Cataract surgery questions

Discussion in 'Laser Eye Surgery' started by Luis Ortega, Oct 24, 2007.

  1. Luis Ortega

    Luis Ortega Guest

    I am planning to have cataract surgery on my eyes.

    I have been nearsighted since about age 14 (need glasses for distance
    seeing) and am now 57, but for about 4 years around age 48-52 my eyes got
    better and I stopped wearing my glasses. They then went back to being
    nearsighted and I also started needing reading glasses for close-up seeing.

    I was told that I had cataracts starting about 10 years ago but it is only
    in the past two years that it has become a problem with driving at night and
    any sort of glaring lights shining in my eyes.

    Now my eyes seem to be perpetually smudgy as well (like looking through
    dirty glasses) both near and far. One eye is definitely worse than the

    When I go to have the surgery, can I ask for lenses that will allow me to
    see clearly at a distance without glasses or will my previous
    nearsightedness make that choice impossible? I would prefer to be able to
    see at a distance without glasses and use glasses for close-up work if that
    is possible.

    Is it a possibility to have one eye set for clear vision at a distance and
    one set for close-up vision (without glasses) or would that tend to cause
    too much eye strain?

    At my age (57) is it likely that whatever lenses I am fitted with now will
    eventually become incorrect as I age and my eyes change shape, assuming I
    live to be 75+? Do people have multiple cataract surgeries as they grow
    older if the fitted lenses become incorrect?

    Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
    (after the operation is fully healed)? Could that damage or wrinkle the
    lenses and impair your vision?

    Finally, I am very squeamish about my eyes and could never adapt to contact
    lenses when younger. The thought of someone cutting into my eye and doing
    things in there creates a lot of anxiety for me. What can be done to make
    sure that I don't twitch or move during the actual surgery and mess up the
    surgeon's work?

    Both my mom and her twin sister had early cataracts in their 40s and
    underwent the old cataract operations done back in the sixties which left
    them bedridden for many days and having to wear those coke-bottle lens
    glasses for the rest of their lives. That may be where I get some of my
    anxiety, but whatever the cause, it worries me that I could do something to
    screw up the operation. I figure that the second eye will be easier after I
    get through the first operation.

    Thanks a lot for any advice.
    Luis Ortega, Oct 24, 2007
  2. Luis Ortega

    Dan Guest

    I had cataract surgery about a year ago, one eye in November and the
    other six weeks later. I'm still thrilled with the results. For a half
    century I wore eyeglasses for everything. Now I don't need them
    (except for reading). I drive legally without glasses; the DMV
    removed their "corrective lenses" restriction. Wow!
    My situation, too. My eye surgeon (I'm not a medical professional) set
    me up for distance vision and glasses for close-up without my even
    After reading and talking to my surgeon I got the impression that one
    distance eye/one near eye was possible but tricky to adjust to. I
    I understand that after healing, "normal" eye rubbing is OK. I rub my
    eyes from time to time. They're OK.
    Right. Pre-surgery anxiety. Of course, I had it, too. The best comment
    I can think of is: if I had a choice now to have another cataract
    operation or to go to the dentist, I wouldn't hesitate to avoid the
    dentist. The eye surgery would be my hands-down choice.

    I think the risk of you doing something to mess up the operation is
    small. Before my operation, the nurse washed around my eye with
    topical antiseptics and painkillers. They also gave me an IV for
    sedatives (and whatever). An anesthesiologist was part of the surgery.

    During the surgery, they propped the eye open with some kind of small
    wire frame. I really couldn't see it and, more importantly, it was
    not uncomfortable. And because of the local analgesics, I could feel
    NOTHING. I repeat, NOTHING at all, including whatever the doctors were
    doing tinkering around in there.

    If you think your anxiety is severe, let them know. They'll just pump
    more happy-juice into your arm.
    I had my surgery in the morning. That evening my wife and I went out
    to dinner to celebrate. And I went back to work the next day.
    Bed-ridden? Hah!

    My biggest restrictions after surgery were not to lift anything over
    30 lbs. for a week (An excuse to skip yard work. Yay!) and not to get
    my surged eye wet for a week (Big deal!).
    You got that right. And I had fun in the in-between time closing one
    eye and looking alternately at life through the new good eye or the
    old bad eye. Two different worlds.

    In summary, cataract surgery? Try it, you'll like it.
    Dan, Oct 24, 2007
  3. Luis Ortega

    Dan Abel Guest

    That is what I chose, and I'm happy with it. Note that there is some
    margin of error in the measurements they using for setting the lens
    power, and it could be off enough that you will have to wear glasses for
    best vision at *any* distance.
    This called "monovision", and many people like it. Others can't get
    used to it. You will also lose some of your depth perception. It is
    usually done with contacts, so those people can just get new contacts if
    they can't adapt to it. If you have this done surgically you are stuck
    with it, and will have to wear glasses to undo it.
    No, eyes don't usually change in that age range.

    No, they do what everybody else does, get new glasses. If your vision
    is correctable, it is unlikely the doctor would do a second surgery.

    Once everything heals and scar tissue forms, they are in pretty securely.

