Only need catarct surgery in one eye
Posted , 6 users are following.
This is a 2 part question
I recently went to the opthomologist and was told that my right eye's cataract is severe enough so that Medicare will cover the cost of a standard IOC lens.
It will be several years before my left eye's cataract will require surgery.
For right now I get along fine with glasses ( I realize most of my vision is through my left eye, as the right sight is cloudy)
The opthomologist is recommending toric for my right eye because of an astigmatism.
My prescription for my right eye is: SPH: -0.25; CYL +0.50; Axis x085
I did not think my astigmatism is all that bad where I need a special lens for it.
So my first question is: Should I wait until my left eye's cataract worsens before I have cataract surgery ?
My second question is: If I have surgery just on my right eye and have a toric lens installed will I be asking for trouble with vision ? (I am thinking double vision as my left eye will be corrected with glasses)
0 likes, 24 replies
Lynda111 dennis27175
Posted
Medicare will cover a standard monofocal lens, which would include all the lenses Ron listed as well as the Eyhance, made by Johnson and Johnson.
Personally, I would get a second opinion from a cataract surgeon who is a fellowship trained Cornea/Anterior Segment specialist. They have an extra year of training in diseases of the cornea and cataract surgery. Find a surgeon who takes time to talk with you and with whom you feel comfortable.
dennis27175 Lynda111
Posted
What's the easiest way to lookup a surgeon's training such as a fellowship trained Cornea/Anterior Segment specialist ?
Lynda111 dennis27175
Posted
If your surgeon has a website, they will usually describe what kind of training they have. Or you can just google "your city and state and Cornea/Anterior Segment cataract surgeon."
Night-Hawk dennis27175
Posted
I had cataract surgery only in my right eye a few years ago, my left eye still does not need cataract surgery.
I waited until my right eye's vision could no longer be corrected with glasses and worse than 20/40 (the driving vision requirement). Early on I had to get new Rx for my right eye for glasses often when the cataract got worse.
I have high astigmatism in my eyes, for my right eye it was about 3.0D cylinder so I went with a tecnis toric monofocal. That was successful in eliminating the initial right eye astigmatism plus its very close to plano too and the IOL has not rotated in the past few years. However I did end up with about 1.0D cylinder residual astigmatism at a totally different angle so I believe that was probably caused by the incision separately. So I get about 20/25-30 distance vision uncorrected now in my right eye which is very good compared to how it used to be. With eyeglasses compensating for the residual astigatism in that eye I get better than 20/20. I use eyeglasses normally anyway since my left eye still has about 2.0D cylinder astigmatism so gets much worse than 20/40 uncorrected.
Anyway I haven't noticed ever any effects like double vision from the toric IOL. But doubt with such a small cylinder (0.5D) it would be needed however.
dennis27175
Posted
Is laser assisted cataract surgery much preferred over manual incision?
RebDovid dennis27175
Posted
Not according to the American Academy of Ophthalmology. In the Academy's Cataract in the Adult Eye Preferred Practice Pattern, approved by its board of trustees in October 2021, a distinguished panel of experts write: "Femtosecond laser-assisted cataract surgery (FLACS) increases the circularity and centration of the capsulorrhexis and the precision of the corneal incisions. It may also reduce the amount of ultrasonic energy required to remove a cataract. However, the technology is not yet cost-effective, and the overall risk profile and refractive outcomes have not been shown to be superior to that of standard phacoemulsification." (Highlighted Findings and Recommendations for Care, p. 8).
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The Academy publication also states: "A 2020 meta-analysis of 73 studies was published in the Journal of Cataract & Refractive Surgery comparing 12,769 eyes that underwent FLACS procedures with 12,274 conventional cataract procedures. It showed significantly improved uncorrected and corrected visual acuity at 1 to 3 months, along with significantly decreased cumulative dissipated energy, improved capsulorrhexis circularity, decreased central corneal thickness at 1 day and at 1 to 3 months, and decreased endothelial cell loss at both 3 to 6 weeks and at 3 months. However, anterior capsular ruptures were found to be more common with FLACS. No differences in visual acuity were found at 1 week and after 6 months, and there was no difference in posterior capsule rupture rates and endothelial cell loss after 6 months."
RonAKA dennis27175
Posted
No, the evidence is that there is no advantage to a laser incision over a manual blade.