Catarac surgey coming up

I am gathering information on catarac sugery. I have an astigmatism and cataracs. My vision is getting blurry more and more each week. I am 57 years old and scheduled to get the replacement surgery done in the next few weeks. I would like to talk to anyone about what to expect and how my vision will be afterward,. I am planning on getting the multifocal lens so I can see far and near.
I would appreciate any response.
Thanks
Pete

[Timothy D McGarity, M.D.]

multifocal lens should improve your vision at all ranges, but the astigmatism may need to be corrected, too. sometimes a laser touchup after the cataract or another surgery to get rid of the astigmatism. you should know that multifocal lens will not keep u from wearing glasses all the time. the goal is to improve vision and help you to not need glasses most of the time. you might need glasses sometimes. you will experience some glare or haloes at night especially with driving.

[Pete0629]

Mr McGarity

Among other things I am wondering about the actual lenses themselves. My eye doctor/surgeon has told me I will be able to see near and far and pretty much not need glasses, which really isn't that important to me. I have alsways worn glases and they don't bother me. However I am more worried about the halo and glare. I do drive for a living( salesman) and am on the road most days of the week. My blury vision is troublesome now but I can see sort of pretty well, kind of. When I get the artificial lenses there is no turning back. The way my doc has described it I think he paints to pretty of a picture. So I'm afraid I will be disappointed with the multifocal lenses.Plus it's going to cost me $ 6000.00 after insurance!
Pete

[TurtleJoe]

I have worn Progressive Lens by Varilux before and after having cataract surgery in both eyes. I am nearsighted and have astigmatism. I chose the plain vision lens for both eyes and after both eyes were ready after the surgery I got a new prescription for Progressives and a year and a half later I am very happy. Let me add that throughout my life my presription was for vision better than normal, below the 20 line; 15 line. I wear the progressives for driving which gives me superb vision way off in the distance. I have never had a glare issue and never coated the lens for anti-glare. I wear 2x half glasses for reading when I work on the computer for work which does not require glasses. The sunglasses they give you after surgery are dynomite.One last thought, for my computer work both eyes should have been set for the same focal distance and not a range which may be the norm for non glasses. Eye drops before and after surgery worked great for me.

[TurtleJoe]

The astigmatism is associated with the cornea and not the lens so the astigmatism is corrected with the progressive llens. The free bifocals you would get under Medicare, if you were on Medicare, I wear for TV.

[Pete0629]

Hi Joe

Are you saying you wear progressive lens GLASSES?  If so is this for your close vision needs?
I am considering the multifocal lens. These are lenses that are inserted into your eyes to replace the cataract lens. I want to know how just having the cataract lens affect your vision, glare, blurriness and so on.
I went to the doctors office today and spoke to the girl that schedules everything. I am seeing the doctor on Thursday and will schedule the surgery probably Aug 9th or 23rd.

Pete

[cwatt1]

I too have multifocal lenses (ReSTOR +3) in both eyes.  I am satisfied with them, but my vision is not perfect.  As Dr. McGarity stated, some multifocal patients do experience haloing or glare at night, although this was never a problem for me.

If you drive for a living as you apparently do, the general consensus is that you would probably be better off with monofocal lenses rather than multifocal.  In  your case, since you do a great deal of driving,and don't mind wearing glasses, my thought is that you would be happiest with both of your implants set for plano (best distance viewing) and plan to wear glasses to deal with the astigmatism and for close tasks such as reading.

There are surgical procedures such as limbal relaxing incisions, LASIK, and PRK that can correct or minimize astigmatism if you wish to remain glasses free as much as possible.  Search the forums here and you'll find a great many posts about cataracts and their associated procedures.

[JodieJ]

PLEASE consider getting a second opinion from an experienced cataract surgeon.  Some people are pleased with their multifocal IOLs, but others are extremely unhappy.  Some people are unable to drive at night because of the glare and halos.  Because (1) you don't mind wearing glasses, and (2) you drive for a living, the risks involved with multifocals may far outweight the benefits for you.  These lenses are a good source of income for the surgeon, although it seems that few surgeons want them implanted in their own eyes.  Consider getting mini-monovision for good distance and intermediate vision and some reading ability without glasses.

[TurtleJoe]

I have three pairs of glasses I use. I wear the Progressive Glasses like I did before the Cataract Surgery. (New prescription of course.) Regular activities and driving. When I work on the computer for work, I can see the screen just fine without glasses, but to read the paper documents I also work on, I wear half lens that are 2X. This way I can read the paper documents with the half glasses and look over then to see the computer screen. The bifocals I have I wear to watch TV since the progressives have a narrow fine tuned area while the bifocal has standard focus above the reading part (above the line).

