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Catarac lens selection

Posted , 7 users are following.

goatfarmer
goatfarmer

Recent eye exam to re-new prescription glasses, diagnosed with beginning cataract in left eye. Ophthalmologists scheduled surgery but I am faced with the dilemma whether to select the Custom Lens, at an additional cost, vs the Standard lens. Got the impression the Doctor incline to suggest the premium lens? If younger it would not be an issue however at the age of 74 not clear if there will be presenting issues with aging and whether premium lens would be the best option? 

0 likes, 18 replies

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  • at201
    at201 goatfarmer

    Posted

    What is the reason for the surgeon suggesting a Premium lens instead of a standard monofocal lens?

    All lenses, Premium or not, have their advantages and disadvantages (besides the higher cost of a Premium lens). There is no perfect lens for anyone. One has to understand those pros and cons and even more importantly what is important and what is not important to you. I will suggest that you try to find a doctor who is willing to spend the time to explain the pros and cons of various IOL options and help you make the right decision.

    • goatfarmer
      goatfarmer at201

      Posted

      I thank you for your prompt response. Scheduled for a pre-surgery exam at the end of the month and I will inquire in detail why the Dr would suggest one type of lens over another. During the initial exam I may have left the Dr. with the impression I prefer not having to rely on prescription glasses being aware regardless of type of lens may need glasses regardless.

      Again I thank you for the input!!

  • phyllis31515
    phyllis31515 goatfarmer

    Posted

    I just had cataract surgery on my right eye less than 48 hours ago. I paid the extra for a premium Symfony multi focus lens. I am thrilled. I can see well at all three distances without glasses. I am scheduled to have the left eye done on August 30 with a Symfony Toric lens. I debated for several weeks about the lens, especially since I had LASIK surgery 11 years ago. I would not let your age effect your decision. I am only a few years younger than you are. I went with my doctor’s recommendation on what would give me the best overall vision without glasses.
    • goatfarmer
      goatfarmer phyllis31515

      Posted

      My primary concern is whether I should factor age into my decision and I intend discussing the issue with the Dr., I greatly appreciate your comments, unless advised otherwise I will not be overly concerned about age in making my decision. Again, I thank you!!
  • derek40125
    derek40125 goatfarmer

    Posted

    Age is important, but only to a certain extent and, in general, it's going to be specific elements of your particular lifestyle (and physical condition of your eyes) that are more important to your decision. For example, the average younger person might be expected to be very active and drive a lot more at night (picking up kids at school and things like that) while the assumption would be that an older person would not. That might not fit your particular situation, though. You might be a 74-yr old who happens to drive a lot at night and something like this would be an important factor to consider when selecting lenses.

    Spend some time thinking about how you live your life, your favorite activities, what tasks you spend time on, what ranges of vision are most important to you (without glasses or contacts). As an example,  I think that knowing if you are a 74-yr old who spends a lot of time on a computer (screen at 30"wink vs a 74-yr old who rarely uses a computer but spends a lot of time reading books (at 12"wink is more important than the fact that you are 74.

    • Sue.An
      Sue.An derek40125

      Posted

      Those are very good points Derek.  Thinking it is something surgeon’s offices should do more of.  While in waiting area we should be filling out a questionnaire asking about lifestyles, hobbies, work, how much reading you do.  This would help guide discussion with the surgeon.
    • derek40125
      derek40125 Sue.An

      Posted

      Everyone is different. In two weeks I'll be on a 10-day trip to the Swiss alps. We'll be hiking a lot at high altitude (although no actual climbing). My travelling companion on this trip will be my 82-yr old father. In addition to having no problem with 10+ mile hikes, he still works full time which includes a lot of travel (flying and long drives - day and night).

      His vision demands are probably different than the stereotype for an 82-yr old. He corrected for intermediate (targeting around 6-8 ft) and also gets reasonable reading vision (lucky guy) and wears glasses for driving/distance or very close work (like removing a splinter). Unlike him, I would not tolerate having to wear glasses for distance   

      Most surgeons, at best, give you a simple Q & A form and have you pick a desired correction range but really there are so many factors you need to consider that this is something people need to spend more time thinking through (and talking to other people about). 

       

    • Sue.An
      Sue.An derek40125

      Posted

      Yes very true.  Likely because I was so taken aback at 53 with the cataract diagnosis I did start looking it up, reading and talking to people (my family did get a bit tired of it - lol) but it was so unexpected for me.  

      But certainly age is no indicator of how active one is or involved so lots of thought should go into decision.

      Enjoy your hiking trip - sounds wonderful.  Only flew over Swiss alps- and even from the sky very impressive.  Great time of year to go.  Your new eyes will be amazed!

