Closing in on Cataract Surgery

Discussion in 'Laser Eye Surgery' started by jerzger, Oct 24, 2006.

  1. jerzger

    jerzger Guest

    Cataracts in both eyes. Nuclear in the left, subcapsular in the right.
    Eye doctor recently told me I'm losing more distance vision. Left eye
    seems to be my close up vision, right seems to be distance. Right eye
    was lazy as a child, corrected with a patch over the left one (if that
    makes any difference). I'm aware I have astigmatism, also hypothyroid
    (positive Tg and TPO antibodies). Tried hard contact lenses early
    20's, couldn't tolerate them under florescent lighting. I'm 55
    now, and can no longer be helped with new glasses. Eye doctor wrote
    down last set of numbers for me:

    sphere cylinder axis
    OD -6 -75 +200 92
    OS -11 25 +225 82

    Since I seem destined to have surgery, probably sooner than later,
    trying to get an idea of what would be best for me. I'm the kid you
    saw in kindergarten with the coke bottle glasses, so it's probably
    understandable that I'd really like to toss the glasses after
    surgery. I've found a few doctors who only do monovision, and 2
    doctors who do Crystalens, ReStor, and ReZoom, but they seem to favor
    one over the other on their web sites. Would it be feasible to try soft
    contacts, one near, one distant, even with the cataract to see how a
    monovision IOL might work out without glasses afterwards? Do any of the
    multifocus lenses work with astigmatism? At all? Anything on the
    horizon I should look forward to? Never have been able to see really
    well, so not expecting miracles, but after 50+ years of wearing glasses
    would so like to toss the frames after surgery. Is there a tool, book,
    article, list of questions to ask, etc. where I can get a better handle
    on what would work best for me so I can make a more informed decision?

    I'd sincerely appreciate any help. Thanks.

    jerzger, Oct 24, 2006
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  2. jerzger

    drfrank21 Guest

    With your history of right eye amblyopia (ie. lazy eye) along with
    your moderate myopia and astigmatism, there ain't no way you're
    going to be totally free from a spectacle correction/contact lenses
    after cataract surgery. You're just asking too much for what the
    current IOL technology has to offer.

    I'd go for best distance correction (especially important since you
    are amblyopic), maybe consider a little undercorrection for your
    right eye (to help with reading) and be happy.

    drfrank21, Oct 25, 2006
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  3. jerzger

    Dan Abel Guest

    With a current correction of -6 and -11, you certainly have the option
    of "tossing" your glasses. Those thick and heavy glasses will be but a
    painful memory. I ditched mine, and now I can get out of bed and do
    many things with no glasses. I can't read and I can't use the computers
    because I am heavily dependent on reading glasses. However, they are
    quite light and comfortable compared to my old glasses (I was -10 and
    -12 before cataract surgery).

    With a 5 diopter difference between your eyes, and based on what you
    posted, you may find that monovision is easier for you to get used to
    than for other people who are used to using both eyes together. I have
    never tried monovision, but people I've talked to like it if it works
    for them.

    I haven't heard much good about the multifocal IOLs.

    Be aware that although you may have some choices, you don't always get
    what you ask for. I was lucky, and both my eyes came in exactly as
    planned, but there is some variation beyond the control of the surgeon.
    You may still end up with glasses, although they will be much thinner,
    depending on the strength of the IOL.

    I would suggest going back through old posts on this group posted by
    people who have been through this. I also talked to people at work who
    had helpful stories. My OD was very helpful. Of course, the surgeon is
    the one who is the expert, but I found it helpful to talk to others also.
    Dan Abel, Oct 25, 2006
  4. jerzger

    Jane Guest

    You have significant astigmatism. Without some kind of astigmatism
    correction, you'll have blurry vision at all distances post-cataract
    surgery without glasses/contacts. You're best bet for correcting
    astigmatism at the time of surgery would probably be toric IOLs and/or
    limbal relaxing incisions. There's a new toric lens by AcrySof, but it
    comes in a limited range of powers which probably wouldn't include the
    correction that you'd need. There's also a toric IOL available by B&L
    that might work for you. A cataract surgeon who is experienced in
    astigmatism correction could probably give you close to 20/20 vision
    for distance post-surgery.

    Opinions about the multifocal IOLs vary. Some people are happy with
    them; others report absolute horror stories. There are lots of reports
    posted at Med Help International (Eye Care Forum), which I strongly
    suggest you check out before proceeding. If you do go this route,
    you'd undoubtedly need laser vision correction post-cataract surgery to
    address your astigmatism. Plan on spending several thousand dollars
    out of pocket.

    There's lots of into available online about cataract surgery options.
    It would certainly be worth your time doing some research before
    scheduling consultations with surgeons. But you can end up with the
    best vision you ever had in your life (at least for distance.)
    Jane, Oct 25, 2006
  5. jerzger

    jerzger Guest

    Hi Everyone,

    I did some reading about the toric IOL and wondering if a piggyback
    might work for my heavy duty astigmatism. Made an appointment with a
    surgeon based on his office stating he's working with the newer IOL's
    including the toric. Also that he and the facility are both in network.
    I'm unsure of the info given about the toric being an extra $500 per
    eye. Can that be right? I was really expecting that figure to be
    higher. Now I'm wondering if we're talking about the same thing. Does
    anyone know if this would be a usual/customery price for a toric IOL?
    Or maybe I'm justing getting nervous? :)

    Thanks again!
    jerzger, Nov 7, 2006
  6. You should opt for limbal relaxing incisions, providing your surgeon is
    good at it and offers it, as your 2.00 cyls are good for that
    procedure. I think it's a lot more predictable than toric iols. I'd
    recommend a moderate undercorrection (-1.00 or -1.50 target) on your
    left eye, and a very slight undercorrection on the right (-.50 target),
    which is accustomed to being less near sighted. Do not let them talk
    you into a multifocal or "focusing" type lens.

    w.stacy, o.d.
    William Stacy, Nov 7, 2006
  7. jerzger

    Jane Guest


    The AcrySof toric IOL is technically not a "premium" lens like the
    multifocals However, my surgeon charged an extra $1000 for it. (I'm
    not sure whether that was per eye or for both eyes.) It is an
    excellent lens which proved to be more reliable at reducing astigmatism
    than limbal relaxing incisions in the clinical trials. However, it
    comes in only a limited range of powers. From the info you posted, it
    probably would not come in the power you'd need to correct your myopia.
    The Staar toric IOL is another possibility, although some surgeons
    have complained that it tends to rotate in the eye, thereby negating
    the astigmatism correction. Your surgeon should be able to recommend
    what would work best in your situation.
    Jane, Nov 8, 2006
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