How many weeks in-between surgeries?

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I saw this post in these forums-

Here in Canada the wait time between surgeries for cataracts is 4 weeks -  6 weeks apart.  The surgeons want to know where first eye ends up so they can make adjustments to the target of second eye.

Sounds good,  but in the 5 weeks inbetween my surgeries I think the first eye that was done was only checked 1 day and 1 week after surgery.  Usually you have a 1 month check but I didn't on that first eye. It was checked the day after my 2nd eye surgery , so 5 weeks from the first surgery.  

I was supposed to have them 2 weeks apart  but had to reschedule due to a bad cough. Still, if I'd had it done 2 weeks after the first , as planned , they wouldn't really have known yet where the first eye "ended up." to be able to make adjustments.  I'm guessing they usually see changes/improvements in the month post-op visit from the 1 week  post-op visit . I have no problems with mine but I think I'd advise others to wait  5 or 6 weeks in-between surgeries. 

However I do understand that some have trouble during that in-between time. I found I could wear one contact and be okay , but when I tried my glasses (one lens had been replaced with clear glass) it was very disorienting. I think it was because my first eye done was done for near vision, the contact Ii had in my 2nd eye was for far vision, but my glasses were multifocals.

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  • Posted

    6 weeks is probably better  if changes are to be made in the 2nd IOL based on how you are doing a month later with the first IOL. The dr's office may need a week to order the IOL. 

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  • Posted

    I had my second eye done in 4 weeks,maybe I should have waited longer ,since I have a dark shadow/rim in the corner of my eye.The surgeon claims it will go away in 4 months. I have yet to see any changes from day one.

    I am scheduled to have YAG treatment tomorrow to clear up the cloudiness on the back of the lens.My left eye has cloudiness also,not sure what his plans will be for it,whether a lens change out to get rid of the black shadow/rim.They say once you have the YAG treatment it's very difficult to replace the lens after the fact.My eyes are worst from the surgery than before the implants.I just hope with time things get better.    

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    • Posted

      Yes once you have YAG procedure it is trickier for lens exchange so if you are contemplating that you should hold off.

      The black rim you see could be edge of IOL.  Some IOLs are more prone to that than others but those come with another complication so it’s a question of which you’d rather.  If the rim is something you see at night with lights then it is more due to your pupil dilating beyond the IOL and that will disappear in time as you age.  Pupils dilate more when you are younger.

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  • Posted

    Hi - I think that quote for time between surgeries is mine and yes Canada (due to surgery being covered by Medicare for cataracts) there is a wait time between surgeries.  About 4 weeks.

    I realize other countries do things differently.

    The only exception would be if you did the surgery privately (not for cataract reasons) but to be rid of glasses.  In that case I have seen them do the surgeries close together.  In my opinion this is done like lasik so no one can compare new vision with vision out of other eye that still has it’s natural lens.

    Yes for cataract surgery it is a long wait and troublesome to manage in between the surgeries.  But I thought of it this way.  I would rather be inconvenienced a few weeks versus put up for rest of my life with sub par vision.  That newly implanted IOL takes weeks to settle and adhere and as it does you could be off target and be slightly more near sighted or far sighted than you wished for.   The 2nd surgery can compensate a bit for that so that you don’t end up with too much of a monovision to deal with.

    Just my opinion but short term pain for long term gain is my bet.

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    • Posted

      The wait time is much longer here, in Metro Vancouver alone currently there are around 23k people waiting for free cataract surgeries. I also read up on the guidelines for 'surgical management' in BC, it can be 20/50 or worse. Sigh! Perhaps we should move to Qc or the Maritimes.

       

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    • Posted

      Quebec is better - my friend says they even pay premium lens cost there.  I think here once yourveyes cannot be corrected with glasses you are approved for cataract surgery however wait to see opthamologist is about 3 months and then I waited another 4 months before first surgery.
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    • Posted

      I am not convinced scheduling cataract surgeries a week a part is best course of action.  However if that is what someone wants not my place to say otherwise.   One can choose their course of action but has to live with the outcome.
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  • Posted

    Annoyingly here in the UK waiting time between surgeries. Well I'm still waiting I had my first eye done 31st January this year. Those getting done at 4-6 wks tho to me it's too early as my eye was much better at the 8 wk stage. But it's 5 mths later and the difference in eyes is awful to deal with I feel like my life is on hold.

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    • Posted

      That does seem excessive.   I know UK like Canada cover the expense of cataract surgery (cataract has to be bad enough though - meaning vision cannot be corrected with glasses anymore). Is it same in UK?
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    • Posted

      In the U.S. for insurance to pay it’s either 20/40 or 20/50 . If that’s all they can correctnyou to you qualify. 
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  • Posted

    I only had one eye done (with the other cataract not causing problems yet) and can say that my vision changed from immediately post-op (about -1.0D) to a little more near-sighted (-1.25D) after about 8 weeks.  I had the sense that it slowly changed somewhere between 4 and 8 weeks, but I can't be sure. Seems stable now (8 months post-op) though I haven't had a recent test. The .25 change may not seem like a big deal, but I assume many on this forum would interested since they may be aiming for a specific result.  The actual target was 1.39D so I guess it ended up pretty close in the end.  Fortunately, my other eye is similar, so I didn't have to deal with the problem of interim asymmetry.

    If I had to do both eyes around the same time, I'd definitely want to wait at least 6-8 weeks, if at all possible, just to be sure about the second target.  Hope this helps.

