Anyone had a cataract operation?

[Mr Pointy]

I'm at the point where I need a cataract operation on my left eye & given I'm severely short sighted (-9.75L, -8.00R with astigmatism) I want the right eye done at the same time. I don't believe it's acceptable to be perfect in one eye & -8.00 in the other so it's unlikely that the NHS will be appropriate as they won't operate on the right eye & they won't fit a toric lens either so I would still need glasses to correct my astigmatism.

Given that there's about 2.25D difference beween my far & near vison I need to choose how to have my sight optimised. Do I go for good distance vision & accept I need glasses for close work or do I go for near optimisation & have glasses for driving etc? I tried monovision contact lenses (one distance, one near) & didn't get on with them & I've read too many stories of flare & halo issues with multifocal implant lenses to be keen on them.

Has anyone had lens replacement done & what optimisation did you go for?

Finally, can anyone with experience suggest a good surgeon I should approach. Either East Berkshire or London would be easiest for me to get to.

[Mr Pointy]

Slushbox said:

I fly and drive, so went for optimisation for distance in both eyes. Can now read house numbers at 150 meters, let alone car number plates. I have reading glasses for close work, but don't need them for using a laptop, TV or much else. I have great focus now from 1 metre to the horizon.

That's interesting & if I could end up like that I'd be happy. Any chance you know how far apart your near & distance prescriptions were?

Slushbox said:

" I want the right eye done at the same time."
Think you'll only be able to get one done at a time, with a couple of months at least in between for it to settle, plus follow-up tests.

I should have been more accurate & said I didn't want to wait for the right eye to deterorate until I had it done. Most places seem to space them out by a couple of weeks.

Slushbox said:

You can google for cataract ops. A lot of the private places do them, often using the same surgeons as the NHS. Prices start from about £1500 upwards.

As with laser surgery personal recommendation is really the way to go & I wouldn't shop for a cataract operation on Google. £1500 would be an absolute bargain but from my research I'm not sure it's a realistic price.

Thanks for posting, it's been helpful.

[Mr Pointy]

So said:

I had mine done with a commercial outfit and was very pleased with the care and outcome. I know a few people who've used them with good results and no problems. Conversely, known a few people who went to RLE consultants and had issues - mostly relating to lack of access to aftercare. YMMV.

Can you say which company/hospital you used?

[Mr Pointy]

So said:

Mr Pointy said:

So said:

I had mine done with a commercial outfit and was very pleased with the care and outcome. I know a few people who've used them with good results and no problems. Conversely, known a few people who went to RLE consultants and had issues - mostly relating to lack of access to aftercare. YMMV.

Can you say which company/hospital you used?

Optical Express in Nottingham.

I’ve no affiliation to them. They just did a good job, gave fast and excellent aftercare and I was quite happy with the experience

Slightly disturbing that I just went through their website form to assess if I was suitable & the result was that 2113% of people with my prescription reached the UK driving standard after the procedure. It also says:

Q: Can I have lens surgery if I am short sighted?
A: The short answer is: A small percentage of patients

Not the best website in the world for someone who is going to be cutting into your eyeballs.

[Mr Pointy]

Has anyone experience of LaserVision in Guilford or Woking?

[Mr Pointy]

anonymous said:

[redacted]

Glad to hear it seems to be going ok for you. The consultant I saw said I'd need to use a contact lens in my unoperated-on eye as glasses would send me loopy. Apparantly it's not only the sharpness but also that the image size is different & the brain finds it hard to resolve.

[Mr Pointy]

Glad to hear it's going well. I'll be having mine done soon.

[Mr Pointy]

paul.deitch said:

I am pretty short sighted and at night get lots of haloes around bright lights when driving which is irritating. Do the haloes go away or are they reduced after the op?

Halos & flares are one of the known side effects of multifocal lenses (pilots cannot have multifocals) so if you are particularly concerned then go for monofocal implants. You might need to get checked why you are seeing halos if you don't have a cataract.

[Mr Pointy]

x5x3 said:

I'm having this done in a month or two - and cannot decide whether to go for "perfect" distance vision. If I do then I will need to wear a contact lens in the other eye and then wear reading glasses for close up. I have been trailing some contact lenses and have found I'm pretty much wearing the reading glasses all the time - 80-90% of my day is on the computer/watching TV etc. Even seeing the satnav in the car without reading glasses is quite difficult.

Therefore I'm tempted to get the eye set so I can just carry on with vary-focal glasses.

For those who have had the Op - how did you decide?

