Questions about cataract surgery.

[C.F.Plinker]

I was just diagnosed with cataracts in both eyes. When I asked the doctor if they were "ripe" he said that they were and that he was referring me to a surgeon for an evaluation. He went on to say that there were several types of lenses that I could be fitted with and that there was a higher copay for the toric or multifocal lenses. He said to talk to the surgeon about the toric lenses because of my astigmatism. I asked whether they ever did both eyes at the same time and he said they did and there would be information about that on the handout he was going to give me.

The advantages of having both done at the same time according to the handout are that you need fewer follow-up visits and copays as compared to having them done separately. I also figure that this also means that you will get the final glasses that much sooner.

Have any of you had both eyes operated on at the same time or know of anyone who has? What were their results and would they do it that way again? (of course I realize that if they had both eyes done they probably would never need to have them done again but you know what I mean.)

What have your experiences been with the toric lenses? Would it be worth an additional $1200 per eye for the torics?

[Doc Highwall]

I had only one eye done at a time and I have the toric lenses, and now my stigmatism is mild enough that I only need reading glasses now.

[DLCTEX]

I had one eye done at a time and about 5 weeks apart. I opted not to have the multifocal lenses as the cost would have been $2500 per eye. I do not have astigmatism. The difference is astounding. Three years later I am still in awe of how great the technology is and the lense implants improved my close vision to the point I can read most print without reading glasses, but it's somewhat blurry. It did wonders for my shooting vision, causing me to have to readjust my focal lenghth on my scopes.
My vision is better than 20/20.

[nvbirdman]

I had my eyes done one at a time with the toric lenses. I can't of course compare it to what it would be like with different lenses, but if I'm going to be using them for the next twenty years, I'll go for the good ones (ordinary lenses would be covered by my insurance, upgraded lenses came out of my pocket).
The surgery itself was a piece of cake. I was laying on a gurney, they wheeled me into the operating room, and did something to keep my eyes open. I never felt a thing, and after a while I heard the doctor say "We're almost done". Only bad part was starting the IV naturally, and after that it was no more disturbing than sitting at home in my easy chair reading a book.

[GaryN]

I didn't go with the expensive lenses because of the possible problems people were having. I went with the standard lens focal point infinity. I can see real good from my knees on out (20/15). I wear glasses for reading and comp. It really helps with the pistol sights. I had a blast while hunting. I could see everything very clear. I was picking up deer from hundreds of yards away. Haven't been able to see this good in years.

[wch]

I had each eye done seperately; I elected for "far" vision lenses and now use reading glasses.
The improvement in scope use was noticeable but iron sights require more concentration for accurate shooting; I shoot optics and irons without eyeglasses.
Looking at these answers and remembering what the surgeon told me it is apparent that each of us may exhibit different results.

[William Yanda]

My wife just had a second follow up today for her cataract surgery. Her Dr. advised one at a time in case of complications. She had laser surgery today to remove a "cloud" and is very satisfied overall with the improvement in her vision. However, no one can explain why she has flashing/jerking sensations in the eye which was operated on. Immediately after the surgery I thought it was going to drive her nuts but she has mentioned it less lately. She will not have the other eye done until someone figures out what causes the flashing/jerking. Her surgery was last June. Sorry, she has no advice re the lenses.

[GhostHawk]

My wife had her first Eye done then the doctor went on vacation, was almost 3 weeks before she could do the second.

Really left her miserable for a long long time as they had to wait for the second eye to heal before they would give her a new eye test and set her up with the correct perscription.

I'd do them both, take a few days to recouperate, and spend the extra for the good lenses.

[scarry scarney]

This all good to hear. Thursday last week they said I needed the surgery, got all "measured" today. Now waiting on medical clearance, I have "other issues" that have to "adjusted." To tell the truth, I'm a little concerned. I was blind for about 2 months last year, and I can see ok in the right eye, but vision is rapidly degrading in the left. At least I'm right eye, right hand dominant.

