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Old 07-08-14, 12:18 PM   #1
Pamestique 
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Cataract Surgery - question re lens relacement

So this is generally an "old folks" issue - I am finally scheduled for cataract surgery (July 23 and August 4) and can't wait to get rid of these awful, cloudy lenses. It's been like looking through cheesecloth for the last 3 years...

I have also been very nearsighted (ie no far vision) for most of my life and have been talked into getting a Crystalens replacement. Cost of the cataract surgery and normal lens replacement -0- - costs of the Crystalens and correction of astigmatism - $8500. BIG DIFFERENCE.

All of my life I have wanted to see like normal people so am willing to pay the price but then started reading about the lens (the internet is a blessing AND a curse) and am now not certain; in fact, I am scared. I have read a few reviews of people very satisfied with the result and lots of reviews from people who are extremely unhappy. I realize unhappy people are more likely to post something so take all the comments with a grain of salt. But now I contemplate if its worth the added expense (man I could buy a nice bike with that money!) and will I get the result I expect or be disappointed. Or should I just do the minimum and be happy with no cloudy lenses but still have to wear glasses to see far?

I welcome any comments, suggestions, experiences, issues any of you are experienced. Again, alittle nervous about subjecting my eyes to surgery and need some reassurance..
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Old 07-08-14, 12:26 PM   #2
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The multifocal implants definitely involve some compromises. If you're one who's very picky about your vision, it may not be right for you. Another option is monovision, you undercorrect one eye so it can see up close. I wouldn't do that without trying it with contacts first. I do that myself with contacts. Also keep in mind you've probably been able to see well without correction up close, you will lose that if you get regular implants corrected for distance.
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Old 07-08-14, 02:42 PM   #3
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It's too bad you need the implants now, but it sounds as though you do. The technology keeps advancing rapidly, which is why I am holding off, even though there are legitimate arguments for doing it earlier, rather than later -- softer lens to remove, younger age of patient. With a -7.0 diopter myopia and a 2-diopeter astigmatism, I shall probably face decisions similar to yours.
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Old 07-08-14, 03:05 PM   #4
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I have to have the cataract surgery... no holding off on that any longer as its affecting my daily life... I could probably hold off getting the expensive lenses and just opt out for the standard lenses... and I might. I'm 63 and how much older do I get in order to see properly?
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Old 07-08-14, 03:13 PM   #5
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I love my bionic eyes. I've had them for over 10 years and have had no problems. I wear a very weak reading glass for fine small print or extensive reading but they are self correcting for distances. Best thing ever.

Marc
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Old 07-08-14, 03:31 PM   #6
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My wife had cataract surgery on both eyes a few years back and it has made all the difference in the world. She had the standard IOLs implanted and uses reading glasses when necessary.
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Old 07-08-14, 04:47 PM   #7
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My dad just went through this last fall. He got the crystal lens lens and is very happy with them. He has had no problems.
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Old 07-08-14, 05:26 PM   #8
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whew - good reviews... okay now I am feeling better. It's just so much money and I worry about what happens if it doesn't work... but I'll give it a go....
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Old 07-08-14, 05:38 PM   #9
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If you can afford them multi-focal is the way to go. Any lack of detail is so slight as to be undetectable by anything but a machine. They are paired with an eyeball reshaping procedure.

Like all procedures of this nature be very careful in your choice of an ophthalmologist. Also sped some time discussing the relative merits of different lenses.

Single focus lenses are archaic and should only be used if you can't afford better, in my opinion.
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Old 07-08-14, 06:12 PM   #10
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If you can afford them multi-focal is the way to go. Any lack of detail is so slight as to be undetectable by anything but a machine. They are paired with an eyeball reshaping procedure.

Like all procedures of this nature be very careful in your choice of an ophthalmologist. Also sped some time discussing the relative merits of different lenses.

Single focus lenses are archaic and should only be used if you can't afford better, in my opinion.
I must take exception with your last assertion. Sometimes the simple solution is just as good. Having near perfect vision, except for near vision, is hardly archaic. In cycling terms, it's like saying a single speed bike is archaic.
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Old 07-08-14, 06:52 PM   #11
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You're going to get mixed reviews on the multi-focal lenses because people have mixed success with them. As John E. said, it's a shame folks are having to make this decision NOW as the technology will likely be perfected within the next decade. Unfortunately, once you have the artificial lens, there's really not a chance for a do-over.