  • britkennels
    britkennels goatfarmer

    Posted

    When it comes to your eyes, if you can afford the premium lens, go for it! Like the old joke, you can't take it with you. I'm only 60, but I had eye issues galore and chose to have cataract surgery (they were starting) because I knew my eyes would never get any healthier. In a nutshell, I haven't had vision this good in decades...completely glasses-free for all distances (better than 100% or 20/20--something I've never had since youth). Yes, there are potential risks and you should become as informed as informed as possible for your particular situation, but I can honestly say I wish I'd done this years ago. I love to read and do counted cross-stitch and the ability to do those, along with other things, and do them lens-free is just amazing.

    If you're interested, hunt down my posting from late June for my particular experience. FWIW, 72 year old hubby had premiums in April and he's had the same great results.

    Please let us know how things go. Good luck!

    • goatfarmer
      goatfarmer britkennels

      Posted

      I agree, if at all possible I would like to eliminate the use of glasses. The other issue I intend to present to the Dr. is by correcting the vision of the left eye how will it effect the vision in the other, does it usually require having the lens replaced on the other. Greatly appreciate the Patient forum I can now ask the questions I had not thought of.
    • derek40125
      derek40125 goatfarmer

      Posted

      Most surgeons will want to implant a Symfony or multifocal IOL in both eyes. However, you don;t have to do this and even if you are thinking about doing this, I'd advise you to wait as long as possible and make sure it;s the right choice for you. No matter how good of an IOL you get, it's not going to be as good as a cataract-free natural lens.

      You didn't mention your current vision situation but if you can tell us the correction on your right eye and if it's glasses or contacts, some people on this forum will give you advice. If you can wear contacts in your non-op eye, you will tend to have better results (especially if you are nearsighted). This is because using glasses to correct your right eye and the IOL on the left will often create a noticeable size mismatch between objects. This isn't and issue with contact lenses. If you are farsighted you'll probably have less of an issue.

      If you can wear contacts then I'd highly recommend you find a good optometrist and try multifocal contact lenses (in your non-op eye) to complement your premium IOL in the other. Ideally you'd get similar or overlapping correction between the eyes so that you are using the full corrective range of your IOL. That's exactly what I'm doing (Restor 2.5D multifocal in one eye, multifocal contact in the other) and it works great. Both the surgeon and the IOL manufacturer have agreed that there is no negative to approach as it's allowing me to use the near focal range of the IOL.

    • britkennels
      britkennels derek40125

      Posted

      Your comment, "No matter how good of an IOL you get, it's not going to be as good as a cataract-free natural lens," isn't 100% true. I'm walking proof of that. While I think it's always best to keep your natural lenses as long as you can, there are many of us who never got great corrected vision. I wore every type of contact lens for decades and it's only now that I have 100% (all ranges) vision. Glasses were worse. Try to picture the stereotypical coke bottle lenses and how they'll distort your vision if they're not perched exactly right on your nose and you get the idea. We won't even discuss the major headaches. When I wore contacts, I was lucky to get 20/40 or so. It didn't matter who was the doctor, it was always the same. For many other reasons that I've previously written, this was the best decision I've ever made when it comes to my eyes. The premium lenses mean that I don't have any type of adjustments from close-up to long-distance. It's like my natural eyesight, only better. Having said that, it's important to emphasize that this is my result and no guarantee for others.

      Talk to your doc, Goatfarmer, and then work out exactly what your goals are. You been given a lot of great advice, but in the end it's your decision. You need to be comfortable with the risks versus your desired results.

      The very best of luck to you!

    • derek40125
      derek40125 britkennels

      Posted

      Thanks for correcting me. You are, of course, correct. I meant a correctly functioning natural lens which still has the ability to accommodate and focus.  
    • goatfarmer
      goatfarmer derek40125

      Posted

      I wear prescription glasses for distance and another pair for reading. Went to renew prescription glasses primarily to check for farsightedness when the optometrists  detected the cataract. A few months prior I was experiencing what the Dr. described as 'floaters', dark flashes in my peripheral vision. When I mentioned I had problems with Bifocal glasses and inquired about the multifocal glasses he indicated if I have a problem with bifocal I would find the multifocal glasses even more problematic?  

      Regret I did not do the research prior to meeting with the ophthalmologists, Intend contacting his office and advise I would like approximately 1/2 hour to ask questions and if the presurgery examination does not allow the additional time then I want to schedule another appointment.

      I can not thank everyone enough for their comments and suggestions and feel better prepared for my next visit!! 

    • britkennels
      britkennels derek40125

      Posted

      Thanks for that, Derek! This is why I love this forum...we can all help each other with no one's feelings on the line.

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