[Duckiller]

Wife and I have both had both eyes done. Mine was done about 4 years apart. One eye got much worse than the other.In the interim I had one eye to read with and one eye forlong distances and shooting. Eventually I had the second eye done. Have the eyes of an eagle but have reading glasses for close up work. Wife waited until she was almost blind. She had them done about six weeks apart. $5.00 per eye co-pay was not too excessive. She was reluctant and scared before the first eye was done. About 4-5 days after the first surgery she could see better than she had been able to in years and really wanted the second surgery as soon as the Dr. said the first eye was healed. We both use reading glasses/ bifocals for close work but then we are both over 70. We didn't get fancy lens'. Remember most people over 40-45 need bifocals. Save your money and grow old gracefully. HAVE THE OPERATIONS! It is the safest operation that a Dr. can do to you. and the new vision is great.

[freebullet]

Rapid developing sub capsular cataracts had my left eye pretty much blind and my right eye fading to blurriness by the day. I had the surgery done last October. I had them done 7 days apart. I waited until just before Christmas to have the yag laser done for the secondary outer lens clouding.

I researched the lens options quite a bit. I decided on having mono vision set up. My left eye set for focus at arms length and the right set for distance. I get by well without glasses at all. I will probably still get a pair of up close reading glasses, but I don't need them. The surgery was no big deal for me.

My mother had the toric lens installed the same days as mine. She LOVES them. She had always worn glasses her entire life. Now she only needs them to read up close. She had both eyes set for distance. You may want to try negotiating a better deal/shopping around. I was able get my mothers down to 500$ for both eyes upgraded to the toric lens done by a reputable surgeon.

The clarity after is crystal clear just as I had 2 years before the medication related cataracts started blinding me. The problem is you loose your ability to focus. They don't make any lens that allows you to focus the way you could naturally. With multifocals it's like having bi or trifocals. You have to move the lens up and down with your eye tissue to get focus at different distances. This is why they have such a high fail rate. If you eye tissue grows back around the little tabs on the sides of the multifocal lens crooked you may not have focus at any distance. My doc had a little deal you put in front of your eye to simulate the multifocals. I wasn't impressed with the overall cost, risk, reward ratio on them. I've seen my father struggle with bi/trifocals glasses for years and didn't want anything of the sort.

If your a millionaire you can have new lens grown from your stem cells and installed. I guess they've done it once.

Shooting after.
I did have to adjust the fast focus eyepiece on the scopes the make the reticle come in to focus and had to swap out a couple vintage scopes that didn't have that feature. I have not played with my open sight rifles post surgery yet. With handguns my mono vision helps. If I use my left eye the sights are automatically in focus. With my right eye set for distance I can see the sight but they are a bit unclear. I can still get a decent flash sight picture with the right eye.

[RogerDat]

My wife had both eyes done a few weeks apart as I recall. We elected to pay the additional for the multi-focus lenses. Figured amortize that price over the next 20 years makes it a good investment. Sort of like buying a good scope, pay once and better functionality for many years. Not needing to purchase glasses was a bonus. She can read or drive without glasses and really enjoys being able to see clearly, especially driving at night. She still doesn't really like driving at night but she can see again without the stars and glare from cataracts so she does not fear having to do it. Just would rather have me do it. What can I say one more reason to keep me around, I'll take it.

I would give it some time between eyes, just to let the body deal with healing in smaller chunks if nothing else. If something does go wrong or is less than optimal it gives you a chance to re-evaluate before proceeding with the other eye.

[dagger dog]

Don't go under the knife thinking every thing is coming up roses.

My cataract surgery caused permanent vision distortion in my right eye, a small vessel that feeds the retina ruptured and that part of the retina was damaged, it didn't show until the 6 week follow up.

I have had astigmatism from birth, the regular lenses corrected 90 % of mine, I will have to go back to have the secondary cataracts corrected it is a deposit that forms on the artificial lens transplant, they can use a laser to remove that deposit.

I wish you the best of luck and do not mean to cause you any anxiety, but rather have you aware of complications.

[mold maker]

Both eyes done,(separately) and the cheaper lenses. I've worn glasses since I was 5 and am now 72. I see better now (from the first day) than at any time in my life.
NO starburst around lights at night.
NO squinting to see detail on road signs 3/4 mile ahead.
NO bobbing the head up and down to negotiate stairs and curbs.
NO more headaches from eyestrain.
I do use bifocal glasses so that close things are as clear as distance.
I can even recognize my Grand kids facial expressions, while they play soccer, on the other end of the field.
If you need it, get it done. The surgery is less traumatic than getting your teeth cleaned, and takes less time.
The difference is absolutely amazing.