My decision was complicated by the fact that I only had a cataract in one eye and, being 55 at the time, probably wouldn't get one in the other eye for another 15 years. I had extreme myopia (-7.5 D) and increasing presbyopia. I opted for the fixed-focal lens, and it's worked okay. Because of my extreme myopia, I was still left at about -1.0 D. I under-correct this with a contact because, although you THINK you've lost your ability to accommodate by your mid-50s, you can still accommodate SOME. The synthetic eye cannot accommodate AT ALL. Thus, to wear reading glasses with the same correction in each eye (i.e., the cheap "cheaters"), it's good to have the "fixed" eye at, like, -0.5 D to balance the natural eye that still has about 0.5 D of accommodation left.

Sorry for the long-winded story. My only take-home message is -- fixed lens looks great, but has 0 accommodation. That said, reading glasses are cheap, and pretty much all your peers need them as well. If you can find multi-focal that work for you, hey, even a great bike isn't worth more than great vision.

Best of luck!
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Old 07-08-14, 07:12 PM   #12
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I had very little astigmatism and back in 2005, multifocal lenses weren't recommended. So I had standard lenses in each eye, corrected for distance vision. My distance vision is ~20/15 and I use drugstore readers for reading and computer work. I love the visual acuity I have now and not having to use prescription sunglasses.
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Old 07-08-14, 07:50 PM   #13
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i had both of mine done years ago.i still wear glasses,but in the sun i have to wear sunglasses because the sun is too painfull without them.anybody else have this problem?
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Old 07-08-14, 09:50 PM   #14
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One year ago I had cataract surgery at age 56. Technically, I was legally blind. Once cataracts start to ripen they ripen fast! Mine did anyhow. My Ophthalmologist did not think the multi-focal technology had yet been perfected and recommended against it. I took her advice and have never looked back. Both my lenses were tuned for distance and only occasionally need reading glasses, but not always. This is an amazing operation. I had forgotten how much color was in the world. I recommend NOT WAITING and not taking any unnecessary chances. Eye sight is just too important.

Matt

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Old 07-08-14, 10:29 PM   #15
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I must take exception with your last assertion. Sometimes the simple solution is just as good. Having near perfect vision, except for near vision, is hardly archaic. In cycling terms, it's like saying a single speed bike is archaic.
Depends on what you want to accomplish. If all you want is elemental vision a single vision lens is adequate. Much the same as a 1998 pickup truck will tow the trailer. But the current model will tow it much more efficiently and safely.

In the same way a single vision lens will do the job. But the multi-focal lens does the job better and with no need for accessory glasses. Surgery risk is very similar I am told.

Note that I am looking at total life, not just cycling. Being able to have good, clear vision all the way from reading, doing electronic work, to driving, to sports, to scuba diving, to whatever with no glasses except safety glasses is a gift.

Remember inserting replacement lenses is a business like any other business. So, before making a decision a person needs to get input from both sides. Me? I think multi-focal technology may get better. But, it is very good now. Much the same as progressive lenses in glasses.
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Old 07-08-14, 11:54 PM   #16
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i had both of mine done years ago.i still wear glasses,but in the sun i have to wear sunglasses because the sun is too painfull without them.anybody else have this problem?
Two decades ago, I worked with a psychophysicist. In the course of some of his work, he looked at blue light detection in the eyes of older Americans. His conclusion was that one of two things happen. Either the lens remains transparent to high-energy blue light, which allows it to damage the retina, or it becomes opaque to blue light, usually by forming cataracts, in which case the retina is spared.

If you are the latter case, then your cataracts may have kept your retinas in good shape, so without them you find sunshine to be painfully bright, kind of like coming outside from a dark windowless building. This is a good thing.
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Old 07-09-14, 08:11 AM   #17
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The most important choice you will make is the ophthalmologist you select. Top three rated programs are Bascom Palmer, Wills and Wilmer. Docs from other programs may be very good, but if your doc comes from one of these three, you can pretty much be assured that you're getting the best treatment.
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Old 07-09-14, 08:25 AM   #18
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If you're going to cough up the big bucks for multifocal lenses and astigmatism correction, I'd find someone using the new laser platforms. It won't cost much more at that point. Find someone like a Lasik, cornea trained person who has experience with the docking platforms. The capsulorexis created by the laser is more predictable, which has influence on the lens position, which is critical in the new technology implants. They can also program astigmatism cuts with the laser.
Don't worry about where they trained, the grades needed to get into the top programs don't necessarily translate into surgical skills. Look for someone who does fairly high volume.
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Old 07-09-14, 08:48 AM   #19
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I've had both eyes operated on for cataracts. This procedure has worked out wonderfully. I can even read without glasses but do squint a bit. I agree with the doc - find people who do many procedures daily. In my case, the surgeon operated in a facility that specializes in eye surgery. I'm a skilled woodworker and yacht builder and as such have a great appreciation of competence where ever I find it. The staff at this facility were so clearly competent I complemented the surgeon and staff in a follow up visit a few days later. Furthermore, I received a form from them asking me to review my experience with them. Of course I gave then the highest accolades.
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Old 07-09-14, 10:23 AM   #20
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If you're going to cough up the big bucks for multifocal lenses and astigmatism correction, I'd find someone using the new laser platforms. ....
to my credit, I did do alot of research before selecting a doctor (the doctor is Dan Tran MD, Stanford Undergrad, Keck School of Medicine graduate, degrees in engineering and medicine; no complaints with the medical board); he is highly recommended, board certified and has a specialty in cataract removal and lens replacement and is trained (in fact he trains other) in the latest laser methods. I have found a number of people who have used his services. Apparently all this is one reason the cost is high. And saeyedoc - thanks for your input. The surgery will include the femo...whatever laser to correct the astigmatism and fine tune the procedure. Alot of what was said is over my head, so your advice is appreciated.

