Normal 42 year old one week to Posterior Subcapsular Cataract next week.

It looks like with correction your wife is able to see quite well for time being. But I know that can change quickly as within 6 months my cataracts went from being able to be corrected with glasses to not being able to be corrected better than 20/60 in Left eye and 20/50 in Right eye.

Her corrected vision numbers: - in front means near sighted and need correction for distance. + in front of number means far sighted and needs near vision correction. Diopters ate in increments of .25

Cataracts depending on where they are can cause a lot of blurring. Typically surgery recommended when a person's vision can no longer be corrected with contacts or glasses and if they can be best to wait, experiment with contacts and get all the info on lenses you can. In Canada if vision with cataracts is 20/40 or worse the surgery and monofocal lens is covered by health insurance. We pay the difference between monofocal and premium lens if we want another lens. You can check with your country's health olan to see what is covered.

Those numbers are very low so she doesn't need a lot of correction (power) in her lenses. It looks like due to cataracts the eye exams couldn't provide the doctor with a complete picture. Eye pressure is normal. Usually concern if it goes above 22 mm Hg.

Thanks Sue, you are very helpful!!!!!!! 😃

I have got appointment with 2 different surgeons lined up in next 15 days. I want to hear what they have to say and then decide who we want to go ahead with.

The Eye doctor who diagnosed my wife said I could wait 1-3 months but advised not to wait longer as vision would deteriorate.

Our insurance will pay for the cake and we have to pay for the icing. We have government regulated private insurance here. Everyone has to have one by law.

I am not rich but can afford whatever is required for my wife!

You're welcome. Wishing the best for her. It is a tough decision and the best decision varies person to person. Good to allow time for shock to wear off and explore the various options and surgeons. A lot of the result comes down to their skill and expertise.

Younger you are you'll want to consider those options to keep on with work and active lifestyles.

best of luck to her.

younger you are the more drastic is the shock of vision loss.

Yes very hard pill to swallow when it isn't even on your radar.

Subjective refractory values from the right +0.5 -0.25 103 °, left +0.5 -0.75 137 °

Those are the numbers commonly used in prescriptions in the US. They indicate that without any correction, your wife is slightly farsighted at the moment. The middle number indicates some astigmatism (more in the left eye), and the 3rd number indicates the axis of the astigmatism. The cataract itself can cause astigmatism, so your surgeon will make some calculated guesses about correcting that. In the US, the toric lenses aren't covered by insurance (tho I believe they should be!) The right eye astigmatism is so small, they probably wouldn't bother to correct it, as it's within the margin of error for surgery itself.

Re: normal vs. cataract patients -

Before cataracts, I was extremely nearsighted, so had incredibly good near vision and terrible distance vision. I wore multifocal contact lenses set to give me normal near and intermediate vision and decent distance vision, then wore low powered glasses over the contacts to drive or to see something at a great distance. Personally, I couldn't stand to wear readers all the time, so this was my choice both before & after cataracts.

Since your wife's visual acuity in both eyes is still very good (compared to many patients), I suspect she will be easily able to tolerate having the IOL in the left eye for as long as necessary until it is time to do the right eye. (Many doctors push patients to do the surgeries within 2 weeks of each other, but that's usually more of a financial motive on their part rather than a genuine need for the patient. Many of us here recommend waiting at least 6 weeks between surgeries as it takes that long for the eye to heal & the IOL to settle, so you can't know the final result till then. I waited 4 months in between.) So you should have plenty of time to experiment with a contact lens in that eye.

Your decision for now would seem to depend on knowing which eye is dominant and then choosing near/intermediate/distance aim according to the most prominent daily vision needs. Your surgeon or optometrist can help you determine eye dominance.

So today I decided to go and get my eye checked at one of the biggest glasses chain here as I was feeling bit weird and my eyes were feeling dry. Luckily I still have 120% far vision and +1.25 and +1.5 for reading glasses (if i remember right). It has stayed same for 1-2 years and I never use those glasses anyway.

So then I got talking to them about my wife and their experiences with cataract customers. I went to two of their shops is different parts of the city and both times I was lucky to find a person who was willing to waste his work time for free.

Both guys said that lot of the people who come after premium IOLs are very disappointed compare to monoflcal IOL patients. Lot of time they even need thicker glasses than pre operation.

They both said if their family member was being operated, they would go for monofocal IOLs set to far.

The second shop guy said similar but he added something else. He said that even the ones who get it perfect initially have issue few years down the line when the power of their eye changes with age etc. Then making glasses gets bit complicated with multifocal IOLs.