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  • Posted

    I think that it is a good idea to follow the advice in your quote "The surgeons want to know where first eye ends up so they can make adjustments to the target of second eye."

    Unfortunately, many surgeons don't follow that rule. In that case, it is up to a smart patient to make sure that there is enough gap between the timing of the two surgeries.

    It is important to have enough period between the 2 surgeries not only for "the

    adjustments to the target of second eye" but also for the adjustment in the calculation of the IOL power of the second eye, if needed, based on what the surgeon learns from the amount of error he/she made in the calculation of the power of the IOL for the first eye.

    If there is a scheduling conflict to have the first eye checked about a month after the first eye surgery, one should delay the second surgery until at least 2 weeks after the first eye examination to have enough time to make the right decisions for the second eye.

    I know that doing this prolongs the period of less-than-desired vision combination of the 2 eyes, but that is worth it because of the associated long-term benefits.

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    • Posted

      Your drs there must share a lot more with you because all these numbers mean nothing to me. No one ever told me what my target numbers were .
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    • Posted

      Unfortunately, even in our area in USA, most of the cataract surgeons don't  spend the time to educate or discuss with the patients on the target vision distance they are trying to achieve with each eye. They just try to get each eye set for far distance and assume that that serves best the need for everyone. And if they don't achieve their target, they just gloss over that fact.

      That is where being an informed consumer helps. If one asks the surgeon the right question, then he/she will hopefully discuss the distance choices better.

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    • Posted

      I am worried about this myself.. My vision was tested at 6 wks when it took a bad turn.. He has based his opinion on what the target is for my other eye surgery on thus but my eye corrected itself at 8 wks ND was much better. Now I'm worried about the results I will get on my second eye when I get my surgery.

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    • Posted

      In my case they were not both set for distance. 

      I have monovision- one for near and one for far distance. I asked  the optometrist who checks me after,  if I’d have better distance vision had I gotten Symfony lenses. He said he didn’t think so. 

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    • Posted

      I am confused - I thought you were advocating for having surgeries close together?   

      If you did (knowingly that you wanted monovision) I would say it is even more crucial to wait for first eye to settle and know that prescription before looking at a target for second surgery.

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    • Posted

      No, I am advocating for waiting about 6 weeks. Of course, if someone chooses not to, that is their choice. The fact that it seems standard here to schedule them a week or two apart makes me wonder if many doctors don't even think about making adjustments for the 2nd eye.

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    • Posted

      A good surgeon will, however when these are done on Medicare dime and no extra money whether they spend time with patients or not - most are too busy and the majority of patients aren’t informed enough to know what to ask.

      No matter what you are purchasing or doing in life it is buyer beware or patient beware - need to inform yourself.  

      When I was first diagnosed it was a total shock - didn’t even know what cataracts were except something my mother in law had done a while back.  She spent 2 weeks at home staring at the floor (not sure why) except we were told she was not to focus or watch TV.   She wore thick glasses afterwards.  Needless to say I was horrified about this surgery.  First thing I did as it was a 3 or 4 month wait to even see an opthamologist was search on the internet for information.  I went to my appointment armed with questions.   The doctor was surprised by all my questions that he had me come in again for another session before I made a lens selection.   

      I was with 15 others for surgery at the hospital.  And with same group at 24 hour post op.  No one else in that group of 15 was even aware of different IOLs or targets and one was completely ignorant that her natural lens was removed.

      What does that tell you about the masses?

      Same doctor- only one of us had a full discussion.  Blame the doctor or the patient?

      With wait times for surgeries in Canada are very long - sad but true but our doctors are far too busy to spend that kind of time with each patient but if you have questions they will.  He didn’t get any extra funding for spending that time with me.

      I am currently waiting to see an ENT - 18 month wait!!!! 

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    • Posted

      Forgive me if I have mixed you up with someone else.   I though your earlier posts (prior to surgery) was that you wanted full monovision although you were contemplating Symfony lenses at the time (I think from what I remember).  But settled on full monovision because that is what you were accustomed to with contact lenses for years.

      Are you regretting going that route?

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    • Posted

      No regrets. I asked after, if I'd have better far vision had I gone the multifocal route (out of curiosity) and he said probably not. One week post op I was 20/32 in my distance eye and I think they expect it to still keep improving. 

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    • Posted

      I , like you, asked A LOT of questions and did A LOT of research beforehand.  At my initial visit, they had me watch a video explaining it all-what was done and why. I can't remember if it talked about the IOL choices, but he did with me. 

      I wonder if your mother in law had the old style surgery before they had artificial IOLs-they took out the old lens and had to wear very thick glasses or a special contact. But I thought that was replaced in the 1950's.

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    • Posted

      If it’s any comfort even if you ask all the right questions and do the reseRch there is no 100% guarantee things go as planned or target achieved.

      My mother in law is still living but now has dementia an been living in an assisted care facility.  Would love to ask her questions but unfortunately she doesn’t know any of anymore. She used to have some lucid moments but not anymore.  I looked up the history of cataract surgery and phaco was used only 5 to 10% of the time between 1985 and 1990.   By mid 1995 it was used 50% of the time.  So I am guessing my mother in law did not have the modern type of cataract surgery or if she did the incision was much larger than it is today.

      My own parents don’t yet need cataract surgery so I didn’t have anyone I knew to discuss my options.  My dad’s older brother lives in UK so my dad asked him a few questions on my behalf.  He went private route 5 years ago and got multifocal lenses and likes them.

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