Cataract Surgery experience, outcome & questions regarding Alcon Acrosof IQ

Thanks for your response! 😃

I do tend to overanalyse everything in life especially when it comes to my health.

I was diagnosed with mild hearing loss in my right ear last year (an ear which has the worst tinnitus in the world) and so the discovery, months later, I had cataracts as well was like a double whammy!

Did you find the peripheral flickering settled eventually? Just seems to be when I look down or sideways. I am assuming this is the IOL settling in.

In terms of sedation I was given a tablet to take the edge off my anxiety; would by far have preferred to have been out of it entirely as eye surgery was ALWAYS my biggest fear but in the UK it seems to be a case of grin and bear it.

I just wasn't expecting any pain at all so that was little disconcerting.

Did you get the desired outcome from your surgery? I'm watching tv right now and with my right eye closed, my left is tack sharp. It's bearable with both but my eyes get tired quickly due to the imbalance.

Did you get the desired outcome from your surgery?

I did. I have -2 lenses in both eyes, although one wound up at -2.5. I've been highly myopic most of my life and wanted to retain my close vision. I'm exceedingly happy with the outcome.

As for flickering, I never had any. I did have negative dysphotopsia in my right eye for about 2 months, occasionally seeing a dark crescent in my peripheral vision, but it wasn't a big deal and went away.

That's great you got the desired outcome!

I went back and forth over distance versus near quite a bit. I was trying to evaluate how it would impact my interests, like photography or my artwork for example and decided I wanted to at least be free of glasses for those glorious hikes in Snowdonia or to see the night sky. The latter means so much to me as I often indulge in astrophotography.

I really won't know how I will feel however until I have my other eye done as right now I'm using my iPhone unaided, so best of both worlds.

hi bookwoman. what is the relationship between iol prescription and glasses or contacts prescription (assuming you used one or the other)? in other words, was your glasses or contacts also a -2? (Im aware contact and glasses prescriptions r different). thx!

Before surgery I wore high-index glasses with a prescription of -8 in both eyes. (I did wear contacts for 40 years, but stopped 7 years before my cataract surgery, so I don't remember the prescription.) One more advantage of surgery: much less expensive glasses!

My current progressive glasses prescription is the same as the outcome of my IOLs (-2 and -2.5).

so since progressive glasses cover most focal points and a wide range, in what range are you glasses free? and im assuming your iol lenses are single vision, correct?

Correct. I'm glasses-free for everything indoors except watching TV. I mainly wear glasses when I leave the house.

Hi Bookwoman,

When you say, I'm glasses-free for everything indoors except watching TV, how would you describe seeing indoors?

Slightly blurry, but it's not like I'm bumping into walls or anything. Everything is clear enough.

That worked out really well!

Hi Ron,

I could try a contact lens but conscious I've never used them, so unsure how easily I would adapt!

Mini monovision was an option discussed at my first appointment so it would make sense to try it out with a trial run.

That is bad luck with the PCO - so many variables with outcomes I suppose I just have to be philosophical about the whole thing and not fret so much.

If you get a cooperative and patient contact lens fitter they should be helpful in getting you into a contact for your right eye. I have found some contacts are much easier to handle than others. The top three contacts I have found for comfort and ease of handling are:

.

1. CooperVision MyDay
2. Alcon Total1
3. Acuvue Oasys 1 Day

   .

   The very worst ones to handle that I have used are Acuvue Moist. Avoid them like the plague... They are like trying to put a round piece of cling film food wrap on your eye. They don't want to stick to your eye, but love to fold back and stick to your finger.

   .

   Keep in mind that you will not need contacts after your second eye surgery. This is just a short term trial to see if you like it or not.

   .

   Right now with your right eye at -2.75 D you have full monovision. That used to be popular, but as you have noticed your vision starts to drop off at 18" or so, while your other distance eye does not start to be good until 3 feet. That leaves a pretty significant gap with not so good vision. That is why full monovision is not used very often and the preference is mini-monovision. At -1.6 D my close eye actually gives me pretty good vision on a large screen 4K TV at 8 feet or so. It is not quite as crisp as my distance eye at that distance but it is pretty good. I have no gap between the two eyes. For some reason I have been fortunate with close vision in my distance eye. I can see down to about 18-20" and if I sit far enough back I can read my 24" computer monitor. Your 3 feet is more typical for a distance eye though. I think I am getting some of that near vision from the astigmatism in my distance eye.

Thanks Ron, very useful! Ive had the worst day today with my vision and have had to take the rest of the week off work for that reason and extreme fatigue.

Every time I think my eyes are working together a bit better, the blurriness returns with a vengeance.

I am going to try and see an optometrist this week to evaluate my options whilst I wait for my follow up call from the hospital and, hopefully, second appointment.

I'll relate what you've suggested and see if I can be fitted with contacts at those values.

It will be difficult to deal with a 2.75 D between the eyes. One option that some use is to just remove the lens from a pair of prescription glasses for the operated eye. That can help, but using a contact lens to correct the unoperated eye can be even better. I started out by using the one lens removed method, but changed to using a contact instead. I get my prescriptions lenses at Costco and they were very cooperative in removing the lens in a pair of glasses, and also in giving me some free trial contacts to simulate the mini-monovivion.

ron, can you explain a kittle how astigmatism improves near vision? thx

I look at the eye like a pie cut to four pieces. When you have no astigmatism all the pieces bring the light to the same focus point and all you need is a spherical correction. Regular astigmatism is when two opposite segments bring the light to the same focus point but not to the same one as the other two segments. That is why a prescription with astigmatism will have the basic sphere correction and then an additional correction with an angle associated with it.

