objects were blurry.) Both eyes also had a strong astigmatism (cornea and/or lenses distorted giving double vision and wavy objects near and far.) I had worn hard contacts for years. As I got older I had to wear bifocals to read. Then I did try the one contact for reading and the other for distance. (Before considering this for cataracts most doctors prescribe one close and one distant contact lens to see if you can adapt.) My brain could not adapt; I could be driving and suddenly everything would be blurry as my brain would switch to the close vision eye instead of the distant one. I had to concentrate to bring focus back to the distant eye; really frightening on Los Angeles freeways.

I did a lot of research (as OregonLuvr and CougarFan can attest I am pretty OCD about researching things) and chose to have the more expensive implanted lenses to change from nearsightedness to distance vision and to correct the astigmatisms. I did not chose the “multifocal” lenses because, according to my research, they do not give as sharp a vision as the single distance lenses and usually there is more difficulty seeing at night with rings and blurry spot around lights. Also the brain must learn and adapt to focusing on one section or the other. Given my history with the contacts, my brain does not like to adapt. Many times people still need to wear glasses because fitting implanted lenses, of any type, is not an exact science. My surgeon said most who choose multifocals are very adamant about not wanting to wear glasses for anything and are willing to put up with any drawbacks.

I also chose to have the more expensive laser assisted surgery because the cuts are more precise and are said to heal faster with less complications.

Medicare only pays for the less expensive single focus basic lenses; single focus for distance or close vision in both eyes, or for one close and one distance. They will only pay for the usual “blade” surgery, not laser.

My surgeon said it is usual to wait three weeks after operating on the first eye to do the second. In my case he only waited two weeks because he did not schedule any operations the week before Thanksgiving, so there is some flexibility. The only minor problem that caused was taking two different sets of eye drops on two different schedules. I told him I was extremely anxious about EYE surgery and needles and would like to be “out” during the surgery. He said there would be a couple of time when they needed me to respond, but they could use Versed for conscious sedation. They did not want my blood pressure sky-high either.

During the surgery for the first eye, the only thing I felt was some pressure on the eye once during the laser part, and then moving to the other operating theater for the lens implant part. Two hours after I got home I could see distant objects clearly with that eye. I did have one complication, dry eye. When the surgeon telephoned in the evening I told him the eye was watering a lot and it felt like sandpaper rubbing over the eye when I blinked. He said to use some gel- type artificial tears and it should go away immediately and it did. I recommend to all my friends that they should have some at home just in case. After the next day follow-up appointment my vision was 20-20 and I was cleared to drive. (I did have to wear a contact in the un-operated eye so that my eyes could work together until the next eye was done.) If you are farsighted and have lenses for distance or nearsighted and get close lenses you will skip this step.

During the second surgery I felt nothing and remembered nothing. When I got home my vision was crystal clear. There was no pain, not even any discomfort. Next day appoint showed vision in this eye was better than 20-20.

As far as restricting activities, I was told to not go jogging or any high impact activities for about two weeks after each surgery.

I love not having to wear glasses, except for reading or close work. I can walk in the rain without having to wipe my glasses, (I live in Washington state) I can walk up and down stairs without having to hold my head steady (like with bifocals.) My vision is still better than 20-20.

Here are links to some of the research websites I used.

http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

http://www.eyedoctorguide.com/cataracts/types_intraocular_lenses_iol.html

https://www.nei.nih.gov/health/cataract/cataract_facts

http://www.medscape.com/viewarticle/813332_1

[FinallyTime]

Judy, I missed a few answers to your questions:

1) How did you decide when you needed this surgery? When looking through my left eye, it seemed like I had a smudge on my glasses, but it didn’t go away when I cleaned them. My vision was getting less sharp but a new prescription couldn’t correct it.
2) What was the recovery like? How long and what were your limitations? Except for the dry eye issue, there really wasn’t any recovery. After the surgery I felt perfectly normal and my vision was sharp.
3) How long was it before you drove? The day after surgery.
4) What else do I need to know about this surgery? See the long post above.