    I had no problems with my first cataract surgery. However, they do not
    use that type of anesthesia anymore due to risks. My eye was completely
    immobile and blind. Now they use a topical anesthetic that leaves
    vision and feeling, but there is no pain. I did very poorly on my
    second cataract surgery. I was unable to lie still, I was literally
    shaking with fear. The doctor didn't believe in tranquilizers. I had a
    much more difficult and longer eye surgery a couple of years later. I
    was given sufficient drugs so that I had no problems, even though it was
    still a topical anesthetic, I was completely awake and could see. It
    would be wise to discuss this with your doctor and also find out who is
    in charge of anesthesia. For my cataract surgery, it was a nurse. For
    my later surgery, I talked to the anesthesiologist and gave my story.
    Even though it was a nurse who administered the anesthesia, it was
    according the doctor's orders.

    Things are a lot better now. It's about 2 hours from checkin to
    checkout. My wife and I went out to lunch after the first one. I was
    perfectly fine the next day, and worked from home.
    Dan Abel, Oct 24, 2007
  4. Luis Ortega

    Jane Guest

    As a former cataract surgery patient, I have some further advice. 1)
    Choose an experienced cataract/refractive surgeon. 2) If you have
    astigmatism, see if it can be corrected at the time of surgery. 3)
    Get aspheric monofocal lenses. 4) Do not have surgery with a doctor
    who still uses needle anesthesia ("blocks"). Needle anesthesia
    carries small but very serious risks, including permanent vision loss
    and eye muscle damage. Most cataract surgeons today use topical
    anesthesia (eye drops), which is much safer. And you can leave the
    surgery center without an eye patch.

    Best of luck. I predict that you will be pleased with your results.
    Jane, Oct 24, 2007
  5. Luis Ortega

    Luis Ortega Guest

    Thanks, everyone for your informative and supportive replies.
    I will report back on my experience when I have my operations.
    Luis Ortega, Oct 25, 2007
  6. Luis Ortega

    Wiz Guest

    A little late to the thread here. I'm in the same boat as the original
    poster. According to my eye doc, I was born with cataracts, but now
    that I'm aging (53), the problem's compounded by the natural aging of
    my lenses.

    The doc said that it's possible for me to go without glasses if in
    addition to having the cataract surgery I have laser surgery (PRK?),
    and that it's possible to have both procedures can be done at the same
    time. The caveat she gave is that there is pain after the laser
    surgery and described it as a "rug burn". Some accounts from people on
    the web who have had this surgery describe it as terribly painful
    afterwards, and suggest the need for heavy pain medication for more
    than a day or two.

    Any experience with that here?
    Wiz, Nov 1, 2007
  7. Luis Ortega

    Wiz Guest

    Not sure that this is a "huge" prescription:

    OD-SPH: -1.25
    OD-CYL: -1.25
    OD-AXIS: 170
    OD-ADD: +1.75
    OS-SPH: 0
    OS-CYL: -3.50
    OS-AXIS: 15
    OS-ADD: +1.75

    When you say the procedures are "approximate", I take that to mean
    that they commonly correct the cataract first, then see what ther
    result is before deciding to do anything else. Is this correct?

    Here's one detail you don't know: My eye doc isn't a surgeon, she's an
    O.D., and she suggested that it *might* be possible to combine the
    cataract surgery with laser, but I would need to check with the doc
    who does the surgery. And for my part, right now I'm just gathering
    all of the info I can about the procedure before talking to surgeons,
    understanding these data points are coming from anonymous people on

    The other detail I left out is that when I had this discussion with
    the doc I was stressing over the whole thing and might have missed
    something in the conversation. Remember the Far Side cartoon where the
    owner is speaking say to the dog "Okay, Ginger! I've had it! You stay
    out of the garbage! Understand, Ginger? Stay out of the garbage, or
    else!", but the dog hears "blah blah GINGER blah blah blah blah blah
    blah blah blah GINGER blah blah blah blah blah..."? I was hearing
    BUT DRUGGED blah blah blah ".
    Wiz, Nov 1, 2007
  8. Luis Ortega

    Dan Abel Guest

    A very good idea, in my personal opinion. There are things in cataract
    surgery that the patient can have a voice in, if they understand what to
    ask for. If they don't (and many people just aren't interested), the
    doctor will do what is best based on experience with most patients. I
    would recommend a Google search on this group with the subject of
    "cataract". Many people have contributed their own experiences with
    cataract surgery over the years.

    Another personal preference of mine is to avoid surgery, that's why I've
    had four eye surgeries.


    My choice was simple, have surgery or go blind. Cataract surgery (which
    I've had in both eyes) is an example of this. It is simply not
    correctable with glasses or contacts. Astigmatism (which you have a lot
    of) is normally corrected with lenses. I would advise finding out
    whether this additional surgery will do a better job.

    Another factor is cost. If you have insurance, it will generally cover
    cataract surgery but not the other. This could make a big difference in
    your decision.

    I support Mike's suggestion that you separate the two surgeries, if you
    decide to do both at all. Cataract surgery involves some measurements
    and stuff that aren't perfectly predictable. I can't say that I
    understand them (I'm not a doctor), but you'll have to sign a form
    agreeing that you understand that you may be a fulltime wearer of
    glasses, despite their best efforts. If you do the surgeries
    separately, the second one can correct whatever problems might be
    uncovered after healing from the first one. You *will* be wearing
    glasses part time, or go without seeing clearly. You can choose close,
    middle or distance vision. You can't get all three, without glasses of
    some sort.

    You left out the last two panels in the strip. In the third, the owner
    is lecturing his cat. In the fourth, what the cat hears, "blah blah
    Dan Abel, Nov 2, 2007
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