.

But to your question, the extension in the depth of focus which can improve near vision comes from having the two segments stretching the depth of focus. There is a price in visual acuity, but it can extend the depth of focus somewhat like an EDOF lens does.

Just thought I would provide an update here on my experience so far.

In terms of visual side effects I still have the annoying peripheral flickering but it seems be lessening. I've read this is common and 'should' hopefully dissipate.

Less expected is the retention of star bursts when looking at artificial lights - not really dissimilar to my right (cataract) eye but sharper in definition with a long horizontal shard of light emanating from the source. It remains to be seen how this will impact night driving in the long term as I've yet to undertake any driving which wasn't during daylight hours and very local, given my imbalanced vision! Looking at the moon the other night with my good 'new' eye, I was a bit disappointed at how blurred it looked. Perhaps I am expecting too much, too soon from just one eye!

I hope the starburst issue will disappear eventually as the lens settles in, however, as I have mild astigmatism in my left eye, I'm thinking it might well be a permanent feature.

Finally, I have developed a very slight blurriness now when watching tv - it was incredibly crisp with no blurry edged text to begin with but I've since noticed a minor decline. Thinking it might be related to the fact my eye has been very irritated lately by the eye drops. This morning it was almost impossible to work as it felt scratchy and sore (seems ok now).

I have my next surgery booked for 13th July and to be honest cannot wait to be a month or two out from that date with no eye drops and decent vision. I would rather not wear glances for distance at all but whatever prescription I end up with I'm just thankful I can see an end date to all the anxiety and stress I've had over this since being diagnosed!

Hi Ron, Did you like the mini-monovision right away or did it take a little while to get used to it?

The honest answer is probably that I don't really remember! I first tried monovision with contacts perhaps 10-15 years ago when I was trying to go eyeglasses free while suffering from presbyopia. About all I recall is that I was having trouble with the handling of contacts at that time and got frustrated with them. But, when I got the contacts in, I don't recall any issues with vision. So, I think went several years just using progressive glasses as I have used since I was 45 or so. When I got diagnosed with cataracts and the possibility of using mini-monovision was raised, I went back to the contact simulation. This time I put more effort into finding good contacts that were easy to handle, and it went pretty well. I don't recall any adaptation period to monovision.

.

I noticed in another post to a "Bill" that you were asking about a number of potential issues with mini-monovision - " the noise, ghost images, fuzz, grit, and distortions".

.

Actually none of those issues should be created by mini-monovision. The actual potential issues are a small loss in depth perception but only in the very near zone where your eye corrected for distance is not providing a real clear image. If fine motor skills are required at a very short distance then all you have to do is pop on some OTC readers, or your progressive glasses. But that said I have actually been able to thread a needle without readers or progressives. It just means you may need an extra try or two to hit the eye of the needle.

.

For me at distances from 2 feet or so out to 8 feet I have very good binocular vision and depth perception because both eyes are very useable in that range. And, beyond 8 feet depth perception is not really a requirement. I park in a very tight garage and have to come very close to the door frame with the passenger side of my truck. So far, I have not hit the door frame with the side mirror, which I have to fold in because the space is so tight.

.

I have seen "exercises" to do to adapt to monovision, but frankly I am skeptical of the need for them. They seem to be intended to make the eye that is somewhat out of focus work better. I think the opposite is what is required. You need the brain to pick the better of the two eyes and ignore the less sharp image. I find that happens without me thinking about it.

.

The other symptom I have seen reported but not experienced myself is a feeling of dizzyness or unbalance. I suspect that is probably like getting a new pair of glasses where the prescription has changed substantially. It feels a bit odd for a few days and goes away. But, as I have said, I did not experience anything like that.

.

Your temporary eyeglass solution will be a good test, but not ideal as having one eye corrected with an IOL and the other corrected with an eyeglass lens can present an image to the brain that is not the same size. That can be a little annoying with a bit of a dizzy feeling, but that effect goes away when both eyes get corrected with an IOL.

To add another anecdote for you...

I had zero trouble with monovision from Day 1. I remember it well, because I am a perfectionist, and at the time I was very concerned that imperfect vision in one eye would bother me. But it was totally fine.

I was relatively young at the time (LASIK, not cataracts), and perhaps that makes a difference. I got about the same -1.5 D monovision that RonAKA recommends, and I am considering something similar now for my cataracts.

Thanks so much for responding to all those questions!

Thanks Phil. I think I would have been less frightened by eye surgery back in the day. I remember being terrified when I was told about needing cataract surgery shortly before COVID. I've been consumed with not making a mistake in terms of the surgeon, lens choice, everything really! I'll be interested to hear what you decide for your cataract surgery.

" I think I would have been less frightened by eye surgery back in the day."

Maybe, maybe not. I remember that I got physically ill when they explained in detail how they actually do the LASIK procedure. I had to sit in the ophthalmologist's office for five minutes with my head between my knees before I could drive home.

😃

These are big decisions. I hope it all goes well for you.

Thanks Phil