Thanks everyone. The eye doctor said that the more expensive kind would only correct my astigmatism, that I would still have to wear glasses almost certainly. She said to get rid of glasses, I would have to get one eye for far vision and one for near vision. But I got the idea that these would be the cheaper ones. I am now really confused. Maybe I heard her wrong.
The one step up more expensive lenses can correct the astigmatism and correct for nearsightedness or farsightedness. If you decide on clear far vision, you will need reading glasses. If you go for clear close vision, you will need glasses for distance. If you are thinking of one for close and one for far, try that with contacts first to see if you can adapt. The very expensive multifocals can correct for both distance or far but I don’t believe they can correct astigmatism too and you still might have to wear glasses.

Here are some reasons why I am not jumping on this:
- I think I see color very well. Might be wrong, but no problems that I have noticed.
You will be amazed at the difference. I thought I had good color vision until I had the surgery. After the first eye I would cover one then the other. With the un-operated eye everything was yellowish and dull.

- And it really doesn't seem to cause me problems right now, even though I don't like to drive at night. Maybe it’s just not yet time for you. They told me not to wait too long, because the lens gets harder and become more difficult to break-up and remove, but they are talking about years. I was told it’s time when the cataracts interfere with your daily living

- Also, this ophthalmologist practices out of a community hospital in Napa with 120 beds. It says it is full-service, but I think I would want to check with someplace like Cleveland Clinic near my other son.
I would check with a specialized optic center that does thousands of cataract surgeries. I was told the success of the surgery depends mostly on the experience of the surgeon.

- Finally, she said the testing to determine what kind of lens I get costs $2,250 per eye. She says I need to get both eyes done at once or I would not be happy with the results.
I talked to three eye centers before choosing. All said the pre surgical exam and measurements as well as after visits were included in the cost of the surgery.

Still need to do more research as what she told me contradicts what some of you said, assuming I heard her correctly.
I think you heard her right and yes do plenty of research. There is no rush to do cataract surgery.

So who of you had really bad vision (mostly near-sighted, but also wear bi-focals), worse in one eye than the other, and got the more expensive lens and ended up not having to wear glasses??
It’s a gamble about having to wear glasses after, even with the most expensive lenses. They hope to give perfect results, but there are no guarantees. I wore bifocals for years. I was very nearsighted. Since I always wore glasses, I don’t mind wearing reading glasses. I bought a bunch at the Dollar Store and have pairs all over the house, carry one in my purse, and have one in the motorhome and in the car.

Sorry I was not clear, Martha. She wants to the two eyes two weeks apart. I was asking her if I could get them a year apart.
No reason to wait, just get it over with and never think about it again. If the surgeries are three weeks apart, you are back to full normal activities in three weeks; high impact activities in six weeks.

And the $2,250 per eye was JUST FOR THE TESTING to see if I could handle the more expensive lens. That’s absurd; the testing should be included in the surgery cost.

There would be another $500 cost per lens. None of this part paid by insurance. Now, usually if something is for medical or something critical like vision, I do not mind spending extra money, but this sounds iffy and not sure I want to have to adjust to different vision in each eye!! I agree about being dizzy enough right now without causing more dizziness! I also think I have lots of time to do this. And I will certainly check with Cleveland Clinic near my son because I want someone who does this surgery hundreds of time a year, not a dozen or so times a year. (Just guessing on the last estimate.)
You are on about this. The only time I would get the “premium lenses” was if I wanted to correct for an astigmatism as well as nearsightedness. (Which I did.) A good eye clinic does thousands of surgeries in a year. It’s the most common surgery in the US.

Best of everything whichever you choose to do. Send me a PM if you have more questions.
K2 (Karen 2)

[snowball]

Judy I had a thought today in regards to seeing color...I think it is such a gradual change that you don't notice it...and maybe thinking it is bright and right and is in fact muted and dull...you won't know until you have the surgery it hasn't even been mentioned for me but perhaps it is because I tend to go to MX
for eye and dental...when I did see a dr here in the states,,.read before my husband retired I wore contacts...had heard of tens that would do the bio so I could read and see distance...he told me to just leave one lens out and did so was able to get used to it...but then I wanted lazer and because you had to not wear contacts for x amount of time before even being tested I took out my lens and started wearing glasses.,..then couldn't afford the lazer oh well I wear glasses to see distances take off to see up close...
sheila

[JudyJB]

Thanks, Karen 2, I really appreciate all the time you took to answer my questions. Ditto for Sheila and the rest.

I am going to put all of this on a back burner and wait for a second opinion until it bothers me a lot more and/or I get to Ohio in a year or so to see someone at Cleveland Clinic's eye center.