It's not easy, partly because the choices are quite wide these days. There are a few things that might alter what you do: how old are you? NHS or private? How short sighted are you? Do you only have a cataract in one eye?

According to my consultant most men seem to like good distance vision whereas women may optimise differently. Your surgeon can pull back the correction slightly so it isn't quite as good at distance but the near point comes closer, which you may find better. You could also try mutifocal lenses although these do carry more risk of issues with flares & halos. People vary widely with what they will put up with though so many people find them ok.

You can have your other eye treated, you don't have to wait for a catatact to develop. It's called Refractive Lens Exchange then, but it's the same operation. You wouldn't have to mess around with contacts if you have both done. They can set one for long & the other for short (so called monovision) but I didn't get on with it myself. You can't get RLE on the NHS though.

I was set on correcting for long distance but now I'm having a look at a Duet lens where they implant a main monofocal lens & then a small multifocal in front of it. If it turns out I can't get on with any halos or flare then they can remove the multifocal lens quite easily leaving me corrected for distance. It's very tricky to take out a multifocal & replace it with a monofocal.

Too many choices really & it's difficult to know how your eyes will react. If I were you I'd want to be glasses free though so I'd look at doing both eyes.

[Mr Pointy]

anonymous said:

[redacted]

Do you think it's an overall positive change? I'm not having a good experience but I have held off posting for now.

Edited by Mr Pointy on Thursday 23 May 17:33

[Mr Pointy]

biggbn said:

It was, and remains, a huge positive change for me. Both eyes done.

How long was it before your sight improved enough to drive? Did it takes weeks slowly improving or was everything clear in a few days?

[Mr Pointy]

anonymous said:

[redacted]

Thanks for asking: it's turned into something of a nightmare to be honest. I had my operation on the left eye about 12 days ago & of course for the first couple of days I couldn't see much at all. Over the next few days things cleared a little but vision was still extremely poor with nothing being sharp & a general mistiness/flare/lack of contrast over the whole field of vision. I am wearing a contact lens in the right eye so I can get around but I haven't been able to drive for the last 12 days: I certainly didn't expect that to be the case & it's proving to be a substantial problem.

I had a routine check up with the consultant a couple of days ago & couldn't read more than three lines down the chart. On examination it seems I have posterior capsular opacification, which is the sort of thing that usually develops after six months or more. The good news is that this is easly treated with a YAG laser session but the bad news is that the consultant wants to wait another couple of weeks at least to give my eye time to finish recovering. The even worse news is that this has meant the operation on the right eye has been cancelled & put back until after the YAG session to ensure I have at least one working eye.

The impact of that is that it will be at least another three weeks before I can even think about being in a position to drive again & I've got to carry on stumbling around with a combination of old glasses, one contact lens & assorted reading glasses. As we all know this is the difficult/annoying phase as the two eyes are so out of sync that it seems you always end up with the wrong glasses on. What was going to be two weeks of difficulty is now looking at being five weeks or more.

The issue hasn't been down to the surgeon or lens fitted as it seems I've just been unlucky with the type of cataract I had; it was at the back of the lens & can attach itself to the capsule & cause scarring. He couldn't take the scarred capsule out as it's needed to support the new plastic lens & you end up with a much more complicated operation - a vitrectomy I think?

So all in all it's not been the magical night & day transformation that everyone else seems to have experienced. A bit of a bugger really.

[Mr Pointy]

mike9009 said:

I drove a couple of days after the operation in my first eye. I am waiting for my second eye to deteriorate, which maybe a few years (see later.....)

I am equally frustrated about not seeing stuff close-up - my very short sightedness (-8 ish) was a real advantage for checking stuff out up close. When not wearing a contact lens in my 'old' eye I can still do this, but this means only first thing in the morning..... not very convenient.

I have subsequently been advised to get my 'old' eye operated on and I am on the NHS waiting list for this to be completed - hopefully sometime in October. In the meantime, I am going to 'play' with a different contact lens strength and see if I can train myself to use that eye for up-close work and the 'new' eye for distance work. If this works I will then have a different strength lens in the 'old' eye when I have the operation.

It seems with readers on, most people need different strengths for different uses. I suspect I am suffering the same. The focal distance with my readers is very narrow, making reading books, other people's screens, my screen, finding screw heads, etc. a little tricky. Is there another way around this other than varifocals??

I think every one who is/was very short sighted (I'm -7/-8) suffers the same sense of loss over the the extreme close vision we had. I used to be able to read tiny numbers on connectors which no-one with normal sight could see, I think that when (if) my eyes are stable I'll look at getting some of the type of magnifying spectacles that watchmakers use for very close work.

