OT- Cataract surgery - which lens option to choose? - Page 2
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  1. #21
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    Very appreciative for the read. I'm 55 and the cataract word popped up at this years exam. Wife is a couple years ahead with the diagnosis. She also has the air bubbles that create the night glare problem too. I've been in contacts since 83. Now with bifocals. I put in an extra pair that I had without the bifocals a couple weeks ago. Unreal how bad the reading vision has gotten. Thanks for discussing the topic and relaying your experiences.

  2. #22
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    If those young people walking or on bikes out there dressed in black had any idea how bad our night vision was they'd be wearing head to toe reflective clothing with blinking leds all over, and stay on the sidewalks.

    I'm currently leaning towards monofocal lenses set for far vision, and correcting everything else with glasses. I'm so used to wearing glasses I'd feel naked without them, and I like keeping things simple.

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  4. #23
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    Quote Originally Posted by FredC View Post
    Several years ago my wife bought one for me but the amber shade did not do that much for me and the dark one was not supposed to be used at night, so I put it away. Got the idea of cutting the dark one at an angle and using it all the time. Pretty much works in a rural setting at night and city driving in the daytime also. the ones with polarizing filter for the dark ones will have the polarizing element as a film. If you try this be careful you do not tear the film as I did on the bottom.
    I tried the dark lenses for a while, until I almost mowed a cop down in the shade from a big tree, where roadwork was in progress.

    He was not happy, but when he accused me of not seeing him, I politely answered that no, I did not see him (implying that he ought to think about standing in the middle of the road in a dark place).

    He did not give me a ticket or anything. But still ...


  5. #24
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    I had cataract surgery but only in one eye and made a different focal length selection. Rather than select either a near or far lens, a single focus lens “for computer distance” was chosen. I do a considerable work wearing a full face respirator and with this lens, most work was within “satisfactory focus.” (Back in my younger days of army service, I had a gas mask lens fitted with lens holder.)
    I have worn glass since 6 years old and have had progressive lens for 25 years. Thus this “computer lens” selection was supplemented with progressive lens in normal glasses. This gives me a full range of clear vision from near too far due to combination of the cataract lens and progressive lens. I don’t mind wearing glasses all the time, since I believe my eyesight is too valuable not to have them protected at all times.

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  7. #25
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    My advice will be a little bit different. Go for slightly uncorrected for distance (20-30 to 20-40) and you will have good vision at moderately close to moderate distance including daytime driving. Probably end up with some arm's length reading ability, enough to read labels in store but will need mild readers (+1.0 or +1.5) for serious reading and a very mild prescription for serious distance.

    This would be if you are strongly nearsighted, otherwise correct for distance and wear readers for close-up. Most people lose the ability to multi-focus after implant surgery although I have heard of people eventually gaining some back with eye exercises.

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    Also, and it doesn't matter how many people tell you until you experience it for yourself, but post-surgery you will be amazed at how bright and colorful the world is and may be surprised at the real color of some of the objects you use daily.

    Most people are very happy post-surgery although I know a few who were disappointed with the result of their lens choice. That is one reason why I suggested going slightly under-corrected. I can do most things without correction although I do wear clear impact resistant lenses for protection. The implants make you a bit more vulnerable than the natural eye.

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  10. #27
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    Yes, the world is way more colorful and nuanced. My first love is photography and I'm amazed how I can now see subtle shades of white. No two pieces of paper are the exact same color. I also just sold my very nice film Nikon F3HP because I couldn't be bothered finding the exact right diopter lens for the eyepiece. Most cameras are set up to view the screen at about a meter, not infinity, and I couldn't focus the damn thing anymore. All the modern digitals have adjustable eyepieces and work great for me.

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    About to fire my current eye doctor, calls are going unanswered, surgery is scheduled for the 15th and no clue what lens they are intending to implant. No one really talked to me about my circumstances, seemed to just go with implants that had a big premium over the Medicare allowance. Do not mind paying extra for better performance but not for something that will end my career or get me killed working a night on the ranch, just so the doctor gets an extra 8 or 10 grand. Talked to 3 doctors so far and only one seemed to care but he was way out on the schedule.