My mother who is passed away had this done about in 2000 at the Kellogg Eye Center connected with the U of Michigan. She later had a detached retina and macular degeneration. At one time she was seeing 3 of the 25 best-ranked ophthalmologists in the country, one for each problem! But her surgery was very different than it is now. I vaguely remember her movements being much more restricted than what you all describe, and it was for several days. I am glad it is better now.

[MandysMom]

Judy, when I was in nursing school, in the late 60's early 70's, our cataract patients were brought back to the ward on a stretcher and carefully slid to their bed with sandbags holding their head absolutely straight. They had to stay in that position 24/7 for I think 10 days and there were no implants so after surgery, which was not undertaken until they were virtually blind, they got these coke bottle thick glasses. So glad times have changed.The funny thing was those patients seemed so elderly, now I am there age and raring to go. Lol
Velda

[MandysMom]

Thank you Karen 2 for your great posts. Very helpful as I talk myself into pulling the trigger for the surgery. I know it's getting time because it's interfering with my night vision and I get unclear vision esp in evening and my year old glasses just aren't helping as much. It's planning surgery between Mel's chemo that has me concerned as he's getting where he drives less and less for bringing me home day of surgery so may recruit a friend. It's reassuring I can likely drive the next day should he need it.
Velda

[Liz]

Judy, it sounds like you need to find another reputable ophthalmologist and get a second opinion. What you were told doesn't sound right at all.

[FinallyTime]

Hi Again Judy,

If you can stand reading more, I went back over the documents the eye center gave me and came up with more things to consider.

These were the surgery options and prices offered by the Eye Clinic I went to:
Traditional Cataract Surgery, cost covered by insurance; surgeon uses “blades” to make the cuts to access the interior of the eye, ultrasound and suction to breakup and remove the lens. Monofocal lenses will be implanted which provide vision at one point (e.g. distance or near.) Most patients will require glasses for near if distance focus was selected or glasses for distance if close focus was chosen. If the patient has astigmatism glasses will be needed.

Premium Laser Cataract Surgery, premium fees are in addition to insurance payment; surgeon uses the laser to make the cut in the cornea to access the interior of the eye. The laser is used to cut the lens into small “pie” shaped sections that are removed by suction. The ORA System Intraoperative Wavefront Abberometer is used to take measurements during and after the lens removal and are used to customize the placement the replacement lens.
Premium Laser Surgery Options and Costs;

Single Focus Lens with Correction of Mild Astigmatism, $1,500 per eye; A Monofocal lens (see Traditional above) is implanted and the laser is used to shape the cornea to correct the mild astigmatism.

Astigmatism Correcting Lens for Correcting Higher Levels of Astigmatism, $2,000 per eye;
A Toric lens implant is used. It is a specially designed lens customized to correct astigmatism as well as nearsightedness or far sightedness. Focus is either near or far as above. This is the one I chose.

Monovision, one eye corrected for distance, the other for near, $1,500 to $2,000 per eye;
Good option if patient wants to do most activities without glasses, but may not be right for all patients. Both near and far objects should be in focus once the brain adapts. Monovision is a compromise. Your vision is never as good as when both of your eyes are seeing at one distance and your depth perception may be reduced. You may need glasses for night driving and extended reading. Astigmatism management is with the laser or Toric lenses.

Multifocal Lens, $2,750 per eye;
The lens design focuses light from different distances on to the retina. Through a learning process patients are able to focus on multiple distances, and are less dependent on glasses for most activities. Vision is not as “crisp” as other lenses. Some patients notice rings or halos around lights at night. Does not mention astigmatism, but does say there are different styles of multifocal lenses available.

As far as recovery, they gave me this information sheet;
Symptoms you may notice for a few days after surgery;
Blurry vision, vision may fluctuate
White part of eye maybe bloodshot or red
Eye drops will sting
Pupils may remain dilated
Foreign body sensation or irritation, like an eyelash in the eye
For a few days you may see;
Blue or pink colors or after-images in your vision
Crescent shaped images (half circle)
Glare from lights or halos around lights-may take a few weeks to go away
Change in colors, usually brighter and less yellow
Final clearing of your vision usually takes two to four weeks. It may take longer if you have diabetes, macular degeneration, glaucoma, or other eye diseases.