I've needed two different strengths of readers for some time: 1.5 for PC work & 2.5 for reading close & I don't know it that will remain the same or not once the RLE surgery is done & dusted. If you've having monfocal lenses then you would probably benefit if you can cope with one long sight & one tuned for reading (monovision). I tried it with contact lenses & didn't get on with it at all. Unfortunately once the lenses have been replaced you loose all accomodation & all you can do is carry different strength readers or try varifocals.

[Mr Pointy]

tobinen said:

Day 2. What a huge improvement. Everything is now HD. Check-up booked week Weds and then I need a new eye test in six weeks. Very happy.

Did you have multifocal or monofocal lenses?

[Mr Pointy]

tobinen said:

He didn't specify so I will presume a mono. I can ask when I next see him. All I saw on the paperwork was an acrylic lens

If you mean my spectacles, then I have varifocals.

If you need reading glasses then it will have been a monofocal lens. If you can read without them it is a multifocal.

[Mr Pointy]

Time for an update as I now have a decision to make.

It's nearly eight weeks since I had the operation on my left eye & four weeks since the YAG laser treatment to remove the PCO at the back of the capsule. After the initial operation my vision was disappointingly cloudy caused by the PCO which it was hoped the YAG treatment would resolve. It has resolved part of the issue but not all of it. While my vision is very sharp there's an overlying mistiness & flare which gets worse in dim light.

I had a sight test with my usual optician & the lens could not be working much better as my vision is 6/6 with just -0.25D of error which is too small to be worth correcting. I can read 8pt text without any other glasses which is good enough for tablet & phone use. The issue is not resolution/sharpness, it's mistiness & flare. I've seen the consultant & it seems I'm just one of those who cannot get on with multifocal lenses. There's nothing wrong with the lens or it's positioning so there's nothing he can do to improve the outcome.

I have to decide what to do about the lens in the left eye & what to have in the right eye. At the moment I have a contact lens in the right & it's providing most of the clarity while the left eye is providing resolution. I don't think I can have the same multifocal in the right as then everything would be misty so it looks as if I'll have to have a monofocal. I don't really want to stay as I am as I have the left at -0.25 & the right at -8.00.

The question is whether I have the multifocal in the left changed to a monofocal. It's a relatively simple operation as the lens is actually a dual lens - a rear monofocal plus a front multifocal which can be removed. I'm just really disappointed as in some ways it's working very well; I can read my iPad & then just look up to see the TV without any reading glasses or the like & distance vision is excellent. I'd really prefer not to have to have readers for everything but I can't see it can be avoided. The big issue is that in dim light there's blurring & I don't like driving at night.

So I've put up another post - what range of sharpness are others getting with monofocal lenses?

[Mr Pointy]

So said:

Was your procedure carried out on the NHS, privately by a consultant or by a “commercial” firm?

And what lens did you have? Reading your most recent post it sounds like two lenses. Was there a reason why you didn’t have a single multifocis lens?

It was done by a private consultant who has been very good - I've now had 10 consultations with him trying to sort this out.

The lens (Sucoflex Duet) is deliberately inserted in two parts so that the multifocal section can easily be removed if performance is not good - as in my case. Removing a normal lens after RLE is a fairly major procedure so given the reports about multifocal lenses I would not have gone for a single lens multifocal implant.

[Mr Pointy]

anonymous said:

[redacted]

How near can you see sharply without glasses?

[Mr Pointy]

tobinen said:

I have my check-up tomorrow but for the past week I have experienced a minor irritation in the eye. It's not painful but I wish it wasn't there. Hopefully he'll see what's what.

I've also noticed that white light is 'whiter' than the non-operated eye, similar to halogen vs LED so I presume that's the difference with a new lens and one which is 49 years old.

These sunny days are a real struggle without sunglasses but I have to wait four weeks for a new eye test so my presciption sunglasses are unuseable

Were you prescribed steroid & antibiotic drops for a month? The colour difference is very noticeable at first but your brain will soon adapt to it.

[Mr Pointy]

anonymous said:

[redacted]

PCO is a common issue after lens replacement surgery & is very easily treated with a ten minute laser session. They will put numbing drops in your eye & then fit a clip to hold the eyelids open: you just then look at a red dot while the consultant fires a laser a few times to burn away the back of the capsule. There's no pain & you will have watery vision for a day or so & hopefully then you will see an improvement.