Cataract Surgery

[missy]

Update for @kenny and anyone else who is interested in info regarding cataract surgery.

I had cataract surgery on both eyes. Nov 7th right eye and Nov 16th left eye.

I am still healing of course so not 100% sure where my refractive error will end up but I am pleased. I initially wanted to be left near sighted after the surgeries because that is how I was my entire life and I read a LOT. But the surgeon convinced me to just leave myself just a bit nearsighted so I could read my phone and intermediate and drive without glasses if I wanted to but not 20/20 at distance without glasses. Because once your lenses are removed you will no longer be able to focus up close so if you fully correct yourself for distance you will not be able to see up close without glasses.

So I did a compromise (approximately -0.75 left eye and -1.25 right eye) and so far I am thrilled. I can read my phone but for small print I need reading glasses (half eye "cheaters" from Costco) and for distance I can see without glasses. Though for night driving I will want glasses but have to wait a month or so before getting that evaluated as the eyes are still healing.

The surgery itself was a breeze. It took three minutes part one and four minutes max part two. Each of my surgeries were in two parts because I opted for laser assist. It is less invasive than traditional cataract surgery. The surgeon took me to a room and broke up the existing lens with cataract with a laser then to the surgical room where he sucked out the old lens and put in the new IOL. I opted for topic IOLs for both due to my corneal astigmatism. Insurance never pays for toric IOLs and they were each 3,950$ but due to being an OD he gave me the family cost of 3200$ each IOL. Still pricey for sure. But it is an investment for a lifetime and fully worth it IMO. If one has considerable corneal astigmatism I would advise strongly considering topic IOLs. It will give you the crisp vision you need.

Only anesthesia was topical (drops for both parts 1 and 2) and IV Versed very low dose (only for part 2).
I was awake for the entire surgery as one needs to be to follow directions and look straight ahead etc.

I did experience a complication with my left eye unfortunately. I think it happened because the medication contact lens (called a collagen shield) the surgeon put in my eye after the surgery for protection (has meds in it and also protects the cornea) fell out as soon as I got home and unfortunately I got a corneal abrasion. Very painful. But it could also be due to underlying genetic issues of RCE (mom) so who knows. I am still healing but feel A OK for the most part.

What to expect. My experience.

1. For three days prior to my surgeries I had to instill two drops four times a day and two times a day.
After the surgeries I had to instill two drops four times a day and one drop twice a day.
Antibiotic drops, steroid drops and anti inflammatory drops. Most surgeons do it this way so it is not unique to my surgeon. To prevent infection and to keep the eye nice and quiet so it can heal.
I will be on these drops for approximately a month and tapering the steroid drop each week. In order to keep track as each eye is on a different schedule (due to having the surgeries at different times) I am keeping a chart so I don't make any mistakes. Even if getting surgery on both eyes at the same time I recommend keeping a chart. As it gets complicated keeping track as one is tapering.

2. No getting the eye wet for a month. This makes washing one's hair challenging. I got a protective shield for this however it turns out I am allergic to that adhesive as well. Should have realized it as I am allergic to all adhesive. So showering is OK but for me hair washing very difficult. And I have to avoid getting water in my eye for one month.

3. I also need to avoid bending for as long as I can avoid it...one month if possible.

4. Also no weight lifting for a week. I am going to extend that to two weeks at least. I asked the surgeon many times about this as I lift weights on a regular basis and he confirmed one week. But being in this field I feel it prudent to wait at least two so I will and I am.

5. Cardio workouts. Surgeon said I can resume next day as long as I am not running at a speed of 6 mph. LOL no worries there. Again while I trust my surgeon who is excellent I decided to extend that requirement as well and waited three days (OK two for my left eye lol) and am walking on my treadmill. Not too fast. At a slow speed of 4 mph and for me that feels safe and I will speed it up when I feel ready. As of now only being 6 days post op left eye and also still healing from my complication of the abrasion I'm taking it conservatively working out wise.

6. Another recommendation is sleeping with the eye protected with a shield. So you don't accidentally rub it while you are sleeping. I slept with it for 7 days as advised on the right eye. But last night at 1AM I removed it from the left because I am sleeping on my back (have the whole recovery time) and do not rub my eyes. And I was getting tired of wearing it because I am allergic to all adhesive and while the tape I was using (tried them all) wasn't bad it still was irritating so last night/early this AM I made an executive decision and removed the tape and shield. And it was night five anyway.


