About to have Cataract Surgery - A Few Quick Questions
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The plan is right eye on 12/11 and left eye a week later. Alcon monodical lenses will be used. The targeted diopters after surgery is -1.00D(right eye) and -1.75D(left), or mini-monovision for near/intermediate. Before surgery, I'm 6.0/6.5 myopic and very slight astigmatism. Questions:
1. The surgeon said if I can stay motionless well, she may just apply topical anesthesia. How difficult is it to stay motionless during surgery? Do you sit down or lay down during surgery? Is recovery easier if applying only topical anesthesia?
2. The surgeon said I could change my mind to monovision for distance/intermediate after first eye is done(right eye). This is because I'm quite myopic and the resulting diopter may vary quite a bit from the targeted -1.00D(even though ORA will be used). My dominant eye is right eye. In monovision, does it matter which eye is which for vision length?
0 likes, 29 replies
Lakesider robert20416
Posted
Hi Robert,
Be reassured. Your plan is exactly what I had. -1.75 and -1.0. First op one month ago. Second op just two days ago. Your myopia is also near identical to what I started with.
As others have said, it’s no problem staying still unless perhaps you suffer from a condition that makes this difficult. I was a little nervous before my first op but that was largely because I wasn’t sure what to expect. The second one, yesterday, I breezed through without a care in the world.
There was no "pain" at all, just a little mild discomfort — perhaps a bit like wearing a contact lens with a tiny kink in it. A really minor sensation. Frankly, I’m not sure what anaesthesia I had. I had a small jab on the back of my hand but I was not 'knocked out'. After the procedure I got up and walked to the recovery room, ate loads of chocolate, then 30 mins later walked 500 metres to my tram, and later got my train and bus home, without ever feeling woozy.
The only moment of worry was walking out of the hospital with one eye bandaged up, into a dense snowstorm. (I live in Switzerland.) But I made it home — and people were very kind on public transport (or perhaps a bit nervous to see me bandaged up like that).
Regarding the one week between ops, I envy you. In my inexpert opinion, the one-month-apart thing is more a hangover from the cautious early days of such surgery, when they couldn’t be certain of success, and so wouldn’t do both eyes at the same time. I’d heard this view expressed a few times, and also heard it at the optician, when I went for some temporary glasses. When I asked the surgeon himself why I had to wait a month, he just sort of shrugged and smiled. "It's how we like to do things here", he said, like a Central American dictator might if asked about imprisonment without trial.
The month between the two surgeries were inconvenient as my eyes were so mismatched. After a few failed experiments I went to the optician and had some temporary glasses made with a slightly adjusted lens to sharpen up distance in the new eye, and had a blank lens put in the old eye, on which I wore a contact lens. Doing this for a month was annoying, but it worked well enough
I’m thrilled with the results so far. Yesterday, after returning from my checkup I drove to the local supermarket and realised, once there, that I hadn’t worn my glasses! This wasn’t the right decision, and I got them out for the return journey, but my point is that I drove without noticing, and that gives you an idea of how good the result seems to be.
So it’s near + intermediate monovision. It still feels a bit weird without glasses, and I'm getting a little double vision. Will this smooth itself out over time? I don’t know but of course I hope so. Even if it doesn’t change, it will perfectly ok for mooching round the house, cooking, casually watching a bit of TV, going for a walk, etc. But for anything that requires more attention, like driving, watching a nature documentary on TV, extended computer work, I will have to wear glasses. That’s fine for me.
The advice I’ve been given is that the eyes will take a few weeks to really settle down, so I should wait about 4 weeks, or just after my final check up, before having my eyes tested for some ‘final’ glasses. My makeshift temporary pair are doing a fine job, so that’s OK with me.
Sorry, I’ve rattled on a bit more than intended. The main message is not to worry, that it was a very quick, painless procedure, and that afterwards you will almost certainly be delighted.
Sue.An Lakesider
Posted
Congratulations on a successful outcome.
Sue.An robert20416
Posted
robert20416 Sue.An
Posted
Sue.An, thank you for the well wishes. just finished my right eye's cataract surgery, the first patient of the day. Received topical anesthesia and IV to make me calm. Can't even tell the surgeon from three other nurses who came to my bed. Afterwards, although my surgery eye was covered with a shield, I could somehow see thru it and it definitely is less myopic then before. No pain, just a little discomfort for now, 2 hrs after. Will see the doctor tomorrow to follow up.
Sue.An robert20416
Posted
Really glad surgery went fine. Give us an update when you are feeling up to it and can see through more than the eyeshield.
Sue.An robert20416
Posted
robert20416 Sue.An
Posted
Sue.An - Thanks for the well wishes.