[johniv]

Had one eye at a time done with regular lenses. Now I use reading glasses but my shooting has improved(finally) Maybe I am just practicing more.
John

[nicholst55]

I recently read an article by an Ophthalmologist who had cataract surgery performed, and was, himself, performing surgery the following day! He revised his opinion of the old mantra 'wait until they get worse,' and now advises his patients to have the surgery as soon as possible. I don't recall which type of lens he had installed, but he was amazed by the results.

My wife is being evaluated for surgery in a few weeks, and I have also been diagnosed with a cataract in my right eye, so this is a very timely topic!

[nvbirdman]

If you think the extra $1200 for each eye is a bit excessive, just be happy you're not a spider. They of course have eight eyes.

[Hardcast416taylor]

Had my eyes done 15 years apart. Went with the less expensive lens for each eye that made me far sighted. I need reading glasses and for driving so my glasses are bifocal. Couldn`t believe the difference in lenses in the 15 year gap. I couldn`t foot the extra money for what they said my benefits from them would be.Robert

[DIRT Farmer]

I am facing the surgery,I can still see 20/15 on the chart but the target peeps no longer have a hole in the center, basicly I have lost all iron sights and the scopes have a fuzzy spot in center. Any more comments on which lense and sighting?

[Doc Highwall]

DIRT Farmer, have your shooting eye corrected for distance.

[kenyerian]

My brother has had both eyes done and I have had my Right one fixed. It is definitely a miracle. We spent yesterday together running dogs, chasing rabbits, shooting some targets all without glasses, He had wore glasses most of his life and I had worn them for over 20 years.

[Bad Water Bill]

Thank you to all that have responded.

Been putting it off for a while.

[DIRT Farmer]

DIRT Farmer, have your shooting eye corrected for distance.

At this point distance vision is good, my problem is that I shoot shotgun and need a 22 yard focal point and love to shoot long range muzzleloader, where I shoot out to 1000.

[Doc Highwall]

DIRT Farmer, 20/20 vision means what the average person can see at 20 feet you can see at 20 feet. The reason 20 feet is chosen is that is infinity for the human eye for most people. At 20 yards your eyes should be in sharp focus. If you wanted to try something get a cheap pair of reading glasses that are the lowest power that you can find, like .75 diopters or less.

[C.F.Plinker]

Update --

Went in for the pre-op at the surgeons office. One of the assistants asked me a few questions and then dilated my eyes so she could get the measurements they needed to get the right lens. After those measurements were taken I got my chance to ask questions. Thanks to all of you for sharing your experiences because that gave me a full page of questions and things to discuss. When I said I was interested in the toric lenses for astigmatism she said we had to do another set of measurements with a different instrument.

They gave me 3 prescriptions for different kinds of drops and instructions to use them 4 times a day starting the day before surgery and continuing for 1-3 weeks after surgery depending on the specific drops. She gave me the consent form to sign and I pointed out that it was for standard lenses and correction for distance vision. She said to discuss that with the surgeon and it could easily be changed. She said I would get a clear plastic eye patch to wear all day after surgery and every night for the week after surgery. I was to tape it in place but take it off for applying the drops. All of the instructions were given to me as a handout. The interesting ones were to go home and nap as necessary because the relaxers they give before surgery take a while to wear off. There will be a follow-up with the surgeon the next day and I should have someone drive me to and from it. They will schedule a optometry appointment 3-4 weeks after the surgery. I asked how many cataracts this surgeon had removed. She said she had only been working with him for a year but in that year he was running at over 100 per month and had been with Kaiser for over 10 years. She left and the surgeon came in.

