Have you had cataract surgery?

March 4, 2009 10:26 AM

I need cataract surgery. From what I have learned so far, I am leaning towards to foregoing the multi-focal lens and sticking with the conventional mono-focal lens. Does anyone have first hand experience with cataracts that can offer any advice? (I'm in the Washington, DC area.)

I have been diagnosed with anterior subcapsular cataracts in both eyes. My right eye has progressed to the point that it is time for surgery. I know that satisfaction with the surgery is higher in patients that wait as long as possible (and so see greater improvement), and I have waited. I have adapted to using just my left eye. Now I am starting to see my left eye start to noticeably degrade, so it's time to do the right one, which is fairly advanced already. From what I have learned, multi-focal lenses tend to create more glare, particularly at night, so that has steered me away from them. I've worn glasses all my life, so eliminating them after surgery is not that important to me, although it would be nice to only have to use them for reading or close work.
I would appreciate any advice or information you can offer. I have not yet selected a surgeon, so any input on surgeons in the Washington, DC area would be helpful, as well. Thanks.

posted by juggler to health & fitness (7 comments total)

I had cataract removal and lens implant surgery on both eyes in 2000 when I was 48 years old. I am glad I didn't wait any longer. I had experienced some vision loss, but mostly I had extreme pain and discomfort from bright light. I couldn't go to the beach, or be around snow on a sunny day because the glare would cause excruciating pain. Driving at night became impossible as well because of oncoming headlights.

When I had the procedures, multi-focal lenses were not yet available, so I didn't get to make that decision; mono-focal for me. So I can't help you with that. I had worn glasses for 36 years, since I was 12, so no longer having to wear them was a terrific benefit of my new, bionic eyes. I only have to use glasses to read now. I get them for $6-10/pair at any pharmacy.

I no longer have any pain from bright light. I no longer have to wear corrective glasses for everyday living. I can drive at night like anyone else. My vision is as good, or better, now even nine years later than it had been in the 20 years previous to the surgery. Having the surgery and implants done at a relative young age is one of the better decisions I've made. Go for it. No need to wait.
posted by netbros at 10:46 AM on March 4

I had cataract surgery in my left eye about 5 years ago. I have a monofocal lens. There is a very little glare with streetlights/car headlights at night but not an unmanageable amount - i wouldn't feel comfortable driving if the glare was much worse though. I think if you don't get on with multi-focal lenses it is possible to have them replaced with the monofocal ones (I have an astigmatism in the eye and was told that a monofocal lens was more suitable). I think if you already wear glasses it's likely you'd still need to wear them afterwards.

i was under the impression that it's no longer necessary to wait as long as possible. certainly my vision hadn't deteriorated to the point where i was relying solely on the other eye. I think the younger you are (I was 30 at the time) the more chance that you will get some clouding afterthe surgery - i was told that as they leave the back of the original lens in, it can cloud over as part of the healing process. the laser surgery they correct this with is quick and painless.

if you have any questions about the surgery process or anything else i'd be more than happy to answer them either here or by PM.
posted by kumonoi at 11:01 AM on March 4

I have a ReZoom multifocal lens in my left eye only. Though my surgeon recommended bilateral implantation when opting for multifocal lenses, I chose to have just the left eye done, as the cataract in my right eye is not currently interfering with my vision. I have been very satisfied with the single multifocal lens. Intermediate and reading vision is excellent, distance vision is very good. I do not require glasses for any activities.

Night vision was slightly problematic at first, not due to glare but to halos. As you can imagine, the halos were particularly annoying while driving. I have noticed that four years post-surgery the halos are much less noticeable, my brain just kind of ignores them.

When my right eye deteriorates to the point that I require another IOL, I'll likely opt to mix lenses, using a ReSTOR in the right eye. There is much literature indicating that this approach produces optimal vision, taking advantage of the strengths of both lens designs.

If you are at all anxious about the surgery, I can tell you that it is quite painless and amazingly brief. The entire procedure took less than 120 seconds, from initial incision to lens implantation.
posted by ArgentineBlonde at 11:25 AM on March 4

I had cataract surgery in both eyes last year, one right after the other. My surgeon made no promises before the surgery, but folks I spoke to had commented about not needing glasses for distance anymore (I've worn glasses since 5th grade).

I received mono focus lenses (I was not offered multi-focus). I'm not thrilled with my results. However, I'd just moved into trifocals (reading, computer, distance) and now am back to bifocals which is better. For whatever reason, the correction I got was for the middle distance (computer). My surgeon admitted she expected me to not need distance glasses and was surprised that the correction ended up working best for "computer" distance. I used to get away without glasses for reading and now I have to have them on to read. Even with my glasses, I have a horrible time threading needles or doing close work of any kind.

Those tiny adjustments your eyes used to do will be gone. I find that frustrating to this day.

I get more eye fatigue now and still have some issues with bright headlights at night.

All in all, things are better with the surgery than without (at least there isn't that constant feeling of needing drops or needing to blink to clear away the cloudy film...) but it is not nearly as statisfying as reported by some.

I have had a little bit of the cloudiness return in one eye--but not enough to have the laser surgery.

The surgery itself was freaky (my EYES!) but not horrible and I experienced little or no post-op pain. I didn't have any systemic drugs because of a miscommunication ahead of the surgery and was fine with the locals they used.

Good luck.
posted by agatha_magatha at 11:25 AM on March 4

I realized I made it sound like I had the cataract surgery in both eyes the same day--what I meant was I waited the bare minium about of time between (I believe about a week or 10 days).
posted by agatha_magatha at 11:28 AM on March 4

Thanks for all the input so far. When I said "satisfaction with the surgery is higher in patients that wait as long as possible" I did not mean to imply it makes the surgery any more successful; it's just that the worse your vision is before you do it, the happier you are with the improvement. Someone who is just starting to be bothered by a cataract will have the expectation of perfect vision restored, whereas someone seriously hampered by a more progressed cataract is happier with the results.
posted by juggler at 12:11 PM on March 4

Mme TT had accommodating lenses implanted (crystalens - google it) and is totally thrilled with them. These are not multi-focal, but true, variable focus lenses that have made her eyeglass- & lens- free for the first time since she was 5. More expensive by a lot, and your insurance may only pay up to the price of monofocals. She'd had either glasses or hard contacts for almost ever and was advised she mightn't find multi's meeting her expectations, based on that experience. They're new enough you may have to scour to find someone who implants them, but discuss them with your doc and with one who implants them before you decide.
posted by TruncatedTiller at 1:25 PM on March 4