    Wish this guy was closer, getting daily emails from his office. Talks about difficult problems with solutions in surgical technique. One the other day talked about enjoying the "flow" when thing are easy and going well. 1309: 90% of your cases are routine – Cataract Coach

    Video is a wrong implant being replaced in the UK.
    CataractCoach 1291: IOL exchange of a segment bifocal IOL - YouTube

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    FredC, The doc will go with whatever company makes him the most money. I just had a total reverse shoulder replacement, and in disclosure just before surgery the doc came in with a form for me to sign acknowledging that he would receive a substantial financial reward for using this particular product and that he was one of four surgeons involved in the R&D on this device. I was ok with it because this guy does over 200 shoulders a year and has a stellar reputation. I figured he'd not use anything that would tarnish that rep. Its working great too!

    The problem is that many if not most doctors get a kickback for using a particular product and they have absolutely nothing else invested in it. They just go with the highest monetary return. It will be hard to get the info you need to find what's best.

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    Fred, that just doesn't sound right to me. I would definitely fire him or put it off, and tell them why. Luckily cataract surgery is not really urgent, so you can afford to take as much time as you need to find a surgeon you trust. I'm lucky, live in a good size city with a big medical school, lots of providers.

    I tend to agree with Gordon, but there must be exceptions, not all docs are in it just for the $$. Doesn't mean they would be the best choice tho...

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    Well I got a call just a few minutes ago. Billing knows how to find me! Had me down for the extra cost implant and LASER enhancement. After doing research I was 90% leaning towards the single focus lens.

    SHEESSH! I could never run a business that way. I guess I am a dinosaur, try to get the customer to the best options and best cost savings. I told the girl in billing that I have lost confidence in them. Supposed to have my contact person call me back, why do I have doubts about that?

    Got a reference from an old local mechanic and have a call into that office.

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    Quote Originally Posted by FredC View Post
    Got a reference from an old local mechanic and have a call into that office.
    Got a vision of you up on a two post auto lift and a bloke working on you with a cold chisel and a crescent wrench.

    Good luck with whatever solution you finally come up with.

    regards
    Mark

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    Quote-"Got a vision of you up on a two post auto lift and a bloke working on you with a cold chisel and a crescent wrench."

    Actually, the guy he referred me to flies a P51 as a hobby. Old mechanic was under a truck when he gave me the name of his eye guy. That was a funny picture though.

    I did fire the one that was scheduled to do the surgery on the 15th, so back to the end of the line.

  17. #34
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    Like Joe Gwinn, I have been nearsighted all my life, and most of my activities are within 2 feet of my face. I have been considering the close vision replacement lenses, although most people don't seem to make that choice. A couple of years ago I went to the $69 glasses place and bought single vision close and distance pairs. I found that I never forgot the distance glasses in the car, but did find myself in situations where I needed the close glasses and didn't have them.

    Ont thing that concerns me is that my prescription has declined from 4.5 to 2 (nearsighted, not sure of the sign) in both eyes over the last few years. Those of you that chose close vision, has there been a shift in the prescription after the installation of the new lenses?

    Scotti, I like your solution. When I pull the trigger on this, I will be certain to discuss this with the surgeon (Dr. Park here in Rochester, hopefully. He did a great job on my wife's very difficult case). I've worn glasses since 2nd grade, so it is very familiar to me, and any shifts sound like they could be readily adjusted with changes in the glasses.

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    I am four years out since surgery and virtually no change in my prescription. I had a checkup with the surgeon that did my surgery two weeks ago. I totally agree with Scotti above.

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    I had my lense replaced also I wore glasses from 2nd grade up to about 3 years ago nearsighted in one eye farsighted in the other also astigmatism in both eyes now I have one eye set for distance and one eye for up close, when checked I have 2020 vision I am 61 now.

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    Quote Originally Posted by wheels17 View Post
    ..............................

    Ont thing that concerns me is that my prescription has declined from 4.5 to 2 (nearsighted, not sure of the sign) in both eyes over the last few years. Those of you that chose close vision, has there been a shift in the prescription after the installation of the new lenses?
    ........................................
    Yes. Mine was (only one done so far, due to Covid) done and intended for good vision w/o glasses at about 18". The plan was the same for both since I was used to that. Eye doc recommended that, it's what he had done for himself.