I then asked him about progressive glasses and he was very nice and explained in detail. I tried them on to get a feel of how they look/work. As someone who does not wear glasses I was quiet impressed by the technology (within the bounds of physics)

He also said I would avoid IOL set for near in one eye and far in another. This is something a friend of my wife who wears heavy contact lenses said too. She once lost one of her contacts while at work and it resulted in a bad experience.

So my initial gut says go for monofocals set to far and use progressive glasses/contacts.

It really depends on each individual.

If a person abselutely hate the idea of glasses, then most are willing to trade in some negative side effects for less depence of glasses.

It really depends on what feels right for your wife, maybe what is right for you is not the right thing for her either.

I know 3 people, that have monofocal lenses with monovison, where one is set to look near, and the other for far.

Two of them do not wear glasses in their daily life, and one of them have had add on lenses in both eyes, because he was depended of glasses most of the time, and now he is not.

All three thinks they have what is right for them, from what options they have.

In the reception at my local eye clinic, the two receptionists working there both have had the Ziess trifocal lenses one year ago, and they absolutely love it.

They never use glasses and when I asked them about contrast lost, they looked at me like I just landed from the moon, they have never giving it a thought.

They both have some of the side effects at night, but they are so happy with what they have got, one of them did not even have cataracts before the surgery, she just wanted to get rid of the glasses she had been using all her life.

It all comes down to what feels right for your wife.

Cheers

Christian

I'm very surprised by what the two optical shop employees (where they licensed optomotrist, opticians, or just regular staff?) told you as every major study shows very high levels of satisfaction with the latest generation of premium IOLs (and you are in Europe, so the customers they see should be the ones getting the latest IOLs). It's good you are asking lots of questions from lots of different sources.I'm sure the optical shop employees are trying to be helpful, but it is interesting that they are suggesting to avoid the only two options which could result in no need for glasses at all (premium IOL and mini-mono). Be sure to ask your wife's two pphthalmologists all your questions and see what they say.

Studies also indicate satisfaction has a lot to do with expectations. For people going in expecting the perfect outcome, they may be disappointed. For people who go in with full knowledge, that even with premium IOLs, they may or may not be completely free from glasses, these people are generally more satisfied.

Ask about potential future vision changes too. My understanding is that lens power is unlikely to change after cataract surgery, even as you age. But ask your eye doctors this question. What could change is astigmatism could change as you get older. But this can usually be adjusted for with a minor laser surgery adjustment.

Monovision (one eye for far, one eye for near), I think ideally is something that you would test out with contacts lenses to see if your wife can adjust to that. Since your wife doesn't need glasses, testing this may not be viable, so that could rule out this option.

For further research, search for a really indepth research article on all the premium lens options:

"Premium intraocular lenses: The past, present and future"

A more limited article: "Young patients express high satisfaction in visual acuity with multifocal IOLs" (based on a limited number of patients under age 40).

Progressive lens eye glasses aren't always a great solution. I am personally the type who is very conservative in dealing with my eyes. So even though my wife got laser eye surgery, I never had laser eye surgery. I've used progressive lens eye glasses for many years. Vision is just ok.

No one is going to definitively be able to give you an expert opinion from a glasses shop. IOLs have come a long way in last 10 years and the pace if change is accelerating. My own optometrist advised me sternly against premium lenses for same said reasons so I went back to my surgeon for another consult with more questions. In Canada due to our healthcare system our cataract surgeons get paid same amount no matter which lens a patient opts for. He said that the lenses are better now and the happy patients rarely go back to see their optometrist if they don't need glasses. So just like on these forums there are more negative reviews than positive - same can be said for optometrists selling glasses.

I actually go back to have my eyes checked yearly as I have a good health plan with my employer and my latest checkup my optometrist grudgingly says I have a good result with my premium lenses.

Please don't mistake my enthusiasm for pushing you towards premium lenses - just want you to explore all avenues. i know people very satisfied with monofocals and dome that are not. Same with premium lenses.

You've said that so much better than I. At work and wanted to weigh in.

I am in Canada and don't have access to latest IOLs.Worried don't limit the exploration and optometrists are not the place for accurate info on this. They would be good to give your wife contacts to see how she does with monovision. Full monovision very difficult to adjust to and loss in depth perception not great as you age. Mini monovision likely very good option if your wife determines monofocals are her solution.

i cannot deal with monovision and cannot deal with progressive lenses. right now i have good distance with Symfony eye and good near with unoperated eye. Both distance and near are irritating for me. That seems to suggest that monovision will not work for me.

mini monovision or -0.5 myopia in both eyes is good because cataract surgery induced -0.5 astigmatism for which I wear glasses. If I am wearing -0.5 glasses for astigmatism I might as well wear -0.5 glasses for myopia while getting little better vision with near. also binocular vision with both eyes at -0.5 would be 20/20.

also when i wear my astigmatism glasses my near becomes even more worse as astigmatism correction makes near vision worse.