My right eye was done last Monday, targeting -1.00D w/ monofocal lens. Well, two post-op visits confirmed -1.00D, bull's-eye! The eye is healing well with fantastic intermediate vision, with little to no glares. One thing I learn about this eye is the focal distance has a range, whereas before surgery I tend to think it as a single point conforming to the empirical formula: focal point=100cm/D. Thus, with a -1.00D corrected eye, I should have a focal point of 100cm, or ~40". In my case, the good focus is indeed coming in at ~40". What surprised me is I can see reasonably well down to 20"! That allows me to function in many of the "near" activities such as iPhone and reading big prints(reading newspaper is still best done w/ a +1.75 reader). This has prompted me to think twice about going with near/intermediate correction as originally planned, haha.
I'm supposed to have my second eye done today but I postponed to next month as I'm now pondering what to target for my second eye, distant or near. I'm trying two sets of contact: plano and -1.75D, to decide which combination I like better. I have yet to receive the glasses to wear when I am -1.75D/-1.00D. So the jury is still out.
Sue.An robert20416
Posted
Since it’s a decision you’ll live with for a lifetime it is wise to take the time you need to decide on target for 2nd eye. Are you leaning towards near vision?
Congrats again. Glad all worked out so well for you.
robert20416 Sue.An
Posted
The monofocal lens is Alcon Acrysof.
I was leaning towards near before surgery and the surgeon said I'm the first patient in her >30 years of practice as an eye doctor to do so. In my second post-op, she asked me "are you sure?" Well, I'm 90% sure, just a little not so sure...haha. With my left eye still having cataract, it is a little harder to evaluate the contact lens tryout. Besides, I still don't the glassed for the near/intermediate pair. I still got a whole month before the next eye surgery so I can take my time.
Lakesider robert20416
Posted
I'm surprised, in fact very very surprised, that your doctor said no one in more than 30 years had asked for near + intermediate vision. Maybe it's a cultural difference but my doctor here in Switzerland said that he recommends naturally short-sighted people like me to stick with near, especially if they do close work --- writing, computing, etc.
It's an entirely personal decision but i'm happy with the -1.75 / -0.75. I would find it a nuisance to have to put on my glasses to read or work close up. As it is, I can see close up and enough distance to pretty much get by without glasses. I can even see enough to drive and watch cinema / TV without glasses, but I do drive with them, just in case. It's a bit like being a kid again, when I didn't wear my glasses for schoolwork, but put them on if I was at a football match or a long way back at a concert.
That said, I'm still adapting to my mini-monovision, 5.5 weeks +1.5 weeks in. It's not entirely comfortable yet and so I'm wearing my glasses a fair bit to help the transition.
There has been quite a lot of correspondence on this forum about opting for near, so you might want to read through some of the discussion before deciding.
robert20416 Lakesider
Posted
Yeah, no doubt, the near-intermediate vision has never received enough considerations from cataract patients for one reason or another, lots of it due to eye surgeons who rarely offers this option. My own preference toward this option stemmed originally from my willingness to wear glasses. It was further cemented after reading Bella, At201, Jenny's...etc posts and now your.
I have now a whole month to decide which option to choose: plano/-1.00D or -1.75D/-1.00D. My preliminary impression toward plano/-1.00D is rather positive due to these observations:
1. The near vision of plano/-1.00D is surprisingly good, seeing reasonably well down to 20". I was expecting 40" or a little short of that, but 20", wow!
2. I knew reading glasses are quite affordable but a chore to carry around. However, a trip to Walgreen changes my perception of them. I found them well made, foldable ones in case are easy to carry, and the narrow lenses allow one to wear them low and not interfering distant vision...etc.
3. Sunglasses with prescription are expensive.
4. Micro-monovision of plano/-1.00D doesn't seem to bother me.
Points 1 and 2 are pleasant surprises. Whether they are enough to steer me toward distant/intermediate vision... I don't know.... yet.
Sue.An Lakesider
Posted
I was nearsighted most of my life so thought of losing that (even with gaining distance didn’t sit well). It is one thing to lose near vision gradually but all at once due to cataract surgery was something I did not want. That played into my decision to opt for Symfony lenses. Since my surgeries- you’re right about a number of posts of those targeting for intermediate/near. It opens the door for people to look at that as a viable option.
Lakesider robert20416
Posted
And it might get even better for you. I was happy with my new intermediate vision shortly after the op, but a few days further on and it improved again! For instance I noticed I could watch TV much more comfortably. If things stay as they are, I won’t use glasses to watch, say, discussion programmes or the News, but I would put them on for HD nature or art programmes where you want to enjoy every fine detail.
You've done the right thing to postpone if you’re unsure, especially as it gives your 'new eye' more time to settle into its final place. I was unsure too, and called my doc. He explained (in a quite unpressurised way) why he’d initially suggested -2.50 and -1.50 for me as a near sighted person, but after a chat he agreed to go for -1.75 and -0.75 to give more intermediate. I’m pleased with this combo.
I'm not surprised that most people favour distance, but I was shocked that no one in 30 years had requested near! @Sue.An's point about driving and Medicare coverage is a very plausible explanation for the assumed preference for distance. Makes sense.
Anyway, I’m pleased that things are going well for you.