Cataract Eye Surgery


Frank Widmann
 

I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.


Ruplanaik Gourishankar
 

I had cataract surgery in my right eye 3 weeks ago with a Monofocal lens with wonderful results. I had no astigmatism and did not require a toric lens. It took several days for the blurring and glare because of the dilating drops to go away. Now I have a 20-20 vision in that eye and am able to see faint stars that I haven't seen in years. My other eye has a slight astigmatism and may require a Toric lens. Before the surgery, I thought my left eye had good vision, and even my surgeon had said it was very early and that I could wait for at least another year before getting it done. Now my right eye with the new lens has an extremely clear vision with vivid colors, whereas the vision in my left eye looks like I am looking through a 70-year-old lens with dull colors, the whites are faded white, unlike my right eye where it is bright white. I want to get my left eye done as soon as possible. If the results are nearly as good as my right eye, I should be able to see so much more at night with both eyes and enjoy my hobby as a visual astronomer. I was blaming the increase in light pollution for not able to see much and now realize that it was my eyesight and this has given me new hope to get out there and enjoy the heavens. And to top that I just received my brand new A-P Stowaway last week!

My understanding of multifocal lenses is that the intraocular lens that is implanted after the removal of the cataract has a fixed focal length, just like a prescription for corrective eyeglasses or contact lens. The natural lens in the eye is pliable and the muscles in the eye are able to change its shape to change the focus to various distances. As we age we lose that ability and need reading glasses. What the doctors have started to do is give one eye distance correction lens and closeup correction for the other eye. So one eye is for seeing distant objects and the other eye is good for reading and closeup work.  Apparently our brain is able to adapt to this fairly quickly, and most people function very well as though they have good vision in both eyes. This has been done with Lasik surgery as well and I know people in my own family who are functioning very well without needing glasses or glasses for distance. I also know someone who has trouble adapting to this and gets headaches.

In my case, my doctor knew of my astronomy hobby and I explicitly told him that I wanted to be able to see distant objects clearly and didn't mind wearing reading glasses. I am very pleased with the results. Another common thing most doctors are performing these days is a Femto laser procedure just prior to the cataract surgery. This takes 2 to 3 minutes and performs the initial incision and softens up the lens and makes the removal of cataract easy and more precise. It takes away some critical human error part of the surgery and from talking to anesthesiologist friends of mine, it has markedly reduced the complication rate of cataract surgery and has made even some average surgeons look like superstars. You may want to discuss this with your doctor. Wish you the best.

Ruplanaik Gourishankar, M.D.


On Mon, Sep 28, 2020 at 6:00 PM Frank Widmann <fjwidmann@...> wrote:
I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.



--
Gouri
Ruplanaik Gourishankar


Greg Hartke
 

Hi, Frank,

 

I had IOL (intraocular replacement) surgery in Feb and Mar of this year. (Both eyes. The second eye was done 2 weeks after the first.) My optometrist advised not going with toric lenses because they often produce haloes around bright objects and I wanted my distance vision to be as clear and unimpeded as possible. The bottom line is that he doesn’t think the technology is quite there yet and I’m glad I heeded his advice. My distance vision is now 20-20, clear and bright, and I consider reading glasses to be a minor nuisance. I will say it’s great to have decent vision again. I say “decent” because 15 years ago (I’m 65), my distance vision was 20-8. ;)

 

Note that my optometrist recommended against toric lenses, though the ophthalmologist he recommended really pushed the toric lenses. My optometrist had no reason to push toric lenses, whereas the ophthalmologist who did the surgery may have been a bit more enthusiastic about the possibility.

 

Ruplanaik‘s comments were excellent, of course, and my experience mirrors his. I, too, opted for laser surgery and the ophthalmologist also fixed my slight astigmatism using laser techniques. After the first surgery, I spent a lot of time blinking from one eye to the other because the color difference (not to mention the brightness) was so striking. I expected that, but the reality was still interesting.