He did an eye exam and looked at the results of the measurement that the assistant had made. He said that the numbers didn't work out for the toric lenses. We discussed the multi-focal lenses and I decided against them. So we will go with the standard lenses. My astigmatism is partly due to the lens and partly to the cornea. Since we are replacing the lens, that part will be gone forever. There will probably be some remaining from the cornea but that can be corrected with glasses of laser surgery. He said he can correct for close up or middle distance but that his patients are happier if he corrects for distance and uses glasses to correct for computer and reading distances. I had a question about rejection because my father rejected his (years ago) and had to have them removed. The surgeon said that doesn't happen these days due to improved materials. He will do the eye with poorer vision and I should have the new prescription for it in about a month. They will do the second eye after that. There will not be any restrictions on lifting after surgery. I may be able to see well enough after both eyes are done to go to the Drivers License office and get the glasses restriction lifted after over 50 years of having it.

Medicare will provide a set of bifocals after each surgery at no patient cost. Of course they are plastic lenses and cheap frames. I will have to pay for any "upgrades" done. I will get these and keep them as backups having the upgrade to progressive lenses. Then after this is all done and the final prescriptions are made I will have an optical shop I deal with make up a pair of safety glasses with progressive, photochromic, glass lenses.

The scheduler just called and I am on the schedule for surgery on March 26.

[tallwalker]

Must be going around... I just got home from setting up my surgery for April 7th with the other eye on Apr 21st. Going for standard lens and distance as well. I shoot High Power XTC service rifle so guess we'll see how iron sights are afterwards. I have worn glasses all my life since I was 8.

[Doc Highwall]

Tomorrow morning I go to have the protein build up on my implant cleaned up by a laser, they did the other eye last month.

[BAGTIC]

I only had one eye done. What impressed me as much as improvement in clarity was the improvement in color. Everything looks so bright and shiny.

[Der Gebirgsjager]

It's a little scary, isn't it? I mean, after all, we're talking about your vision--so precious to anyone, but especially shooters and readers. I approached it cautiously and just had one eye done at a time, 3 months apart, now one year ago for the last one. My vision had gotten progressively worse over the preceding 5 years until I had to struggle with the highest magnification drugstore glasses and things were still fuzzy. I'm sure that I would have spent the last 10-15 years of my life blind. I went with the standard lenses and now see 20/20 in one eye and about 20/15 in the other. I only wear reading glasses for small print and can easily read this computer screen without glasses. Other than reading, I can see out to infinity very clearly. The worst thing about the operation was insertion of the IV. After that there was no sensation or pain at all, and recovery just involved using two different types of antibiotic eye drops for a couple of weeks. Best thing is---I'm back in the bullseye again. Thank you God, for giving us this wonderful technology.

[C.F.Plinker]

Another update.

After reading your posts, I decided to visit the Mom and Pop optical shop where I get my glasses to see if they had any ideas about what I could do for the period from the first surgery to the optometry visit after the second surgery. I turned out that as soon as I said cataract Mom took over. She had both eyes done at the same time a couple of years ago and said NOT to do that and to have them done one at a time. She suggested that I get some plano/2.5D bifocal lenses to go into my frames and then put them in one at a time after each surgery. I showed her the frames I had and they took measurements and pictures of them so they could match them. This was more difficult than expected since the company that made them had gone under since I bought them and also because they are safety glasses frames. They did find them and got them ordered in.

Then the big day came. You have to have a Responsible Adult (RA) drive you to and from the surgery as well as the follow-up visit. We showed up at 6:30 am (surgery was scheduled for 8:00) and got checked in and went up to the waiting area. After about 15 minutes we went back to the preop area and I was seated in an industrial sized recliner. After checking to make sure I knew who I am and what I was there for, They put numbing drops in my eye and a wad soaked with the eye dilation solution between the lower lip and gum. Other patients for cataracts were coming in and I found that they had two rooms set up for doing the procedures. Yes, they are called right and left because they do all of the right eyes in one and the left eyes in the other. This is because the surgeon works from the side of your head instead of working from the top of your head. I did take the relaxer pills.