My primary concern is just to get rid of the cloudiness of the cataracts... it affects my life in so many ways, I just need that taken care of. My next concern is being able to see far... all of my life I have been severely myopic and have always wore glasses and contracts. I told the doctor I was not concerned about having to wear reading glasses, doesn't bother me now; won't bother me after. The fact the Crystalens will correct middle vision is a bonus, I think, since I am on the computer long hours or every day and I struggle now with being able to read the screen and see the keyboard.

I do appreciate this community and its experiences and find all your comments a great help in making my decision. Sure not convinced but now have a list of questions to ask the doctor on Friday during my "pre-op".
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Old 07-09-14, 11:29 AM   #21
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I have had both lenses replaced. the first was a Crystalens as sold to me by my Ophthalmologist. I was not happy with it. The second was a standard lens as approved by Medicare. This result was far superior. I went to a different Ophthalmologist on the second lens. I spent a lot of money on the Crystalens and found it considerably poorer in vision quality.
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Old 07-09-14, 11:36 AM   #22
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I have had both lenses replaced. the first was a Crystalens as sold to me by my Ophthalmologist. I was not happy with it. The second was a standard lens as approved by Medicare. This result was far superior. I went to a different Ophthalmologist on the second lens. I spent a lot of money on the Crystalens and found it considerably poorer in vision quality.
Crud... now back at step one... have any idea why the lens did not work for you? How was your vision prior to replacement?
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Old 07-09-14, 12:23 PM   #23
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I had mine done last year. My afflictions were cloudiness and presbyopia. My doc installed single vision lenses and told me I'd probably need some readers for reading and computer. He was correct. I'm glad I had the work done. The surgery was about 15 minutes for an eye. The prep and recovery took longer than the surgery. First day after surgery and i wore a big eye patch for 24 hours. For the next five or six days, I wore a small plastic eye patch at night to prevent me from rubbing/scratching my eye in my sleep. Post surgery, doc gave me a list of "don'ts". I pressed him on what all of those "dont's" meant in relation to cycling. He took his pen and scratched through all the "don'ts" and wrote DON'T FALL. He told me the lens needs to get set. I stayed off the bike a few days and was good to go.
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Old 07-09-14, 12:29 PM   #24
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Pamestique, re-reading your initial post, I'm curious why you think you'd still need far-vision glasses if you went with a fixed-focal lens. As I mentioned, I was highly nearsighted prior to my left lens replacement. Following surgery, I'm just under -1.0 D in that eye (i.e., about 20/30). I wear a -0.5 D contact lens (which gives me a good balance with my right eye for reading glasses), but even without the contact lens the vision in my left eye is pretty amazing. When I wake up in the morning, i can SEE (at least through one eye).

If I wished, I could have LASIK to correct the left eye that final diopter. But personally, I like having the flexibility to tweak the correction to match my right eye. And as someone who has worn glasses since 2nd grade, it's wonderful to actual have distance vision!
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Old 07-09-14, 01:05 PM   #25
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[QUOTE=mcmoose;16923195]Pamestique, re-reading your initial post, I'm curious why you think you'd still need far-vision glasses if you went with a fixed-focal lens. ....QUOTE]

Actually I don't entirely understand this and will discuss it further on Friday. If I can get far vision with a regular lens (ie paid for by insurance) why not do just that? I will be asking that question along with others... one of my other concerns is down time; I really don't want ot be off waork for several weeks and I get that may happen with I go with teh Crystalens. I probably asked that question 3 or 4 times last visit and didn't get an answer. I will insist on one Friday...
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