Other things to avoid after surgery;
Wear the eye shield (curved clear plastic with ventilation holes, covering the eye, held in place with tape) while resting or sleeping during the day and first night after surgery. I thrash around a lot sleeping so I wore the eye shield every night for the first week.
Normal activities may be resumed the day after surgery
Bathe and shower as usual, but try to keep water and soap out of the eye
Avoid swimming or hot tubs for a week
Do not use mascara or eye makeup for the first few days after surgery

Best of everything,
K2

[MandysMom]

Just remember something funny/ interesting after Mel's cataract surgery. For about 12 hurs or so after he came out of surgery I could look in his eye and see the ID code # on the edge of his new lens because his eye was still dilated. Then it disappeared covered by the pupil as it closed.
Velda

[JudyJB]

Velda, my grandmother was elderly at the age of 70. We grandkids had to take turns spending the night with her, and my mother, and my two aunts who lived very close had to bring her meals to her every night. (She was picky and used to "shop" by calling all three to see what they were having that night, so she was a bit of a character.) I am 74 and still going strong!

K2, I have worn glasses since I was 12, so I really don't mind wearing them. I think the one lens far and one near would not give me the vision I want and at my age, I really don't want to go through all the adjustment. I think I would go with the same choice you made.

This has been an excellent discussion. Our vision is so important to us because it is our connection to the outside world. And I do remember the sandbag treatment. How wonderful that all of this is so much easier these days.

[MandysMom]

Judy, I have worn glasses since I was 3 years old, contacts for a few years, glasses the remainder of the 65 years since I was 3! I have decided to spend the $$ for the very best combination of treatment my eye Dr can give me ( the extras after what insurance pays) as I figure I deserve to finally be without glasses for the first time in 65 years, or at least mostly without glasses. Let you know if the eye Dr says he agrees I'm ready. My biggest fear is losing my ability to lay here at night without glasses and read with iPad on my chest. Mel lost his closeup vision and the VA has never been able to get any glasses,that help, him be able to do the fine tiny electronics he used to do. It's been very frustrating for him. He and I are both nearsighted by birth and have astigmatism too. I wear Toric lenses now but they can't completely compensate. My Opthamogist told me my eyes are very much shaped like his and the retina has safely come loose rather than tearing as it often does with the elongated shape of my eyeball so I'm good there and he felt in April 2016 that between special IOLs, laser surgery, and lasik incisions, he could get my eyes pretty close to perfect. That would be a miracle for me, to see the distant trees perfectly and be able to read without glasses. It would be so much fun to walk into a store and buy a regular set of fancy sunglasses from the shelf!
I agree Judy, the advances have truly been a miracle. Back when I was in nursing school people were made to wait until the cataracts were quite "ripe" and hard and the surgery was,quite brutal and sutures were used. People were all but totally blind, so seeing at all with thick glasses was life changing. There eyes had this white area before surgery where you could easily see the cataract. Now days they know that if they wait, the cataract is harder to remove and not being able as well to see the retina through the bad lens hid bad things like detachment because they could not see it, not to mention how having ng good vision is so important to staying independent. So now they operate much sooner to give us better quality of life and prevent missing what is,going on inside the eye. So, in spite of the fact that having to submit to this makes me feel older than I feel at almost 69, I need to get over myself and get it done if ready.
Velda

[Carolinagal]

Good responses here, I just wanted to add that you do need 2nd opinion and a place where this surgery is a specialty and plenty of experience with procedure. I dreaded anyone messing with my eyes but I'm very pleased with results. Recovery time was a snap except for drops several days afterwards and I was told not to bend over, otherwise I didn't feel any effects from it, except " I could really see again".

I think you're very wise going somewhere else. My sis had had hers done with good results so picking out surgeon or clinic was not a problem I had.

Good Luck!
CArol

[MandysMom]

I have been perusing a lot of information and videos over the past few days. I came across a women Dr named Dr Sandra Lora Cremer. She has very good videos on eye care and in particular cataracts and the types of lenses and why they are now used. She is within a eye group called Visionary Eye doctors but had her own channel under her name. She has both Spanish and English versions so don't be confused if she comes up speaking Spanish, just go back and choose the English one!
I think if Dr agrees I will choose femtosecond laser surgery with Symphony lens.
Velda