People who have had cataract surgery say colors are more vibrant. I have not noticed this. But my left eye didn't have a cataract (if it did it was super mild) and it was just my right eye that had the moderate cataract. And I do not think it was affecting my color perception. But that is me and ymmv and likely will.


Leaving you with a pretty photo with vibrant colors. I see it the same now as I did before.






I hope I am not forgetting to share anything important. Feel free to ask questions and if I can answer them I will.

Good luck to all getting this surgery. It is fairly easy with low complication risks for most.

 

[missy]

Addendum. I realized some people might not know the abbreviations/terms

IOL-intra ocular lens. It is what the surgeon implants in your eye to take the place of your lens that had the cataract

Also, immediately after the surgeries I could not see. It was a white haze. Due to corneal edema (swelling) which is normal after the surgery and the dilation. The drops they use keep your eyes dilated for approximately 12 hours. For me there was no pain associated with the surgeries. Just a pressure on the eye. My vision remained white and hazy for a few hours and by 10 hours after the surgery started coming back and by the next day I was able to see fairly well


The shield they give you for eye protection after the surgery. Mainly for sleeping but if you are in a risky situation where something could hit your eye they want you to wear it. Bring sunglasses to your surgery because my surgical center did not provide any UV protection as some do. So just in case yours does not. I bought a pair on Amazon that goes over the surgical eye shield. And I felt well enough after my first eye surgery to go on a walk with my DH. And I wore the shield and the sunglasses from Amazon that fit over the shield. Photo of the eye shield they put on you after surgery.



The sunglasses I got to go over that

Amazon.com

OK that's it. Let me know if you have any questions

 

[kenny]

Surgery was yesterday, and today was the post-op exam with my surgeon.
Surgeon's Cliff Notes: "Wow, extremely good results."

Again, I opted for the cheaper fixed focus-distance replacement lenses, which have little chance of being able to focus from very close to infinity.

To pick the best lenses for you, they ask you to rank three distances, in the order how important they are to you personally ...
* Far distance
* Arm's length, for computers and phones
* Very close, for removing a splinter in your skin, or threading a needle.

My priorities were:
1. Arm's length
2. Very close
3. Far distance

I was asked if I was really sure of that, because my rankings were the most rare.

Now, 24 hours after the surgery, I can already tell the close focus will be excellent.
Per my surgeon's test today I could already pass California's DMV test for driving (far distance) without glasses.
I say "will be" because as is customary I have a lot of post-op tearing that messes with the focus.
Over the next days/weeks that tearing will decrease and go away.

She was amazed when I pulled out paper with my questions printed, using a font size of only 12 points.
I read it sans-glasses with little problem.
I had no idea that was unusually good next-day surgery results.

After being farsighted all my life I'm now nearsighted, but my far vision is expected to improve over the coming weeks.
I MAY end up needing NNNNNNOOOOO glasses, for life.
Boy! I'm a happy camper now! ... or is that a crappy hamper?

THIS IS WONDERFUL!!!!
I keep reaching for my reading glasses to use my computer - but I no long need them!

 

[Demon]

Surgery was yesterday, and today was post-op exam with my surgeon.
Surgeon's Cliff Notes: "Wow, extremely good results."

Again, I opted for the cheaper fixed focus-distance replacement lenses, which have little chance of being able to focus from very close to infinity.

To pick the best lenses for you, they ask you to rank three distances, in the order how important they are to you personally ...
* Far distance
* Arm's length, for computers and phones
* Very close, for removing a splinter in your skin, or threading a needle.

My priorities were:
1. Arm's length
2. Very close
3. Far distance

I was asked if I was sure because my rankings were the most rare.

Now, 24 hours after the surgery, I can already tell the close focus will be excellent and per my surgeon's test today I already pass the California DMV test for driving (far distance).
I say "will be" because as usual I still have the excessive tearing that messes with the focus.
Over the next days/weeks the tearing will go away.

