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1397648 tn?1288142926

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
66 Responses
1731421 tn?1358823371
MEDICAL PROFESSIONAL
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.
1397648 tn?1288142926
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
Avatar universal
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.
Avatar universal
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.
1397648 tn?1288142926
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
Avatar universal
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.

Avatar universal
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.
Avatar universal
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).
Avatar universal
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.
1397648 tn?1288142926
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
Avatar universal
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.
Avatar universal
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.
1397648 tn?1288142926
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
Avatar universal
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.
1397648 tn?1288142926
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.
Avatar universal
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.
Avatar universal
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
574673 tn?1234125978
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
Avatar universal
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.
1397648 tn?1288142926
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
1397648 tn?1288142926
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
Avatar universal
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.
Avatar universal
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!
1397648 tn?1288142926
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

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