Cataract operations

[Grahame Collins]

Having worn script glasses for twenty five years, I have had the warnings from the optometrist all through that time that I would require a cataract operation in the future.

The time arrived and I duly presented to the ophthalmologist and my eyes were measured and then duly had cataract surgery on right eye.

Ten days after I can see quite well out of the right eye without glasses. My script glasses now seem useless and I can read off the computer screen ,quite well , without them for the right eye.

I have another month without reading vision in the left eye even with glasses.

It seems very strange. Its something the docs have not mentioned other thani would need to be scripted for reading gasses ???.

For those who have similar operations whats been your experience.

Thanks
Grahame

[Marc]

Hi Grahame.
I had cataract surgery last year on both eyes, a month apart.
Cataract surgery is today a misnomer since it's not only removing the lense that has opacified, but replacing it with a new lense, and that is why you can see without glasses. So it is really cataract removal, and refractive surgery via intraocular lense all in one.

Do you know which lense was used for you?
I had "AcrySof IQ Vivity Extended Vision".

What you can do for now, is removing the lense from the right side of your reading glasses, and use it like that for reading.
Depending on the lense the surgeon will use, you may need reading glasses or not.
My experience is no glasses unless I want to read minute letters like the one on the eye drop bottle in a poorly illuminated room. Otherwise I can read any size font with proper light.
Driving day or night, no problems.

I keep an el cheapo reading pair +1.5 in my pocket but never actually use it. The old glasses are of course useless now.
My brother is an eye surgeon and he recommended extended vision over trifocals, due to the halo of light during night driving.

(I can read Nietzsche quote below off my laptop at 400 mm distance without any problem)

[Grahame Collins]

Do you know which lense was used for you?
I had "AcrySof IQ Vivity Extended Vision".

They gave me a credit size card thingy which proclaims it is:
TECHNIS Simplicity (tm) Delivery System DIB00

DIB00 *23.5D and a serial No.
tuther side information data reads DIB00 +23.5D 0 with diag bar and small r 13mm
0 with diag bar and small b 6mm

No idea what it means.

Thanks for the tip with the glasses. I need a smaller set of screw drivers to undo the mini screws. Trip to tool shop tomorrow.

Thanks
Grahame

[WCD]

I had cataract surgery about 10 years ago. After surgery the eyes can't focus so you need glasses to help with that, at least to some extent.
The surgeon asked me if I wanted specs for distant vision or close vision. He said many people preferred specs for distant vision and few for close vision because they preferred to talk with people without wearing specs. He also took time to explain that while he would try to achieve what I wanted, the results did not always come out as hoped.

My preference was to have distant vision good without specs (better for driving) and close vision with specs as I wanted eye protection anyway when working with machine tools etc.

His warning about focus outcomes was wise: the left eye came out sharp for distant objects as requested but the right one focuses a bit closer than distant. In daytime I need no specs for driving but I did get a pair for night driving though the effect is so small that they are used only when driving on unlit roads.

Optometrists have tried to convince me to use variable focus specs, but they distort vision slightly so visual checks of straightness/squareness/roundness/symmetry didn't work for me, and I stick with old fashioned bifocals (looking over them quite often), or less obtrusive 'reading glasses' when convenient, and if eye protection is not needed.

Bill

[Marc]

Before intraocular lenses, cataract surgery was just the removal of the natural lense, and people had to use massive glasses to compensate. In india the gurus who "return vision to the blind" use a technique done with the fingers. The guru squeezes the eye and dislocates the lense out of its position and into the vitreous body where it goes to the bottom. A crude better than nothing maneuver.

With the introduction of a lense to replace the crystalline lense, the beginning was a simple fixed lense that obviously only works for the chosen focal distance, just like any monofocal glasses, ergo the question ... do you want to see up close or far.
Lately there has been some developments in lense technology with mono, bi and trifocal lenses, and then extended vision.

What can be done, and Grahame you can discuss this with your surgeon. You had a monofocal lense inserted with 23.5 dioptres , you can ask to have a different correction in the second eye, so one eye focuses closer than the other. In time the brain will learn to see far with one eye and close with the other and minimise the need for glasses.

With cataract surgery, there is a singular phenomenon, where the first eye that is operated turns out to be the best of the two. The second eye never achieves the expectations of the patient after the first operation. The surgeon himself does not know why. The surgeon I used told me jokingly "I want to be only first eye surgeon".
And no, so far replacing a lense for a different one is far too risky. My brother told me ... it can be done but one shouldn't do it. Not very reassuring.