[TurtleJoe]

Regarding the halo effects, I do not experience this problem. My day and night vision with the plano cataract replacement lens when used with the progressive glasses, is the same.

[Pete0629]

What do you mean " your vision is not perfect" ?  I have set a date of Aug 23rd to get the multi focal lens put in my eyes. I can cancel it of course but I have decided I want to go for the full monty on benefits with the implants. Can you tell me IN DETAIL what you like about the lenses and what bothers you about the lenses.
I do drive a lot but I do want to be glasses free, I suppose, if I can.
Thanks
Pete

[cwatt1]

My distance vision is roughtly 20/25 to 20/30 -- clear enough for almost any distance viewing, but, as I said, not perfect.  I'm able to drive without difficulty.  I do have issues with near vision, although if my environment is well lit with natural light I see quite well for reading or other activiites.  Reading is a problem with low light, and it's not as good with incandescent lighting as it is with natural sunlight.

So far I've gotten by without glasses, but I do plan to get a new prescription (progressive lenses) in the future for those situations where reading is a problem or I want absolutely clear distance vision.

[disappointed66]

Definitely reconsider not to  get the multifocal lens.I had the Restor lens. Night driving was a nightmare!  Check the archives on this subject.  I had to have the Restor multi explanted and replaced with a monofocal lens.  Both eyes are now done with mini-minovision and I see excellent at all distance.  I just need readers for the smallest print, otherwise I am glasses free.  My advise is the monofocal lens.  I do not think you will be sorry.

[Pete0629]

To all
I'm surprised to hear all the negative things about the multifocal. Surely there are people out there that love them, otherwise why would they sell them. Is there anyone that loves the multifocal? I don't want to have a pair of glasses hanging around my neck for when I read. I'm still working and want the freedom and convenience they offer, if that's indeed true.
Pete

[disappointed66]

Why would they sell them?  The profit margin on these lenes is tremendous.  I am not saying that all eye care pros do it for the money, but I am sure a lot do. Insurance covers (as does Medicare) monofocal lenes.

[Pete0629]

I realize there is profit in them but at some point there has had to have been successful studies done.
I would like to hear from anyone, that's still working, that's had it done. I would like to know of the lighting,vision sharpness, adaptability of your eyes to the new lenses ect....I'm not on medicare so I'm not concerned that the government pays for them, I will do that myself.

[cwatt1]

Pete, please see my post above.  It is unfortunate that disappointed66 and some other posters have had bad experiences with multifocal lenses.  I do enjoy my multifocals and I would have them implanted again.  Also see the various posts by Yarrow, who is extremely satisfied.  I was merely pointing out that my vision isn't perfect.  However, I have been able to get along quite well glasses free most of the time.  Really the only times I am in need of glasses are close work in low or dim artificial light, menus in dimly lit restaurants, or sometimes at fast food restaurants where it is a little problematic to see the menu items posted behind the counter.  For most multifocal wearers, it is unrealistic to expect to be totally glasses free, although it's possible for some people.

I was fortunate not to have experienced starbursting, glare, or halo effects, but you should know that this is sometimes an issue for multifocal users,  In addition, you should know that light is focused in more than one point (i.e., it must accommodate both near and distance vision at the same time) with multifocal lenses, meaning that only about 50% of the available light is used for each focal point.  This fact can cause night driving to not be not as sharp for some people, which is presumably the reason that multifocals are generally not recommended for people who frequently drive at night for a living.

I have a blog on this website that details my own journey and exprerience with cataract surgery, which I would invite you to read if you're interested.

[disappointed66]

Pete,

I was willing to pay for them myself, but I did not get the results promised. Oh,what a mistake I made!

Go to the archives.  Click on my user name.  You will find a lot of information.
Please do not make a hasty decision.

I can read all of the above without glasses with monofocal lenses.. My night driving is excellent.  No glare.

  Everyone's eyes are different.  You need to discuss this with your eye care professional thoroughly.  As jodij said, get that second opinion.

  I am happy that cwatt1 had such good results, but too many people have had bad experience with the multi. Unfortunately there is no guarantee with either.

Good luck

[londonbridge]

I agree with Jodie J and dissapointed 66. I had one Restor implanted and then explanted within six months after very poor vision. You can read my posts. That being said you will find more people posting in these forums that are experiencing problems because that is why people often turn to forums.

That being said I think you need to weigh your options carefully and at all costs choose a highly experienced surgeon who has implanted the type of lens you are choosing many many times. Keep in mind that there does not seem to be a lens out there that does not require glasses at least some times. I have blended monovision set for distance/intermediate and only wear progressive glasses to read fine print in dim light, i.e. I can usually read my blackberry and news print. I think you may sacrifice the quality, sharpness, lack of glare for the option of perhaps having a wider range of vision with premium lenses. For me I rather have the best quality of vision and put up with glasses occasionally.  