    It ended up good at about 10" w/o glasses. Was initially good for closer than the planned 18", and then shifted even closer than that.

    Thinking about getting the other done (whenever that is possible) for a longer distance, so I can find stuff w/o having to have glasses on. I hope that difference won't mess up using binoculars or stereoscopic microscopes. Will check with doc when setting up the next one.

    So far, some days the one I had done is at 20:20, other days it is at 20:50 or so. Don't know why.

  21. #38
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    Quote Originally Posted by JST View Post
    . . . I hope that difference won't mess up using binoculars or stereoscopic microscopes. . .
    It will unless the eyepieces have sufficient adjustment range to compensate, or unless you don't mind wearing glasses while using the equipment. In addition, it can affect depth perception if the difference you choose between the eyes is great. This effect is fairly subtle and most people don't realize that they are compromised.

  22. #39
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    Quote Originally Posted by thermite View Post
    Folks have vastly different "systems".

    Not just the shape of the eyeball (not always the same left and right) the lense capsule in the eye nor the retinas. Also the specialized nervous-system signal pre-processor they feed into.

    Rare is the Doc who bothers to delve for the fine details, person A to person B of those bits.

    After a near-disaster, Reston, VA facility, I escaped, took my problem to Hong Kong, found that expertise.

    Dr. Dylan Chan did his part perfectly, no anaesthetics (DNA thing, plus it is HIS preference as well..) but still got a few surprises.

    - Zero scar by day three under 40X magnification (DNA thing).

    - Seems some folks can shift a rigid lense on the long axis with ease. "Ciliac muscles like an Olympic weight lifter!" he said. Dunno how. It just happened automagically.

    Result is 20/15, sub 1/4 Diopter LR/diff, annnd ability to read the fine print on a pill bottle or see individual leaves on a tree in the far distance without need of external lenses.

    It can take ten or so seconds for my eyes to MOVE that lense, "Zumar style", but it needs no glasses, any tasking, any distance.

    I wasn't sure if I'd take up flying again, but had him goal for starry, starry night, major metropolitan area ground lights.

    Works a treat for night driving and garish Hong Kong nights in a city of constant light-shows, too.

    Downside is need of at least mild sunglasses, outdoors, most days.

    UV thing, as there is no problem with high intensity light, indoors.

    Night driving and fog or snow driving is outright magical. No issue with oncoming headlamps, even if on high-beam, and I can still see colours in the grass at the verge, off side.

    Happy man! At 76 I see better than ever I did at 18/19, per USAF flight physical.... with one exception.

    Andrews AFB had re-run one test three times with re-calibration and added observers, each go. I was clocking the widest night-time COLOUR peripheral vision they had yet measured.

    No longer!

    Cataract lenses do NOT do peripheral vision nearly as well as natural vision can.

    BFD. I run better mirrors on the motor cars, and have re-trained - rigorously - to SWIVEL the head a LOT more.

    Howard Hughes to Noah Dietrich:

    "Find the experts, Noah. Find the experts."

    Dr. Dylan Chan has abnormally good natural vision, works FAST with no drugs. A bit of a legend, he had done over twelve thousand lenses before age forty and leaving Government Hospital to found his own clinic.

    He and his "girls" took three times as many test readings as is usual. Spread out over time of day and day of week before ever he selected the lenses.

    That's how he got that sub 1/4 Diopter Left/Right match.

    We also elected to NOT laser-away a window in the back of the capsule. He said the eye will try to place tissue on it.

    I said no, it will not. I'll order it not to do. It hasn't.

    Amazingly capable systems, humans are. No need to now HOW you command your staff. Only that you do.

    The rest is built-in. Thank God in her clever engineering.

    Does the USA have equally capable eye Surgeons? I'm sure we do.

    But have no idea whom. Dylan was already known to our family for no-drug rebuild (several hours of it) to my Mother in Law's cornea after serious tearing and impact damage in an accident. It went perfectly.
    Bill, the results sound great, but you don't say what lens was used, and what processes.


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