During today's surgeon appointment she was amazed that I pulled out a paper with my questions printed on it in a font size of only 12 points.
I read it with little problem, with no glasses.
I had no idea that was unusually good surgery results.
I'm a happy camper now!

THIS IS WONDERFUL!!!!.
I keep reaching for my reading glasses to use my computer - but I no long need them!

IOW

Great news! I'm very happy you had such good results. Now I'm kind of hoping that my cataracts get worse quickly (I asked my ophthalmologist how bad cataracts had to be to have surgery and she said much worse than mine. )

 

[kenny]

Great news! I'm very happy you had such good results. Now I'm kind of hoping that my cataracts get worse quickly (I asked my ophthalmologist how bad cataracts had to be to have surgery and she said much worse than mine. )

FWIW, if you're really in a hurry (and have the funds) I'm pretty sure you can get it done now (out of pocket) without having to meet your insurance company's criteria for cataract severity.
However, if you are in an HMO, you'll probably have to find a new doctor and surgical facility.

BTW, 2 days post-op, the tearing is almost gone, and my vision is way better today.
Now I can't believe the razor-sharp screen resolution of my 2022 24"iMac desktop computer.
Even with glasses it appeared nowhere near as sharp as it looks now.

I still have much sensitivity to bright light, and even a bit of pain if direct sun shines on anything in the room, even if it's only in the far edge of my field of view.
When my surgeon gave me those old-fart glasses, I responded, "Oh No! I'm not THAT old." She said, "It's won't hurt you to be old for two weeks." LOL



Another positive, I can see much better in dim light, and the world seems a bit more blue now. I think cataracts tint your vision towards yellow/brown.
GIA would grade my old natural lenses S/T SI2, but my new ones are D IF.

Oh Praise Science!

 

[kenny]

They asked, "Why in the world would he wear THOSE sunglasses?

Uhm Captain Obvious ... to turn on all those hot young chicks at the pick up bar.
Like, DUH!

 

[momofive]

My husband had it done about 5 years ago. He was relatively young, (59). I told him to get a second opinion, but he went with a surgeon a friend used and it was horrible. Not the actual surgery, but for some reason they gave him distance lenses in both eyes. When he went to drive he couldn't see the dashboard. He spent months going to different eye doctors trying to correct it with glasses. Finally settled on cheap internet tri-folds. Now they are all over the house!! I don't understand, because I know someone in their 80's who had it done. They gave him intermediate distance and he rarely uses glasses for anything except extended reading. I don't understand why they didn't do that with my husband. He just went along with whatever the doctor told him.

I use mono-vision contacts. One for distance and one for close up. I love them. If I ever have to get cataract surgery, that's what I would get, unless there is something different and better at the time.

 

[missy]

Kenny glad your surgery went well.

My husband had it done about 5 years ago. He was relatively young, (59). I told him to get a second opinion, but he went with a surgeon a friend used and it was horrible. Not the actual surgery, but for some reason they gave him distance lenses in both eyes. When he went to drive he couldn't see the dashboard. He spent months going to different eye doctors trying to correct it with glasses. Finally settled on cheap internet tri-folds. Now they are all over the house!! I don't understand, because I know someone in their 80's who had it done. They gave him intermediate distance and he rarely uses glasses for anything except extended reading. I don't understand why they didn't do that with my husband. He just went along with whatever the doctor told him.

I use mono-vision contacts. One for distance and one for close up. I love them. If I ever have to get cataract surgery, that's what I would get, unless there is something different and better at the time.

Ugh, the surgeon made a mistake in your dh's case. Of course it is up to the patient to decide what compromise vision wise is best for them but the surgeon should have guided him.

It is always going to be a compromise in terms of vision since once our natural lenses are removed we can no longer focus up close. Especially at his age of 59 because at that age he still had accommodating power to be able to focus close at least to some degree. So either the surgeon can correct someone for distance, intermediate, near or do mono vision (one eye corrected for a different distance than the other). Which is what you are doing successfully with your contact lenses. And yes I think when it comes time for your cataract surgery that would work best for you given your experience with mono vision contact lenses. All of it somewhat if a compromise. I warn people to stay away from the multi focal IOLs because while it will work for some it is too much of a compromise for most. And I do not see that improving anytime soon. The most unhappy cataract surgery patients are those who chose multi focal IOLs. Driving at night is especially challenging with that option.