Take all the time you need to make this decision. You are young and need your eyes/vision for a lifetime. Good luck.
londonbridge

[cwatt1]

Excellent points made by all.  If you are dubious about multifocals and wish to consider monovision or mini-monovision as suggested by JodieJ and londonbridge, it would be wise to try this with contact lenses first to make sure you can tolerate the imbalance -- a few patients are not able to adapt well.  JodieJ is a fan of mini-monovision and has written many posts regarding this option.  In this case the imbalance between the two eyes is less, you should have good distance and intermediate vision, and your near vision should be reasonably acceptable as well, although you would probably still need glasses for fine print.  As for me, I didn't want to bother with reading glasses, and have never tolerated contact lenses well, so the multifocals made sense to me and my eye surgeon considering my pupil size was acceptably small.

Although I have had a much better experience with multifocals than either disappointed66 or londonbridge, I have found that I have experienced some degradation in visual sharpness as a tradeoff for better vision at all distances.

I hope all of us have not confused you too much.  I do agree that in your case a second opinion is probably warranted.

[Pete0629]

The less light thing does make me a little hesitant. What does that mean!? Will I be in dim light all the time now. You see right now my right eye is getting pretty bad. It's blurry all the time, even with glasses. My guess is my right eye is probably 20/70 or so.But if I hold things kindof close I can read with my right eye without glasses. My left eye is really close to 20/20 with glasses I can see things at a distance really well with my left eye It's definately my dominant eye at the moment. I have compensated enough over time that my left eye carries the load so to speak.I can drive at night, I do it all the time now. So I'm worried now if I get this I'll have decent vision during the day but have to stay home at night and that would suck. When I get this surgery I would like to have both eyes back. I , like you have not tolerated contacts well. That's why I never wore them. But my glasses have been something I suppose I have had to adjust to. For me to even think I could be , for the most part, without them, I have to admit, makes me pretty happy.
I don't know how to find the archives in this place. I would like to read all the stories you all have talked about.
Pete

[Pete0629]

I did finallt figure out how to get to your journal, quite interesting. Did I understand it correctly that you waited quite a long time to get the second eye corrected? I have my surgeries 1 week apart. I don't know if I mentioned it but I do have astigmatism, mainly in my right eye, which he says he will correct.
Pete

[disappointed66]

Pete

There is nothing more for me to say except check out the archives and click on Londonbridge and my name  on the forum for a lot more information. If I knew then what I know now, I never would have gone for the multi.

Do not make a hasty decision.  Good luck to you.  I wish you the best of outcomes.

[cwatt1]

Yes, there was about a three-month period between the two eyes.  As you no doubt read from my journal, I waited until my intermediate vision was reasonably good before having he other eye done, as I use a computer extensively at work..  I had quite a bit of astigmatism in my left eye, and I ended up having three separate LRI (limbal relaxing procedures) before it was eliminated..I presume LRI is what your eye surgeon contemplates for you?  This is the most common method of correcting corneal astigmatism, assuming your eye surgeon is experienced and comfortable with the procedure.

As I mentioned, night driving is not an issue for me, but starbursting, haloing, and sometimes less contrast (see my comments above about dual focal points) tend to make it more difficult for some multifocal users.  I doubt if this would eliminate all night driving for you, but I mention it again here because it can be a problem for people who drive extensively at night as part of their profession.

You can visit the archives here by clicking the button at the top of the forum (this and the community forum), or you can type "cataracts", "ReSTOR", "multifocal IOL", or any other terms into the search box at the top middle of your screen.  As disappointed66 stated, you can also view posts by a specific user.

Best of luck!

[Pete0629]

I will read your journals as well. I am still looking into all of this but I am hearing there have been quite a few good turnouts also.
I spoke to a person that had it done by my doctor yesterday. He's a pilot and said he flew his plane the day after having it done. He loves it, he's the same age I am 57 and still works, I am going to talk to another person today I think.
I am having that relaxing procedure done on my left eye for astigmatism, I know I said right in my last entry but it's my left.
Cywatt1, I see you live in Illinois, so do I. I am in Decatur Illinois and will have the surgery in Bloomington. My doctor has done thousands of these procedures and his nurse is working with me to make me feel comfortable.
Anyway, I'm still researching so if you have anything to add please do.
Thanks
Pete

[disappointed66]

Hi Pete,

Just want to let you know I do not need progressive glasses, but I would have gladly gone back to them instead of having the multifocal lenses. My vision rght now is so good I see excellent distance, no problem with the computer and I am surprised that I am reading small print without reaching for glasses unless it is extremely small.