HI:)

Yeah, as others have replied - a lot of misinformation coming from the glasses shop staff. After IOL is implanted there is no change due to aging. You could get macular degeneration later but that is generally considered a result of genetics and diet, not aging per se. The relative permanence of the choices made now is why many of us researched our options before surgery.

Going without a contact lens for a day is not a good comparative test for mini-monovision at all!! You have no idea what the person's prescription was, hence the diopter difference between eyes. Actually now people are beginning to use the term "micro-monovision", which is what I have, with a difference of only a half diopter (0,5D) between eyes, (vs. 1 diopter for mini-monovision). Either of these would be far less than the prescription for your glasses that you don't bother wearing.:)

As someone else wrote, what works for you may not work at all for your wife. I haven't seen her preferences mentioned yet. Chances are she will have a better idea once she sees the 2 opthalmologists. Does she speak English? This should very definitely be her choice, as she will live with it for the rest of her life.

No doubt you will go thru a number of "decisions" and reversals in this research process before you arrive at a final sense of the best course of action. 😃

Just to be clear when I speak about "MY" preference, I am basically speaking about her preference. I don't have any preference as such because I don't know what to choose or what would be right or wrong choice for her or for anyone 😦

She also keeps changing her view 😦 I will start a list of questions to ask the surgeon on Friday!

"My understanding is that lens power is unlikely to change after cataract surgery, even as you age. But ask your eye doctors this question. What could change is astigmatism could change as you get older. But this can usually be adjusted for with a minor laser surgery adjustment."

Yes I will ask the surgeon. Yes I understand the actual IOL lens power might not change but if shape of your eye etc changes then is the end result not similar?

Regarding minor laser surgery, so in laser surgery the shape of the cornea is changed? How many laser surgeries can a cornea handle if it needs one every 5 years or so as you age?

It is all so confusing to be able to make the right choice!

Yes everything will be her choice! I am only helping her as she feels helpless currently as far as making a choice is concerned. Hopefully after seeing the two surgeons we will have more clarity!

Yes my wife speaks English and 100% fluent in 6 languages 😃 Most of the questions I have asked here are actually from her 😉 I am just being her personal assistant.

I may have worded it poorly, but yes of course the power of the implanted IOL lens will never change. What myself and some of the other people are saying is the eye itself is not growing once you are an adult, so we've never heard of the eye needing a different power lens as you age after cataract surgery.But you should ask the doctors to see what they say.

I think what can change as we age is degree of astigmatism, as shape of the cornea changes. For people with glasses, this could require a change in eye glass prescription.

During cataract surgery, and after cataract surgery, astigmatism can be corrected with a very safe procedure called "Limbal Relaxing Incisions" . These are tiny incision made at the edge of the cornea, that relaxes the cornea and allows it to be more rounded. So not as invasive as directly changing cornea itself.

I would add that I think most people are not going to require adjustments after cataract surgery. But if the concern is astigmatism changing as you age, Limbal Relaxing Incisions are a safe and available option to address that should the need arise.

Worried - this is s cut and paste from Mayo clinic as we cannot post links.

I asked my surgeon about prescription changing and he said only during 6 week healing process as IOL settles.

''Will my vision deteriorate after cataract surgery?

Answer From Alaina L. Softing Hataye, O.D.

No, your vision generally doesn't deteriorate after cataract surgery unless other problems arise, such as macular degeneration or glaucoma.

In cataract surgery, the eye doctor (ophthalmologist) removes the clouded lens from your eye and replaces it with a clear, artificial lens. This lens is very durable and should last for the rest of your life. Sometimes the capsule that holds the artificial lens becomes cloudy after cataract surgery. This can affect your vision. An eye doctor can use a laser to make the lens capsule clear again."

If your wife does speak English she may want to pose questions herself. I know the forums were and still are a tremendous help and support. Hard to get that second hand. She may still be dealing with shock of it all but as time passes she may wish to reach out. We are of all ages and stages of cataract surgery and inly want best for her. There will be dome she'll connect with more than others and it'll be a good support for her.

Sometimes the capsule that holds the artificial lens becomes cloudy after cataract surgery. This can affect your vision. An eye doctor can use a laser to make the lens capsule clear again."

Her Mum had that come after cataract so chances are my wife will get that too! Grrr!

I will get my wife to post here on the weekend.

PCO (cloudy lens) is much more common than thought. A number of articles I have read say if one lives long enough you'll get it. I am starting in LE and today marks 2nd anniversary of first surgery for me.

Square edge IOLs do a better job at preventing it vs round edge. However square edge IOLs have higher incidence of edge glare than round ones. Another compromise / trade-off in IOL selection process.