No more blind spots

August 20, 2009 5:30 AM

A friend requires cataract surgery in the near future, and has some questions about his options for MeFites who've pondered the same issues.

(I have seen this thread and pointed him to it - juggler, have you had your surgery yet? What did you decide to do?)

My friend is 43. He has been mildly nearsighted since 12 and has worn glasses/contacts for distance vision since then, but has never had problems with very close vision. The cataract in his left eye is quite advanced, the right one less so; he is planning to have both done, but has not chosen his replacement lenses yet.

Single focus lenses: It appears that he could choose to have single focus close-focus lenses in both eyes, or single focus distance-focus lenses. If you have two close-focus lenses, how well can you see small things up close, like tiny iPhone screws or needles to thread? If you have two distance-focus lenses, can you read without glasses and do other close work? Is there a reason to choose one over the other? If you could do it over, would you get the same focal distances?

Multi-focus lenses: What kind of lens did you get? How happy are you with your overall vision? Was it worth the extra expense? He has BCBS insurance and will probably have to pay above the coverage cost to get multi-focal lenses.

Special bonus question: Anyone with the new Crystalens accommodating lens? TruncatedTiller, you posted that your wife has them - is she still happy? How does it compare to her natural vision?

Thanks, hivemind. If you prefer e-mail, drop me a note at metacatlet @ gmail or MeMail, and I will pass it along.

posted by catlet to health & fitness (5 answers total)

I had cataract surgery about 4 years ago, at the age of 35, and had the Crystalens put in both eyes.

What I had was the 1st generation lens, and as I understand it, there have been 2 newer generations since, with more accomodation and a larger lens to help with edge glare.

Personally, I am extremely happy. I was going nearly blind before the surgery, and now have 20/20 in one eye, and 20/40 in the other. The slight monovision was not by design, but there are often measurement errors when doing the first eye, and hence my first eye ended up at 20/40.

That said, I am glad it worked out that way, as the accomodation in my first-gen lenses would not be enough to see well (or read) at near vision if they both were 20/20.

Other than that, vision quality is excellent even with the slight monovision. I have some glare from lights at times (but as I said, it appears to be improved in later versions) and I never think about the lenses. It's as if I still had normal eyes, but without the need for glasses or contacts.

Any other questions, feel free to post, and I'll try to answer them.
posted by eas98 at 7:05 AM on August 20, 2009

I had cataracts in both eyes and had surgery last summer. I chose the multi-focus lenses (intraocular lens by amo) and am pretty satisfied, but there are some issues. The way that these lenses work is that that there are three or four ( i see four, but doc says that there are only three) "focus points" where your vision is the clearest. For distance viewing, it is unbelievably crisp and clear. The trouble that I get into is this.. the way that the lenses are built, your closest focus point is situated on the outside of the lens so when you are in bright light or sunlight, you basically lose the ability to see clearly close up because your pupil constricts which cuts off your access to that part of the lens. This can be helped with reading glasses though. Also, be prepared to get a pair of glasses for strictly computer use. Any time you use any device emits light it will fuck with your vision. Other than that, try to stay calm during surgery and follow all post surgical advice and you should be good.
posted by citizngkar at 7:10 AM on August 20, 2009

I had cataract surgery in June. My left eye has a lens for medium - long distance (i.e. driving, watching TV from the other side of the room). My right eye has a lens which is perfect for reasonably close up work (reading a book and computer screen).
The only time I need reader glasses is for reading small print in a poor light.
Needless to say I am very happy, having worn glasses for the last 30 or more years.
Not only the clarity but the colors are a revelation.
My lenses are Tecnis Asoheric IOL Intraocular Lenses Model XCB00.

I have no experience of multi-focus lenses. Is this what Tiger Woods and baseball players have?
posted by lungtaworld at 7:25 AM on August 20, 2009

I had a single-focus lens installed in one eye in 2001 so that I had 20/20 vision, and used a contact lens to correct the other eye. It was great-- my doc set me up for overall clarity at middle distances, and I had no problems with close work or distance vision.

I am looking forward to getting my hands on better tech when this one eventually gives out-- I was 25 at the time, and I doubt this thing is going to last 55 years without needing a replacement-- but overall it was a great improvement. I did eventually have a retinal detach and subsequent repair that have put me back in glasses, but I was in no way a typical cataract patient and my surgery was tricky, so it wasn't surprising.

I suspect that whichever way your buddy and his surgeon elect to go with it-- I trusted my doc completely and took his advice because we had a great working relationship-- he'll be thrilled with it.
posted by fairytale of los angeles at 1:24 PM on August 20, 2009

Coming back to post a follow-up: my friend had his left eye done last week and chose to go with a single-focus distance lens. He will probably have the right eye done this fall and may go with a single-focus close lens, or maybe a multi-focal. The Crystalens was appealing but insurer limitations are already making this pricy so the extra cost wasn't worth it.

Thanks again, everyone. He really appreciated your input, and I've marked everyone best answer because he found all responses helpful.
posted by catlet at 1:39 PM on September 29, 2009