The doctor that did the Restor was excellent, the surgery was good,.but the vision was terrible. I am very particular, I want everything perfectly clear.I am an independent person but  the starbursts and glare at night were so bad I  did not go out. I did change surgeons.  The surgeon I use now is rated one of the best on Long Island

If you should decide on the multi, I would wait as Cwatt1 has before you go ahead with the second eye

Best wishes. D66..  

[TurtleJoe]

Hello, How did you make out with the first lens. Tell us all about the results. Please.

[QuilterGal]

I'm 50 yrs old and my first cataract surgery is scheduled in three weeks.  I originally vetoed multifocal lenses as an expensive experiment (I've never been an "early adopter" of technology - I like to wait for the bugs to shake out first).  Besides, with a slight astigmatism, I assumed that multifocals weren't a real option.  But my doctor says she can take care of the astigmatism and do the multifocal (ReSTOR) if I'm interested.  So naturally I'm revisiting the decision. I want the best possible vision I can get - if I'm going to do this, I want to do it right and only have to do it once in each eye.  I'm trying to figure out how much clarity in distance and midrange I would be giving up to get the near vision.  And, how common and how severe are the halos and glare?  I have both now with contacts (all lights look like dandelion puffs to me).  Is it worse with the implants?  And I'm still not clear on the mini-monovision thing.  

I'm very myoptic (one eye is 9, the other 10 diopters) and I've been wearing glasses since I was 2 1/2 (yes, a toddler) and have needed cheaters since I was 38.

[Pete0629]

First to answer TurtleJoe, I am scheduled to have my first eye, which happens also to be my worst eye, done next Tuesday Aug 23rd. I will let you know what my experience is. I think I'm pretty good at expressing my thoughts so I will be as detailed as I can be.

QuilterGal
I also have made the decision to get the multifocals( Restor) also.I also have an astigmatism and will have that " relaxed" procedure done at the same time. I have talked to many people including some on this site and I really haven't had answered those very questions you are asking to the satisfaction I need. I also feel early technology isn't always the best way to go but my life being finite as it is, now is the best time for me for as we all know I'm not getting any younger.
The glare, halos, distance, nearness( is that a word) sufficency of light,and all the questions I have can really only be answered when I go through with it. If it turns out to be
a negative at least I made the decision with , pardon the pun, my eyes wide open!

I was put in touch with a couple of patience from the doctor I am going to. They both had positive things to say about the procedure. For you naysayers out there yes I realize they could have sent me only people that were going to say nice things.

I guess in the final analyisis, after all the information I have gathered I have to hang my hat on that trusty old human trait that has seen so many of us humans through so many adversities over the last several centuries, our old friend HOPE. Without hope we would still be rubbing sticks together or living in caves or riding horses or believing in mulitiple Gods or living with horrible disease or , well name your poison....

I'll let you all know what happens Tuesday or soon after.
By the way I have taken a 2 week vacation to have this done. One of the patients I talked to said I had better plan things to do because I will be really bored after the surgery, so I am planning to go see a Cardinal game, see a blues street festival and ride my motorcycle a lot!! Well see...
Pete

[Timothy D McGarity, M.D.]

Hi Pete and others,
We will continue to follow your progress with the ReStor lens. I personally implant these lenses, but they are not perfect and that is exactly what I tell my patients who elect to have these implanted. It sounds as if you have done extensive research and that will serve you well. Go Cardinals!

[cwatt1]

Oh, you misguided Cardinal fans!  Go CUBS!!!

[Pete0629]

I didn't SAY I was a cardinal fan! I just said I was going to see them play, mainly because I got free tickets from one of my vendors! They will be playing the cinncinatti Reds and we will be routing for the Reds! Who is my team you may be asking? Jim Hendry got fried yesterday finally! Go Cubs!

[JodieJ]

All of the people I know who are happy with their ReStors have the following characteristics:  healthy eyes (no retinal problems, no dry eyes), small pupils, no astigmatism, an experienced surgeon.  Everyone is not a good candidate for multifocals.  Because of the division of light that is intrinsic to multifocal design, there is always a loss of contrast sensitivity--vision is never as sharp as it would be with monofocals.  Although the Crystalens is not perfect, it might be a better choice for more people than ReStor, but it requires a surgeon who is experienced with the Crystalens.

If I were having cataract surgery today and had astigmatism, I'd definitely go for a toric IOL.  I had limbal relaxing incisions done to reduce/eliminate my astigmatism back in 2006.  The result was excellent right after cataract surgery.  However, each time I had an eye exam, I learned that some (more) of my astigmatism had returned.  It's been five years now since my cataract surgery, and at my last exam about 75% of my astigmatism was back.  My optometrist just sighed and said that my results were not that unusual.