Then it was time to put the show on the road. I was wheeled in to the procedure room on a little cart. All I had to do was back out of the cart, sit down on the table and spin around so I was laying down where they wanted me. They put a small plastic sheet over both eyes and cut slits in it so they could work on my right eye. The surgeon came in, put some clamps in to hold my eye lids open, and lowered a light until it was over my eye. My only instructions were to keep looking at the light. It was bright but nowhere as bright as the slit light they use for a regular eye exam. That's really all I saw. It changed and moved just a little as they were working, and there were two or three periods where there was some discomfort but they lasted less than a second. Then the light became less clear and was moved away and it was all over. Back into the cart and to the preop area. This time into a wheel chair and the RA was told to get the car and bring it around to take me home.

My eye had a fairly clear shield over it. I could open the eye but it was more comfortable to just keep it closed. I took the shield off to put drops in at lunch time but put it back on. By early afternoon I had it off and found that I could see better without my glasses on that eye. So I took the lens out of that side of my glasses. My vision with the operated eye was better than with the unoperated eye without glasses on that eye.

The next day was the postop exam. The Dr. said everything was fine and my vision would only improve from there in out. I asked about driving and shooting. He said I could drive that afternoon if I felt up to it and shoot whenever I wanted to.

Back to the eyeglass store. Son was getting ready to fit the lens to the frames and noticed that it was very pink. He decided to hold off until I came in. We decided to just put one of the blank lenses that came it the new frames into my old frame replacing the one I took out.

Right now objects about 2 1/2 to 3 feet away are the sharpest and distant objects are almost as sharp with the operated eye as with my good eye using my glasses. I go get the prescription for the right eye in 3 weeks and then we will schedule the cataract removal for the left eye.

[Bad Water Bill]

Thanks for a great report.

Yes I definitely need both done BUT.

[scarry scarney]

Good reads. I had mine (left eye) done about 4 weeks ago. Dr just pulled the left lens of my glasses out for now. Right now, I use the right eye for close work, left eye for far, feels weird, so most of the time, I just don't wear the glasses, except to drive. Last Dr apt (1 week after surgery), he said my vision is about 90% where it is supposed to be.

I don't know if or when right eye will get done.

[C.F.Plinker]

The week after the cataract was removed I went down to the range with an air pistol to see what differences there would be since the cataract was in my sighting eye. Before the operation I would see two bullseyes, one above the other, due to the astigmatism. I used safety glasses with a +2.5 correction in order to get the front sight in focus and then a 5/64 diopter to give better depth of field. I brought along a plain (no correction) pair of safety glasses, opaque tape, and a spare diopter. The first thing I noticed was that I could see the front sight fairly sharply without any glasses. The second thing was that there were still two targets down range. They were closer together than before but they were side by side. My astigmatism had changed. I taped up the upper portion of both sides if the safety glasses and installed the diopter where it needed to be for a natural point of aim. Then I proceeded to ventilate some targets.

The following week I went back to the range again with an air pistol. Couldn't see the front sight, couldn't see the rear sight, and I couldn't see the target. I could kind of tell if the sights were semi-aligned. I put 5 pellets into a 25 yard center that was at 10 meters just so I could say that I did some shooting. When I got home I sent the surgeon an e-mail describing my problem. Twenty minutes later the phone rang. The surgeons office called and said they had set up an appointment with an ophthalmologist at the clinic I usually go to in 45 minutes -- be there.

I was and after his examination the diagnosis was posterior capsular opacification. This is the "secondary cataract" that others have described in their postings above. The laser surgery was scheduled for two weeks later. In the meantime I used a .22 with a red dot and shot my usual scores.

The laser surgery was painless. You put your chin and forehead in the same device that is used for a slit lamp examination and look at a light that is in front of the bridge of your nose. Then the surgeon uses a laser to cut an opening in the lens capsule that is just behind the lens that was implanted. I heard clicks as he fired the laser and saw different patterns of lights and lines that changed but did not seem to have any rhyme or reason for the changes. I could not see any flashes as he fired the laser. After about 20 clicks he said he was done and I could go home. I could have driven home but, because they dilated one eye, I was glad to have someone else do the driving.

I am seeing better with that eye but it still has astigmatism and I am nearsighted with that eye. I have an appointment with an ophthalmologist in 3 weeks for an exam and prescription. Then we will work on the other cataract.

Now to get a pistol with iron sights and head to the range.

[MtGun44]

Going in Monday to get right eye done. Praying for it to
work normally.