I chose to be left slightly nearsighted so I could see intermediate (dashboard while driving) clearly and see distance relatively clearly (20/40 uncorrected) and still be able to read my phone. For small print and prolonged close work I use reading glasses (half eyes from Costco for example) and for most everything else I do not need glasses. It is quite the change from my pre surgical vision capabilities. For me this was the best compromise but there is no one size fits all.

I hope your dh has adapted and is doing well. I have OTC reading glasses in every room lol

 

[Demon]

FWIW, if you're really in a hurry (and have the funds) I'm pretty sure you can get it done now (out of pocket) without having to meet your insurance company's criteria for cataract severity.
However, if you are in an HMO, you'll probably have to find a new doctor and surgical facility.

BTW, 2 days post-op, the tearing is almost gone, and my vision is way better today.
Now I can't believe the razor-sharp screen resolution of my 2022 24"iMac desktop computer.
Even with glasses it appeared nowhere near as sharp as it looks now.

I still have much sensitivity to bright light, and even a bit of pain if direct sun shines on anything in the room, even if it's only in the far edge of my field of view.
When my surgeon gave me those old-fart glasses, I responded, "Oh No! I'm not THAT old." She said, "It's won't hurt you to be old for two weeks." LOL



Another positive, I can see much better in dim light, and the world seems a bit more blue now. I think cataracts tint your vision towards yellow/brown.
GIA would grade my old natural lenses S/T SI2, but my new ones are D IF.

Oh Praise Science!

D IF

Yeah, I think I'll wait till insurance will cover it. I've learned a lot from this thread - I didn't know you could choose your distances with cataract surgery, and I think I would do mono. I had lasik done a long long time ago, and mono worked really well for me. I'm glad you've done so well with your surgery.

 

[AprilBaby]

I had my right eye done this morning at 8:40 am and was out at 9:30. I had the drops and 1 shot of versed before I went in and a second right before they started. I saw lots and lots of colors and a white light at the end of the tunnel. I thought it seemed like the people who claimed to have died and come back. I could not see anything else. Taking the lens out was fine, putting the new one in was slightly painful but only lasted about 15 seconds. I had hazy white vision for a few hours. My return visit was at 2:30 pm. I did an eye test and was 20/25. My left eye could not even read the giant E. I got a contact lens for the left eye until it is done in 2 weeks. I was extremely nearsighted. Right now I can’t read anything or my watch, phone, labels at stores. I will probably now get medium to close range glasses. I’m thrilled with my far vision but I have a different problem now with the near vision. Again, it is only day one. I had pain in the afternoon about 3/10 it felt like broken glass in my eye. It’s gone now, my eyes are just very tired.

 

[AprilBaby]

Today I had eye 2 done. This time I think the nurse missed the vein and the versed didn’t do a thing. i felt almost the entire operation but it went quickly. My eye hurts a lot! Eye 1 is excellent, I can see forever. Left eye is 20/20 5 hrs later even with cloudiness. Not a happy camper tonight but in a few days I will be very happy. I have readers for close up. If eye 2 had been first, I would have given another operation serious second thought. Now I’m just glad it’s all over and I won’t have to do it again!

 

[missy]

Today I had eye 2 done. This time I think the nurse missed the vein and the versed didn’t do a thing. i felt almost the entire operation but it went quickly. My eye hurts a lot! Eye 1 is excellent, I can see forever. Left eye is 20/20 5 hrs later even with cloudiness. Not a happy camper tonight but in a few days I will be very happy. I have readers for close up. If eye 2 had been first, I would have given another operation serious second thought. Now I’m just glad it’s all over and I won’t have to do it again!

I'm sorry you are in some pain. It could be a corneal abrasion which is not uncommon. I had one on the second eye too. It was much better in 24-48 hours. I was given a bandage contact lens so the pain was minimal. Consider asking for one if you are still in considerable discomfort tomorrow. Good luck and may your healing and recovery go well and quickly. And congrats on being done with both surgeries

 

[AprilBaby]

Thanks Missy! Feels much better today, just a little cloudy.