[TurtleJoe]

One more day to decide. My summary, monovision, Progressives, 2x half lens for reading and computer data entry. My last point. If you are active, you should wear protective eye wear to protect your eyes and the investment you made in them. My progressives Rx is still perfect for me 2 years after prescribed. I am 68 and still see perfect with the combos described.

Brst of luck. Joe

[Pete0629]

Well I had the multifocal lens implanted Tuesday of this week. So far I have to say I am pretty disappointed. I cant read anything and I cant see distances yet. Wednsday I woke up and had a fogginess over my eye. Now the fog SEEMS to be very slowly subsiding but I still cant see worth a darn. I went to see an eye doctor, not the surgeon, yesterday in the same office as my surgeon. She said it will take time for the swelling and stuff to go away. But I was at least expecting to see some simblance of good vision, not happening at the moment. I'm scheduled to have the other eye, my only decent eye, done next Tuesday. I couldn't do my job right now, thank god I took 2 weeks off.
Worried.
Pete

[JodieJ]

Cancel the surgery for your second eye!  Please don't have surgery on your second eye until you are satisfied with the results of your first eye.

[cwatt1]

Yes, I absolutely agree with JodieJ.  Wait until your vision stablizes and you have an idea how this is going to turn out.  If you need a lasik touch-up or additional LRI you want to make sure you have the ability to see beforehand.

[disappointed66]

I agree with Jodi - cancel the appointment on the second eye.  I had the same results as you described. I was told I would do better when  the 2nd eye was done. No way!  I would not let them go near  the second eye and I was not going to let them do any "touch up" on the Restor implant eye.

[TurtleJoe]

I hope, I say I hope you removed your eyeglass lens from your old glasses frame on the operated eye side before you put your old glasses on.

[Pete0629]

LOL yes I did remove the right lens from my glasses before putting them on. I'm not the sharpest knife in the drawer but I did know to do that. The problem with wearing my glasses now is everything is off kilter. It's like both eyes are trying to focus at once, almost feels like I'm cross eyed.

Don't worry to all that said wait until my other eye is stable before even considering surgery on my now only good eye. I couldn't even consider the other surgery at this time because it's the only good eye I have left. The whole aurgument of my eyes improving after both eyes have been done doesn't hold water with me. How on earth could my right eye be improved if I went ahead and had the surgery done on my left eye!!? Doesn't make sense. Luckily my left is almost 20/20 with my glasses on. I am planning on asking the doctor to , hopefully they can do this, give me a new lens in my glasses for my right eye and bring it up as much as possible and so it will function appropriately with my left eye. At this point if I can get my vision back with glasses I'd be thrilled with that!!
Whats also strange to me is when I went for the follow up exam the eye doctor tested my right eye and said I had 20/25 vision. Now I don't know what kind of test they determine those results on but when I left the office I told my girlfriend I couldn't read any of the writing in the magazine in the car, couldn't read license plates on cars right in front of us, couldn't read road signs nor could I see the road clearly at all, plus I can't see the writing I am doing now on the computer. Its all with my left eye now. If that's 20/25 vision then give me back my almost blindness I had previous to the surgery! I'm beginning to think the tests they do at the office isn't reflective of the real world.

At this point I might also let him do a touch up on the right eye. Since it was all but gone anyway I suppose it can't get any worse.
As I stated before my biggest fear is doing my job when I go back to work in about 10 days. I HAVE to be able to see clearly to do my job. I drive a lot, look at machinery both close and far, I'm in dim and well lit areas. If I can't do that I'm screwed!
To say the least I am very disappointed. Thanks for all your concern and I am trying to keep a positive outlook believe it or not. Each morning when I wake up I look outside and expect to have an ah ha! moment. so far still waiting.
Pete

[motorbird]

Hi, been following this and wonder whether your doc discussed Crystalens. I had Crystalens HD implanted in both eyes a year ago, now I see better than 20/20 distance, 20/20 intermediate and an easy J2 reading, J1 in good light, no glare, no halos etc... I had cataracts and needed a +2.5 for reading before the implant. Possible to explant the Restor before it's too late and consider Crystalens?

[motorbird]

Hi, been following this and wonder whether your doc discussed Crystalens. I had Crystalens HD implanted in both eyes a year ago, now I see better than 20/20 distance, 20/20 intermediate and an easy J2 reading, J1 in good light, no glare, no halos etc... I had cataracts and needed a +2.5 for reading before the implant. Possible to explant the Restor before it's too late and consider Crystalens?

