When is the right time to do cataract surgery?
Posted , 7 users are following.
Hi folks.
55 year old male, in the UK. Was first told I have cataracts just over two years ago. I've been myopic since my teens and current prescription is -4 in both eyes. No other issues except I had PVD in both eyes last year which has left me with floaters (I understand that this is a normal age related thing and is not concerning). Not diabetic, no other health problems.
I have seen two opthalmologists who have both advised me to wait as my corrected vision is still good. This is true when reading an illuminated black on white eye chart in "laboratory conditions" but my low light vision and contrast sensitivity have deteriorated. I still drive at night but am aware of needing to be more careful and get halos around lights at night and sometimes glare. Also I ski quite a lot in winter & have increasing difficulty in low light conditions (not being able to see the contrast of bumps and terrain on the snow unless it's a sunny day).
I explained the above to the surgeons I have seen but didn't think they really listened to me, just relying on the prescription and slit lamp exam. One of them said he would do it but call it "lens replacement" not "cataract surgery" (this would mean I would have to pay 100% out of pocket as my insurance company would only contribute if it was deemed necessary)
My vision is functional. I only have difficulties in low light or at night. I would quite like to ditch the spectacles (in so far as that might be possible) and now I know that I will require lens replacement surgery at some stage, I would quite like to do it before I start getting more serious visual problems.
So should I keep looking for a surgeon who will do this now or am I being a bit obsessive?
0 likes, 41 replies
RicG BlimeyORiley
Edited
What do you see without correcting glasses/contacts when you look at a light source (especially circular ones like headlights, or illuminated power buttons)? Do you see multiple instances of this light in a circular pattern? You should keep a distance greater than 0.25m/10 inch (4 Dopters) from the light source.
BlimeyORiley RicG
Posted
Hi. I see a blurry light source with a bit of halo around it, nothing as you describe.
RebDovid BlimeyORiley
Edited
I think you need to find out what the rules in the UK, whether through the NHS or private insurance. Here in the U.S., the surgeons I've seen basically have said it's time for cataract surgery when they degrade your vision more than you're willing to accept. I'm 73, so I think this advice is especially true for someone your age.
BlimeyORiley RebDovid
Posted
Thanks. I don't think there are any rules in the UK relating to this.
The NHS won't provide cataract surgery until you are pretty far gone and then only
Insurance will pay, usually only for monofocal but you can top up for premium lenses. They do require a "procedure code" from the surgeon before they will process a claim and that is down to the surgeon.
RebDovid BlimeyORiley
Edited
If you have private insurance and it's up to the surgeon, then at whatever point you are experiencing unacceptable vision due to your cataracts I suggest finding a reputable surgeon who will give you the "procedure code". It may require multiple consults, but unless you're clearly premature in wanting the surgery, I should think you'll be able to find someone.
BlimeyORiley RebDovid
Posted
Oh I know that I can find someone. There are several companies that would definitly arrange the surgery and provide the code but would that be more in my interests than theirs, at this stage?
I am moving more towards waiting.
Guest BlimeyORiley
Edited
I'm the same age. I have one eye done and and the second one should be done soon. It's up to you. If the vision is impacting your life to a degree that isn't acceptable to you or impacting your ability to work or drive, then it's probably time. What is your best corrected distance vision? Mine was 20/40 in both eyes.
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Some of my issues before surgery were…
BlimeyORiley Guest
Posted
Thanks. My corrected vision on a nice bright day or looking at an eye chart is fine (20/20 or better). It's in low light and at night when it's lacking.
Guest BlimeyORiley
Edited
In that case, I would tend to agree with the advice to wait. If you are correcting to 20/20 that's great. But it's up to you. If those things are critically important to you then you could consider it. But the longer you wait the better the technology gets. There are some exciting new IOLs in development which may reach commercialization in the coming years.
BlimeyORiley Guest
Posted
Thanks. The first surgeon I saw said the same thing, new lenses come out all the time so the longer I wait the better the tech might be.
RonAKA BlimeyORiley
Posted
FWIW, there are no IOLs in the pipeline that I would be holding my breath waiting for. There are lots of promises but not nearly as much delivery. But, you never know. There may be a miracle solution right around the corner that will surprise us all.
Guest RonAKA
Posted
Juvene is in FDA trials and it very promising
RonAKA Guest
Posted
One can always hope. I read about one lens that provided good initial results but the accommodation ability decreased over time.
Lynda111 RonAKA
Edited
Ron
Google intraocular lens market expected to grow Yahoo.
RonAKA Lynda111
Posted
Yes, I am sure it is a market with good future growth, but probably will be driven by better availability to free coverage for cataract surgery. At least in Canada I am sure that there would be many more surgeries if people could get them implanted as soon as they are diagnosed with a cataract, instead of having to wait months or even years. Those changes are occurring in Canada now, and as more more private clinics are allowed to offer healthcare funded procedures the market will grow. Currently I don't think the market is being limited by availability of lenses. Manufacturers are stepping up. It is the governments that are lagging with the funding.
Lynda111 RonAKA
Posted
Yes, I have heard that waiting times are an issue with health care in Canada and the UK. But since Blimey lives in the UK and has private insurance, he will likely have access to new IOLs before those who live in the USA will. The FDA approval process is slow and cumbersome compared to the EMA.
Guest RonAKA
Posted
The Mexican study had promising results (and zero incidence of PCO). The defocus curve doesn't quite match a healthy human eye (it's a little better than an EDOF in terms of range) but since the lens is accommodating the contrast across the entire focus range is much better and dysphotopsia isn't an issue.