At the moment, the best overall choice is extended vision. Trifocal lenses that allow close, medium and far distance are a good choice for patient that no longer drive at night.
Cost with the new lenses and not counting private fund and medicare, is around $6K per eye, but this can vary widely.

Here is an article describing this new lenses.
https://www.ncbi.nlm.nih.gov/pmc/art...%20of%20focus.

[BobL]

My Optometrist has just referred me to get my cataracts sorted. The photos of my lenses show the right eye is worse than the left which is consistent with the view through my right eye being slightly foggier than the left but Optometrist reckons they will probably recommend doing both.

[eskimo]

The first lens implants around early 70's were put in front of the iris and immediately behind the cornea. Those implants caused problems for the cornea over time, and many people such as myself, had to have a corneal transplant/s.

Wife had her implants done a couple years of ago and they have been great.

I will be up for one to my right eye, in I hope long distant future, as it has early signs going opaque, but at this stage all is good...lefty aint tho...its buggered.

[Normanby]

I have been a patient of an eye surgeon in Townsville for many years since being referred by an optometrist for Glaucoma management plus general eye health so cataracts have been under review too. I have been wearing prescription glasses for more than 25 years for reading and distance. Last October the surgeon suggested I consider getting my cataracts done but as well he gave me a brochure promoting stents for treating glaucoma. When I was ready I need to make an appointment to discuss the procedures including costs as both cataract and stent procedure would be done together.
I would like to read comments from anyone who has stents inserted in eyes or who knows someone who has had this procedure. I think it is a fairly new procedure with certain risks so not sure I want to have the stents done. No problems with having the cataract procedure as my late wife has this done 20+ years ago with the lenses curing severe astigmatism so didn't need glasses or contacts afterwards.
I will attach a copy of the glossy stent brochure which has basic information. The surgeon said these are the smallest stents made but I suppose they would have to be minute.
Gerry.

[BaronJ]

Hi Grahame, Guys,

I'm probably not a good candidate to talk about cataract surgery, not having mine for a relatively short time. I had the choice of distance or close up vision lens inserts. I chose long distance simply because I do a lot of driving and don't mind wearing glasses for close up work, I tend/tended to use glasses in the workshop anyway.

The only issue that I've had, and its taken a couple of years to cause a problem, is a fungal type of growth that gradually causes blurring of vision in one or both eyes, in my case the left one. It was quickly, in less than five minutes, painlessly cured by laser treatment. Though I was warned that it could reoccur and affect the treated eye again or get it in other eye. But I was assured that it wasn't a problem to have the laser treatment done again.

I'm quite satisfied with my vision now and can see at least as well as I could 30 years ago.

[Marc]

Hi Grahame, Guys,

I'm probably not a good candidate to talk about cataract surgery, not having mine for a relatively short time. I had the choice of distance or close up vision lens inserts. I chose long distance simply because I do a lot of driving and don't mind wearing glasses for close up work, I tend/tended to use glasses in the workshop anyway.

The only issue that I've had, and its taken a couple of years to cause a problem, is a fungal type of growth that gradually causes blurring of vision in one or both eyes, in my case the left one. It was quickly, in less than five minutes, painlessly cured by laser treatment. Though I was warned that it could reoccur and affect the treated eye again or get it in other eye. But I was assured that it wasn't a problem to have the laser treatment done again.

I'm quite satisfied with my vision now and can see at least as well as I could 30 years ago.

No fungal growth. That is a common complication post cataract surgery, and in the words of my brother, it is surgical untidiness.
The opacity is caused by the old lense epithelial cells not completely removed prior to implanting the new lense. This undergo hyper-proliferation and migrate to the visual axis of the new lense. The molecular mechanism of this event is yet unknown. That is why surgeons clean up properly before inserting the lense.
The lense can be cleaned up with laser at a later stage. It's not something that can go from one eye to the other. It is caused by cells left behind during surgery, so if your first eye was done properly, it will not be affected.

[BaronJ]

Thanks Marc, Guys,

The opacity is caused by the old lense epithelial cells not completely removed prior to implanting the new lense. This undergo hyper-proliferation and migrate to the visual axis of the new lense.

It took a long time for this to happen to me ! The original surgeon that did my right eye took the time to explain what he was doing. He was very reassuring. The one that did my left eye was very very quick and it was as if he wanted to get it over with quickly.

It's not something that can go from one eye to the other. It is caused by cells left behind during surgery, so if your first eye was done properly, it will not be affected.

My original comment was not intended to infer that the fogging could be transferred to the other eye ! Just that I was told that there was the possibility that it could happen in my right eye. Up to date I don't have any issues with either eye.