[cwatt1]

I'm happy to hear you've had a good result with your Crystalens implants, but I have to disagree with you regarding the possibility of using it in Pete0629's situation. You are correct that if an explant is needed it's easier if done sooner rather than later, but if vision with the ReSTOR can't be improved I would not risk another premium lens.  A monofocal is always a safer choice.

[disappointed66]

I would not have the touch up done.  If an explant is needed
having the yag makes it more difficult.. I agree with cwatt1 the sooner the better. A monofocal is always a safer choice. I was told to be patient.  It was not easy, One day at a time and the right decision was made by me, and I am sure you will do the same. Keep that positive outlook.

Disappointed No More

[motorbird]

I'm a patient (though one who has done a lot of reading on the subject) not a doc so couldn't possibly make "recommendations" in Pete0629's particular case, but some patients unhappy with Restor have successfully had them explanted and replaced with Crystalens. The reverse seems not to have happened. Naturally I agree that monofocals are least likely to develop complications and if Pete0629 doesn't mind wearing specs to read and work at a computer then it's probably an easy choice. Personally I find total freedom from specs and contacts (and I was -10 both eyes) a revelation, a new way of life, and if this were now taken away from me I'd be very cross. However, if I had never experienced this new freedom I would very likely be satisfied with monofocals. There are no absolutes in this business (except the certainty that cataract and presbyopia await us all one day or another).

[londonbridge]

I have to agree with what others and you yourself have said. Do not have second eye done before first eye is stable and do not do a yag as if you need an explant few doctors will want to risk operating when there is a hole in the back of the capsule. I had a Restor explanted after six months of misery and agonizing over what to do. I have a mono focal toric set for mid distance in my non dominant eye. Other eye still has small cataract and I wear a contact lens because the eyes are 7 diopters different and can't wear glasses to correct that amount of difference, only a contact. When I do second eye I will have it set for plano thus I will have blended mono vision. I am glasses free usually except for reading in dim light or to sharpen computer. This is very acceptable to me as I needed glasses just to see the alarm clock each morning.

Anyway there will be a resolution to your dilemma. Proceed cautiously and  if your need an explant I recommend mono focal and you can do a combination of distances to minimize your dependence on glasses.

[Pete0629]

Little update, seeing much better today, I could read the newspaper this morning.
Talk soon
Pete

[TurtleJoe]

Go get them Tiger. You have us all sitting on pins and needles.

[TurtleJoe]

For us followers, Hurricane Pete is as important as Hurricane Irene.

[Timothy D McGarity, M.D.]

Hi Pete, still following this thread. Thanks for the update. I don't have many patients opt for the ReStor or any multifocal IOL. This is mainly due to cost, but also the potential side effects scare some away from it too. The vision during the first week can be poor. This is related mainly to the eye healing, but also your brain: adapting to multiple focal points and deciding which image to use (near, intermediate and far). I will be implanting a few multifocals on Wednesday of this week and I am going to encourage my patients to post their results here for others to follow. I wish you the best of luck and I feel like you are making good progress. Take care.
Tim

[Pete0629]

Tim

I can finally post something a little longer. I have been in Springfield Illinois this past weekend helping my son and his buddy compete in a Blues & BBQ competition. We were very busy Friday and Saturday selling completely out of all the various BBQ he had made up.

Anyway, I did have a pretty good day yesterday seeing fairly well. Not as good or sharp as when I have my glasses on and looking through my left eye, which is 20/20 or really close to that. I did notice I could see better Friday night while at the festival. I noticed I could see further and closer, more comfortably, but I also noticed I couldn't see the individual bricks on the building diretly across the street, they were a blurr . Then Saturday morning I noticed I could read the newspaper plus I looked up at the brick building across the street again and noticed I could see the individual bricks clearly. I was pretty excited about that. But today everything is back to kind of a blurr.
So I am seeing the surgeon Monday at 9:30am. Unless I have a dramatic improvement I think it's best to postpone my second surgery until this eye stablizes, hopefully at a better level.

Do you feel I will see further improvement over the next week or two? I would feel better getting some sort of a timeline.
I would very much like to hear from anyone else that is just having this done. So hopefully your patients will post also.
Pete

[Timothy D McGarity, M.D.]

Hi Pete, in my experience your vision will continue to improve. It can take weeks for your brain to fully adapt to this "new" vision system (multifocality). I would expect your vision to become clearer especially over the next 2 weeks. Also, the cataract surgery alone can take a few weeks to heal. During this healing phase the vision will fluctuate, but will continue to improve as you heal.
Best wishes,
Tim

[Pete0629]

Well had a less than good day Wed. Couldn't see that well so I wore my glasses a lot. Taking the presnisone 4 times a day kind of affects me, makes me feel funny.
This morning, Thursday, I seem to be seeing better although seeing the computer screen isn't easy. I hoping for better vision over the next few days as I am driving to St Louis to meet my girlfriend, who's flying in, for a long weekend. As I had said before we will be seeing a Cardinal game and visiting an area that will have blues music, looking forward to it.

I am also going to try and find a really good pair of Oakley sunglasses. They have polarized lenses and I can see really clearly through them.

It's funny, now that I have been on the computer a little while I can see it much better, weird!
Pete

[disappointed66]

Hey Pete,

Monos or multis, we are all pulling for you.    Being from New York, I am a Yankee fan, but the Cardinals are also one of my favorite teams.  Enjoy your weekend.

[cwatt1]

Hi Pete.

Sounds like things are gradually improving -- good news.  It took a week or two before my vision reached the point of being reasonably stable.  Multifocals require a period of neuroadaptation because of the dual focal points.  I think the fact that your vison improved while you were on the computer is definitely a positive sign.

[Timothy D McGarity, M.D.]

Hi Pete, I tried to get my one ReStor patient from yesterday to comment, but he prefers to remain more private. I can honestly say that he is having some of the difficulties you are having, but I am confident he will make good progress too. Thanks for keeping us posted.

[Pete0629]

Definately had bad morning Friday but after taking ibuprofen when I was leaving to st louis, of which I was driving alone, my eye did a 180 and I could see clearly. I handled the st louis 5:00 traffic with no problem. I could see really well the rest of the night. I am seeing pretty , although seeing my writing on my droid is difficult.
Sorry your patient didn't want to share doc but their choice, maybe they'll follow mine and see what they are going through is normal.
Pete

[Pete0629]

Was a great time this weekend. Stayed at a hotel where they were auditioning for American Idol. I met a guy at the bar that had a friend in the contest. He called his friend over and he sang for me right in the bar. The place went silent as he sang and he was really good! His names Greg, remember it!

I was disappointed in that I couldn't see the baseball being pitched or follow it after being hit at the Cardinals game. It bummed me out so we left after the 4th inning.Also I went to my brothers fund raiser for a union he belongs to today and they had a golf game, closest to the pin deal going on. I have played it every year because my brother is one of the organizers. I hit 5 balls trying to get them as close to the flag as possible. I couldn't see the balls after I hit them, in bright sun, after about 40 yards, another disappointment.
I do see my TV screen and basic stuff but I am finding any finer focusing I need to do is just not there, so far.
Pete

[TurtleJoe]

Hope your return to work was visibly acceptable. How are you doing?

[Pete0629]

I have decent days and then, like today, I have to wear my glasses, which gives me the feeling of being crosseyed. Returning to work wasn't too bad last week although I didn't have to go out of town much last week. My vision is still not as good as when I wear my glasses. I can SEE but it's , for lack of a better word, limiting. Near isn't clear or precise, but I can make things out through the mixture of blurr and clarity. My distance vision? I don't have the keen distance I once had or currently have with my glasses, but again between the blurr and clarity it has been a challenge . I have read many things about multifocal lenses. In the brochures it says people that are very particular are not good canidates for the lenses. I would really love to have the committee that wrote that discription define for me their interpretation of " too particular" I define it as seeing comfortably, it continues to be a struggle and very much an energy drain for me to see. Also the neuroadaptation I have read and heard about. I'm beginning to wonder if it is the same thing as suddenly having one leg slightly shorter than the other and eventually your brain and body adapt to that change so you don't notice it as much,but in the final analysis is that really a neuroadaption or learning to finally accept less than what you once had.
I know I sound negative about this today and I apologize for my down attitude today.I have found this is very draining for me from day to day. I am not retired so I have to enteract with society in a very indepth way daily. No one wants to have this succeed more than me. I will continue to be patient and also realize I'm running against the clock for an explant IF that is what I eventually decide to have done.

On the positive side, I can see TV very clearly, anything with a lighted background, like when I have to read the eye chart, is easliy read. But as I have stated before when realife viewing enters the picture there are a lot more challenges.

I'll keep you all informed.
Pete

[Pete0629]

I went to the surgeon this past Monday to determine how I am progressing. After taking several tests it seemed my vision in my right eye is at about 20/50. It was a relief to me that they were able to bring my vision back up to 20/20 with added lenses with glasses. They told me the lens they would have to put in glasses for my right eye, the one that had the surgery, would be a very mild lens. Not what I wanted to hear but it didn't surprise me and at least, like I said, I was relieved I could get my vision back to excellent eventually. The doctor said there wasn't really any indication of swelling in my eye anymore. For the first time he mentioned the possibility of an explant. He wants me to stay the course, other than reducing the prednisone to twice a day, for another 4 weeks to see if further improvement develops.

Fast forward to Tuesday, I woke up Tuesday and my vision was much improved! All day I could see much better, distance and near.  While driving I kept testing it, one eye open, one eye closed, one eye open, one eye closed. I'd put my glasses on then off, on then off. My right eye was about, in my estimation, 10% to 15% less than my left eye while I was wearing glasses, the best I had experienced to date. In fact my buddy and I rode our motorcycles yesterday evening well into the night, of which I was a little anxious about, with no real problems.Today was pretty much the same thing, although my near vision isn't as keen today, but still pretty good. If I could see another leap of improvement over the next week or two, 10--15 % then I'd be satisfied.

So the roller coaster ride continues but at least I've seen what seemingly is an improvement this week.
Pete

[Timothy D McGarity, M.D.]

Hi Pete, sorry just now getting back with you. That's great news that your vision is correctable to 20/20. Too bad the first surgery couldn't nail down the 20/20 vision with the implant the surgeon placed. There are multiple factors involved in nailing down the 20/20 powered IOL, but if the correct power is determined for you and instead ends up after the surgery that you are still a little near or farsighted and have a little remaining astigmatism, then laser vision correction or LRI will typically correct this (so would a prescription for glasses, but you are trying to get rid of the glasses). I always discuss this with my patients. Usually the IOL I pick (about 95%) is very close to 20/20, but rarely it leaves them with a little bit of needed correction, then I perform laser vision correction or LRI or incisional enhancement. Other doctors approach it differently. I wish you the best of luck and it sounds as if you are keeping a positive attitude. I would recommend you stay the course with your doctor. Also, keep the post running!

[Pete0629]

Hi Tim

Thanks for getting back to me. I will say it is nice to have access to to you during the interim between doc visits. My right eye didn't have any astigmatism. I may have stated it did in earlier e-mails, getting confused some. The only astigmatism is in my left eye which hasn't had the surgery yet. My right eye seems to have settled in a " not quite where I want it to be" state. When working on the computer I have to pull it close enough so my left eye can see it well. This is where it gets weird, my right eye CAN see the computer words but they're hazy and not as comfortably seen as with my left eye. Now I realize if I had the other eye done it may improve with my " binocular vision" correct? But it's also scary because I am rolling the dice giving up my only clear ,or maybe comfortable is better, near vision in the process.My distance vision is ok, not great or sharp but ok.
Yesterday was cloudy all day. I had some discomfort seeing the road at a distance although I haven't worn my glasses, for help with my left eye, for a week or so now.
Question: My surgeon mentioned doing something with a laser that essentially , as I understood it, cleans off the back of the lens or something like that, to improve the lighting and vision. But he said he's waiting to do that because once he does this it makes it more difficult to explant the lens.
My delimma of choices--If I have the multifocal explanted and have the monovision implanted in both eyes I am, in my understanding, giving up any chance at near vision such as reading but an improvement of distance vision will entail, requiring glasses almost everytime I read, along with a reduction of starbursts and halos at night.
If I leave the multifocal in and at least have some near & distance vision without glasses with a possible improvement of both visions with both lenses implanted and a continued improvement as it heals, I end up needing glasses whenever I want sharp vision in either near or far distance. Is that a fair assumption?
Thanks for the help
Pete

[Timothy D McGarity, M.D.]

Hi pete. I understand what you are saying. You mentioned that a "weak" glasses prescription would get right eye to 20/20. At this point I would offer you an enhancement to get the right eye to 20/20-incisional enhancement or laser vision correction. I would hold off on the laser to "polish" behind the lens, especially of a prescription will get youth 20/20. The ReStor lens will give you a broad range of vision, but it won't be as sharp is a single focus IOL or your younger-years-non-cataract near vision without glasses or distance vision with glasses. Again, that your right eye can get to 20/20, this means excimer laser or incisional enhancement would get you there too, along with glasses. Make sense? I would ask your doc about enhancement other than laser to polish behind the ReStor IOL. keep me posted.

[Pete0629]

Tim

So to make sure I'm reading you right. The incisional or the excimer laser would/should/could bring me back to 20/20 with, if I'm reading between the lines here, minimal risk or at least less risk than the yag( just learned the term). OR getting a perscription for glasses would bring me to the same place. is this correct? Not a combination of both?

The incisional is cutting on the eye? The excimer is with a laser?

Hmmm, I wonder why he didn't mention these options at our last meeting.

Pete

[homecrafter]

A related discussion, IOL/ CATARACT was started.

[Pete0629]

A related discussion, Disappointed66 was started.