cataract options.

[jerry233]

I'm 62. Have worn glasses since I was 4, bifocals for the past 20 years or so. I've been fine with that situation until 3 years ago when my vision started to deteriorate quickly. I was surprised to find out that I had cataracts developing in both eyes. Have had to make frequent purchases of new glasses since then up until this past year when the cataracts seem to have stabilized. My vision uncorrected in OS is 20/200, OD 20/70. And with glasses it is OS 20/70, OD 20/25. OU 20/25-30. I would like to see better, I don't see birds flying or other distant objects as well as friends can.

So, I've been putting off getting serious about surgery because of cost (high deductible), fear, and confusion. There seem to be so many options. I have astigmatism in both eyes and don't know if that is a limiting factor in lens replacement. I spend a lot of time outdoors, skiing, biking, boating and would love to have good distant vision where I didn't have to wear prescription glasses, especially under goggles. At the same time having both eyes corrected for distance and being in a complete fog for close and middle distance could be a challenge. I had read that ReZoom or Crystalens can offer a 90% chance of doing without glasses all together but am concerned about the increased risk of side effects, and maybe that 90% is overly optimistic. And not sure if they work with astigmatism (-075 OD, -2.50 OS).

Would appreciate any input about this. Thanks.

[JodieJ]

Here's a non-professional opinion:  consider mini-monovision (distance vision in dominant eye, intermediate vision in non-dominant eye) using Alcon's toric IOLs.  With a little luck, you'd only need glasses for seeing small print.  And forget about ReZoom altogether--a terrible option.  With the Crystalens you'd need an additional astigmatism-correcting procedure, and your final results probably wouldn't be as good as mini-monovision with toric IOLs.  You can use the search feature of this site to do more research about these options.

[jerry233]

Thanks again to you and Jodie for your help. I live in a fairly good sized town and there are a bunch of board certified surgeons to choose from.
I will start to make contact with their offices and let  you know how it goes.

[londonbridge]

I agree with Jodie. I have mini monovision with my intermediate eye toric IOL set for intermediate and currently wear a distance contact in dominant eye until I have further surgery. I am pleased with this result and only need glasses for reading fine print and sharpening computer work.
londonbridge

[JodieJ]

$250 not covered by insurance is a lot of money.  I'd suggest that you do a little more research before setting up appointments.  There is a wealth of information in the archives of this website, but you should probably focus only on the more recent threads.  (Technology changes fast.)  Your research will give you a better idea of current options.

There is a doctor directory at www.aao.org--and all the doctors listed are board-certified.  I'd suggest that you choose an experienced surgeon.  If you opt for a toric lens to correct your astigmatism (OS), you'd want someone who is experienced with this type of IOL.  I'd also suggest that you choose someone who uses an IOL Master, which provides more accurate eye measurements than older techniques.  Many surgeons have websites which provide information about their practice, and you can probably get answers to some additional questions (free) by calling.

If you decide that you really want the Crystalens, you should probably stick to the referrals on the Crystalens website.  You will need a surgeon who is also experienced with astigmatism-reducing procedures.

Re your question about binoculars:  Mini-monovision will hopefully give you something close to 20/20 vision at distance with both eyes, as well as good intermediate vision.  Having both eyes set for distance vision would give you slightly better distance vision with both eyes, but everything within arm's length would be blurry without correction.

[Sandy Feldman, MD, MS]

Dear jerry233,

The ReZoom, Tecnis Multifocal, ReStor and Crystalens should be able to assist in giving you better sight with reduced dependence on glasses.  Each of these lens options has different possible side effects so you should discuss with your eyeMD what is the best option for you.
Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[jerry233]

Thanks for your help. I had been so focused on the new multifocal lenses that I hadn't considered the other options. I guess that the next step would be to interview a few different surgeons in town and get their opinion on what would work best for me. I had gotten a quote of $250 for an initial consult. That gets a little spendy if I want to talk to several opthamologists. Is that a reasonable charge?
Also, I do a bit of bird watching. Do you know if I have my left eye set for intermediate distance, could it still be tuned in for distance when viewing through binoculars?
Thanks again.