 

IOL replacement is a once-in-a-lifetime event and I wanted the results to be of the “no regrets” variety. Mine were. I have a colleague at work who opted for multi focal length toric lenses and she has slight haloes which would drive me nuts. In addition, the placement of one of her lenses was slightly less than optimal, which means that she needs a slight correction to achieve perfect distance vision.

 

YMMV, but I would highly recommend sticking to mono focal length replacements.

 

Regards,

 

Greg

 

From: main@ap-ug.groups.io <main@ap-ug.groups.io> On Behalf Of Frank Widmann
Sent: Monday, September 28, 2020 5:57 PM
To: main@ap-ug.groups.io
Subject: [ap-ug] Cataract Eye Surgery

 

I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.


Frank Widmann
 

Thank you. My doctor will be using the Femto laser procedure. I was leaning toward the monofocal lens, but felt it wouldn’t hurt to ask.  

Frank

On Sep 28, 2020, at 4:39 PM, Ruplanaik Gourishankar <gnayak48@...> wrote:


I had cataract surgery in my right eye 3 weeks ago with a Monofocal lens with wonderful results. I had no astigmatism and did not require a toric lens. It took several days for the blurring and glare because of the dilating drops to go away. Now I have a 20-20 vision in that eye and am able to see faint stars that I haven't seen in years. My other eye has a slight astigmatism and may require a Toric lens. Before the surgery, I thought my left eye had good vision, and even my surgeon had said it was very early and that I could wait for at least another year before getting it done. Now my right eye with the new lens has an extremely clear vision with vivid colors, whereas the vision in my left eye looks like I am looking through a 70-year-old lens with dull colors, the whites are faded white, unlike my right eye where it is bright white. I want to get my left eye done as soon as possible. If the results are nearly as good as my right eye, I should be able to see so much more at night with both eyes and enjoy my hobby as a visual astronomer. I was blaming the increase in light pollution for not able to see much and now realize that it was my eyesight and this has given me new hope to get out there and enjoy the heavens. And to top that I just received my brand new A-P Stowaway last week!

My understanding of multifocal lenses is that the intraocular lens that is implanted after the removal of the cataract has a fixed focal length, just like a prescription for corrective eyeglasses or contact lens. The natural lens in the eye is pliable and the muscles in the eye are able to change its shape to change the focus to various distances. As we age we lose that ability and need reading glasses. What the doctors have started to do is give one eye distance correction lens and closeup correction for the other eye. So one eye is for seeing distant objects and the other eye is good for reading and closeup work.  Apparently our brain is able to adapt to this fairly quickly, and most people function very well as though they have good vision in both eyes. This has been done with Lasik surgery as well and I know people in my own family who are functioning very well without needing glasses or glasses for distance. I also know someone who has trouble adapting to this and gets headaches.

In my case, my doctor knew of my astronomy hobby and I explicitly told him that I wanted to be able to see distant objects clearly and didn't mind wearing reading glasses. I am very pleased with the results. Another common thing most doctors are performing these days is a Femto laser procedure just prior to the cataract surgery. This takes 2 to 3 minutes and performs the initial incision and softens up the lens and makes the removal of cataract easy and more precise. It takes away some critical human error part of the surgery and from talking to anesthesiologist friends of mine, it has markedly reduced the complication rate of cataract surgery and has made even some average surgeons look like superstars. You may want to discuss this with your doctor. Wish you the best.

Ruplanaik Gourishankar, M.D.

On Mon, Sep 28, 2020 at 6:00 PM Frank Widmann <fjwidmann@...> wrote:
I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.



--
Gouri
Ruplanaik Gourishankar


Frank Widmann
 

Thank you. My doctor originally recommended a Monofocal lens because of my astronomy hobby. He planned on doing a laser procedure to correct my mild astigmatism. After the eye measurements were done he suggested a monofocal toric instead. The price difference between the two lenses wouldn’t cover a boat payment, so I don’t think there is any adverse incentive. I plan to meet with him one more time, and your information will be very helpful.

Frank

On Sep 28, 2020, at 5:27 PM, Greg Hartke <ghartke@...> wrote:



Hi, