Reading ability after cataract and lasik surgery

Discussion in 'Laser Eye Surgery' started by Scotti, Jul 10, 2004.

  1. Scotti

    Scotti Guest

    I have a cataract on my left eye that needs to be removed. My right
    eye is fine, but the doctor has offered several possibilities for me
    to consider, one of which is to have lasik surgery on the right eye
    two weeks after the cataract is removed from the left eye. This sounds
    like what I want to do.

    However, he has told me that my eyesight will not be "perfect" when he
    is done, and I will still need glasses to read. My understanding is
    that I cannot be tested and fitted with new glasses until the eyes
    "stabilize" which can take 1 to 2 months. Meanwhile, I am under
    contract to write a book. The manuscript is due December 15. I was
    given a short turnaround time as it is, and I cannot take "1 to 2
    months" off.

    I need to know if I will be able to read well enough (assuming all
    goes well) after both surgeries to continue with my book project? Or
    should I wait a few months (the doctor said I could wait up to 6
    months, but he wouldn't like to go any longer)?

    At present I am seeing okay. My right eye, as I said, is fine.

    If anyone has had these procedures, I would really appreciate hearing
    what your vision was like during the time before you were able to get
    new glasses. The brochure says I can "resume normal activities" and
    "read or watch TV" -- but if I am really going to need glasses to
    read, how am I supposed to read before I get the new glasses?

    Thanks to anyone who can help.
     
    Scotti, Jul 10, 2004
    #1
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  2. With modern cataract surgery, the the eye can see fairly well once the early
    healing is over, few days to a couple of weeks. A refractio is best done
    once little change can be expected, 4-6 weeks out. HOWEVER, under
    circumstances such as yours, you can refract as soon as 1-2 weeks. May have
    to be redone at 6 weeks out, but you can work during that early time with
    the glasses (ie. Write the manuscript). Technically you can work reading
    from 1 eye, or if the other eye isn't way off power, you can get reading
    glasses before the LASIK, and put it off til after the LASIK.

    Cataract surgery almost never has to be done within a certain time frame
    unless it is a "mature" cataract - not sure why he said 6 months max.

    The LASIK is another story, as things will change from that also. Why would
    you need LASIK done? Is there a significant refractive error?
     
    David Robins, MD, Jul 11, 2004
    #2
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  3. Scotti

    Scotti Guest

    The LASIK is another story, as things will change from that also. Why
    would you need LASIK done? Is there a significant refractive error?

    ===============================

    Thanks for your response, Dr. Robins!

    I am 53 years old. I wear very thick glasses (to put it in lay terms).
    At present, my left eye can only be corrected to 20/60 because of the
    cataract.

    As for wanting to do the cataract surgery in 6 months or less, I
    understand this is due to not wanting to wait until the cataract
    hardens, making it more difficult to deal with.

    I am being told that I have two options:

    1. Remove the cataract from my left eye and basically return vision in
    that eye to what it was before, maybe a little better. Do nothing to
    the right eye (it has no sign of a cataract developing at all). Keep
    wearing thick glasses as I always have. If a cataract develops in the
    right eye, make that eye just a little better than it was before.

    2. Remove the cataract and insert a lens that gives me much better
    vision in my left eye than I had before. I would then have to wear a
    contact lens in the right eye OR have Lasik on that eye because
    otherwise, the two eyes would be too different from each other.

    I do not want to wear a contact lens. (I don't want the hassle, plus I
    tried soft lenses in the 1980s and my vision was not sharp enough with
    them. I have astigmatism. I wore hard lenses in the 1960s and 1970s,
    and do not want to go there again). Lasik sounds better to me than
    wearing a contact lens. I would still probably need reading glasses.

    I realize that I may develop a cataract on the right eye down the road
    (no sign of it yet). If that happens sooner rather than later, I will
    just have to accept the fact that I sort of "wasted" the Lasik
    surgery.

    I was told that another option would be to do "cataract surgery" on
    BOTH eyes, making them "match" vision-wise. However, the surgery on
    the right eye would not be covered by surgery, as I do not currently
    have a cataract on that eye. It would be much more expensive than
    Lasik (which isn't covered either, but is less expensive). The benefit
    would be that I would not need cataract surgery in the future on the
    right eye (well, I know they can form again, but it would be somewhat
    of a preemptive strike).

    I am thinking my best bet may be to wait until at least November or
    December to have the cataract surgery on the left eye.

    Closer to that time, I can decide if I want Lasik on my right eye or
    if I want just the cataract surgery on the left eye, leaving my vision
    essentially the same as it was before the cataract formed. I must
    admit that has a certain appeal. As I grow older, I really don't want
    to add "things to remember" (like reading glasses) to my life. I don't
    really want to hop in the car for a vacation and discover 300 miles
    down the road that I forgot my reading glasses. I never forget my
    glasses now because I can't see much of anything without them, so I
    wear them all the time and I'm used to it.

    Does that make sense? Again, I truly appreciate your thoughts.
     
    Scotti, Jul 11, 2004
    #3
  4. Scotti

    Scotti Guest

    Oops! I wrote: "However, the surgery on the right eye would not be
    covered by surgery..."

    I meant it would not be covered by insurance.
     
    Scotti, Jul 11, 2004
    #4
  5. Scotti

    Scotti Guest

    One other thing I should have said. I believe my right eye (without
    the cataract) is -8. In other words, I am quite myopic. My doctor said
    if I want to leave that eye alone, he might go to -7 or -6 in the left
    eye, but no more. Then, if I get a cataract on the right eye, he might
    go to -5 or -4 with that.
     
    Scotti, Jul 11, 2004
    #5
  6. You surgeon's recommended numbers seem reasonable under the circumstances. I
    wouldn't go more than 2 diopters difference from eye to eye. Remember that
    as the right eye starts developing a cataract, it will likely get more
    myopic first.

    You mention not wearing glasses at all. Surprise! Unless you go for
    monovision (1 eye for distance, 1 eye for reading power) you WILL still need
    glasses, since the operations do not increase focusing.

    Most mopoes should not be made plano in surgery - you surgeon, under the
    best circumstances, would probably leave you a little myopic (maybe -1 D)
    you have some reasonable at-home vision. If so, you will need glasses for
    driving. If you don't want that you can aim for plano (zero) but I find most
    lifelong myopes don't like that.

    Another thing - LASIK does make it a lot harder to calculate the correct
    implant power to make the eye a given power later on. You're better off with
    a contact in that eye now, if you can handle it. In a myope there is a small
    retinal detachment risk with either LASIK or cataract surgery.

    Cataracts don't usually get that much harder in 6 months, but a high myope
    like yourself any have a thinner capsular bag than others, so any
    significant hardening my increase capsular tear rates. I personally haven't
    had much problem in that regard.
     
    David Robins, MD, Jul 13, 2004
    #6
  7. Scotti

    neil0502 Guest

    : I have a cataract on my left eye that needs to be removed.
    My right
    : eye is fine, but the doctor has offered several
    possibilities for me
    : to consider, one of which is to have lasik surgery on the
    right eye
    : two weeks after the cataract is removed from the left eye.
    This sounds
    : like what I want to do.
    :
    : However, he has told me that my eyesight will not be
    "perfect" when he
    : is done, and I will still need glasses to read. My
    understanding is
    : that I cannot be tested and fitted with new glasses until
    the eyes
    : "stabilize" which can take 1 to 2 months. Meanwhile, I am
    under
    : contract to write a book. The manuscript is due December
    15. I was
    : given a short turnaround time as it is, and I cannot take
    "1 to 2
    : months" off.
    :
    : I need to know if I will be able to read well enough
    (assuming all
    : goes well) after both surgeries to continue with my book
    project? Or
    : should I wait a few months (the doctor said I could wait
    up to 6
    : months, but he wouldn't like to go any longer)?
    :
    : At present I am seeing okay. My right eye, as I said, is
    fine.
    :
    : If anyone has had these procedures, I would really
    appreciate hearing
    : what your vision was like during the time before you were
    able to get
    : new glasses. The brochure says I can "resume normal
    activities" and
    : "read or watch TV" -- but if I am really going to need
    glasses to
    : read, how am I supposed to read before I get the new
    glasses?
    :
    : Thanks to anyone who can help.

    Forgive me, Scotti . . . I mean no disrespect, but....

    The answers you get will either serve to allay or exacerbate
    your concerns, but in neither case will they have any
    definite bearing on _your_ particular outcome.

    I'm a (new) writer myself (certainly not a doctor), and a
    patient considering a clear lens extraction/IOL (possibly
    followed by a LASIK procedure), just as you are. If the
    surgeon is saying that a waiting time of six months poses no
    problems, and you have a manuscript due in five months,
    where's the decision? Write your book, write it
    _beautifully_ well, have your surgeries, and enjoy your new
    vision.

    Now, on a practical note, it is quite _likely_ that what the
    doctor means when he/she says that you "will still need
    glasses to read" is that you've reached "a certain age"
    where presbyopia sets in and you need reading glasses.
    Neither the cataract surgery nor LASIK will cure presbyopia.
    In fact, cataract surgery increases the need for reading
    glasses in that eye. If you need reading glasses now,
    you'll still need them.

    It's likely that simple dime-store readers (or your current
    readers) will work for close work out of both eyes. You
    should verify with your doctor that this is what he/she was
    implying.

    Best of luck,

    Neil
     
    neil0502, Jul 13, 2004
    #7
  8. Scotti

    Scotti Guest

    ....You mention not wearing glasses at all. Surprise! Unless you go for
    monovision (1 eye for distance, 1 eye for reading power) you WILL
    still need glasses, since the operations do not increase focusing.

    ============

    Yeah... I kind of wondered about that. So it sounds like the best case
    scenario is basically that I will wear glasses that aren't as thick as
    my current ones.

    I've pretty much decided against Lasik in this situation. I KNOW I
    will get a cataract on the other eye (at least it sure sounds like a
    "given"), and it probably won't be very long before it develops.

    I'm putting the whole thing off until November or December anyway. I
    kind of wish I would develop a cataract in the other eye before then!
    It would simplify things a lot. But my doctor said he did not think
    that was likely.

    Thank you again for your time. It is really helpful to get feedback
    from an additional source.
     
    Scotti, Jul 14, 2004
    #8
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