Cataract Surgery and After

I’m 63 and just had cataract surgery on my right eye with a lens implanted. The implant lens is a fixed focal length for distance vision. The Dr. said that he couldn’t recommend the variable lenses due to the amount of correction. So now I can see perfectly anything over about 3 feet away. But I do need correction to see anything closer such as reading.

We’ll be doing the left eye in about three weeks and I need to decide if I want to have that eye corrected for reading. But of course I’d need correction for distance.

I’ve worn glasses for over 50 years, so having to wear glasses is no big deal to me. I’m thinking that having both eyes the same would allow driving with no glasses, as well as allow general life with no glasses.

If I have the left eye corrected for closeup vision I couldn’t buy cheap reading glasses for working on the PC etc.

I know that some folks do contacts that way, but the lens implant is a little more permanent.

Any experiences or advice to share?

Good question to ask.

Kindly, what were the cost? Both for the operation and for the lens?
Would the variable lens cost more than the fixed? Are you on Medicare?

Hope my questions are not rude or too personal. Thanks.

I’m covered by insurance, not Medicare yet, and I don’t have the cost breakdown here with me, but my memory says somewhere in the $3000 range. I’ll try and post the cost breakdown this evening when I get home. I know that it was broken down between what I’ll call a “facility fee” and the actual doctors fee. Anesthesia fee as well. I don’t recall if a lens cost was listed.

GaryM, I’m in pretty much the same boat as you. I’m going in for cataract surgery on my right eye in a couple of weeks, to be followed up by the left eye a few weeks later.

I had LASIK surgery on my eyes a few years ago and at that time opted for the “monovision” approach where the right eye was corrected for distance and the left eye for reading. It worked OK at first, but as I got older, I found I still needed to get the cheap reading glasses for closeup reading.

I’ve decided to get both eyes corrected for distance and resign myself to the fact that I’ll still need glasses for reading and closeup work. That way I will have good vision in both eyes for driving and things far away without glasses.

As far as cost, I don’t think it makes any difference one way or the other.

My wife just had a cataract surgery the week before Christmas, with the second one scheduled in a couple of weeks. She has an astigmatism so she went with the toric lenses, even though we have to pay out of pocket for them ($900 per lens). If she would have gone with the regular lenses they would have been included in the cost of the surgery. She’s having both eyes corrected for distance and is planning on getting some cheap readers for the close-up stuff if she needs to.

Hope that helps.

I appreciate the responses. I also had astigmatism, but it was in my lens rather than in the cornea. So no special lens was required. If it had been in my lens, there would have been an additional cost of about $220 per eye.

Unless I hear some persuasive arguments against, I’ll go with both eyes the same and get glasses with progressive lenses that are uncorrected on the top and reading on the bottom. I’ve been experimenting and a reading glass that’s a 2 seems pretty good.

My prescription is about a -9 diopter, so right now the issue is a difference in image size between my left and right eye.

Before you decide, is there any way you can wear glasses or contact lenses for a few days, where the correction would simulate this scenario?

I have heard of people doing something very similar for Lasik - having one eye corrected for distance and one for reading, so they can do without glasses at all times. I’ve also heard (no cite though) that they recommend wearing contact lenses to mimic that for a few days, before deciding on that approach. The idea being, this lets you see whether the discordant images (one in focus, one not) would be tolerable.

Personally I believe I’d find it to be a nonstop headache. Then again, I could never get used to full-on progressive lenses that covered the whole range of vision - I wound up getting “room distance” progressives where the better correction covers only 20ish feet away and the lower bit covers the computer. Then I got a separate pair of glasses that I use for driving and movies and nothing else.

That may be possible and I’ll ask, but I’m so anxious to get the second eye done that if it would move the procedure back more than a day or so I’d be loath to do it.

Why bother with the progressive lenses? Just go to your local grocery store and get some of the cheap reading glasses with a 2.0 (or whatever you need) correction, and put them on when needed. The rest of the time you can be spectacle-free.

I had both sides done with bifocal implants in early 2007. My doc does a variety of eye surgeries, and I took the opportunity to ask a lot of questions. I asked him if having one eye fixed for distance and the other for close would take away my depth perception. He said that it would. I know one guy who had it done that way, and he’s happy with the arrangement.

Gary M has already had many of his questions answered. For others’ sake, let me say that everybody’s eyes are different, and not everybody is a good candidate for what I had done. My doc said it was likely I wouldn’t need glasses after the surgery (I don’t,) but it would be unethical for him to guarantee it.

My insurance paid for the surgery completely, but the bifocal implants cost $2000. Single focus lenses would have been covered, though.

If I’d never worn glasses I’d probably be more tempted to do the one eye closeup, one eye distance thing. But having worn glasses as long as I have it’s no big deal.

What I’m really liking so far, even with only one eye done, is not having to find my glasses to use the bathroom at night as well as being able to lie in bed and see all the trees in our woods as the sun rises. I’ll also not have to walk in the rain with my head down to keep the rain off my glasses.

If you use a desktop computer (not so important for a laptop) I would recommend getting bifocals with the lower half set for reading up close (about 12" is good for me) and the upper half for reading a computer screen (probably about 24", but you might want to check your own setup). With regular reading glasses, unless you normally read at arms length, you will be leaning in to the screen all the time, and it will be even worse with bifocals if only the bottom is for close up work.

However, make sure the guy writing your prescription very clearly understands the distances you want. I have one good pair like this that I use all the time (made at the place I actually had my cataract surgery), but trying to get another satisfactory pair has been very difficult. I had this screwed up twice by prescriptions that have set the distance in the upper half much to far away, at 4 or 5 ft.

If your distance vision is good enough after the surgery, just don’t wear glasses for distance. I did get a pair of progressive lenses but I hate them for walking about. They cause weird distortions.

Was there any pain in recovery?

Be very careful that you investigate of having one distance eye and one close eye. My daughter was born that way. She does have depth perception although it is far from perfect. She has tried glasses that correct only the myopic eye, but it leaves the two images different sizes. As she gets into her mid 40s (she will e 44 in a month) she will probably find that she can read without glasses, but only with one eye. It seems like more trouble than its worth, but its up to you.

But look before you leap. I realize that asking here is the first step but we cannot give medical advice (not that I am qualified) and it should not be the last step. When I have cataract surgery, I will want both eyes the same.

I had both done in 1991/92 for distance. Spliting them, as was the case between surgeries, was a real headache pain. If you get them to see distance, you can now wear **cool sunglasses **instead of dork flip-ups or snap-ons.

No pain in recovery - to bonitahi.

As **smithsb **said, no pain at all after the surgery. The worst I had was what I’d caqll a slight “itch” in the eye and that was hardly noticeable after a day or two.

**bonitahi **had asked about cost. Here’s the cost breakdown:

Surgeon’s Fee $1500
Specular Microscopy $150
A-Scan $110

Surgery Center Facility Fee $2232
Intraocular Lens Implant $575

So that’s $4567 per eye, not including the anesthesia fees which are billed separately, and I don’t have any numbers for that. I’ll have to pay some of this, perhaps $400 or so.

I’m glad I’m not a spider with eight eyes!

Unless the doctor has a really persuasive argument I’m going with both eyes the same. I appreciate the qustions and suggestions and will answer any other questions posed.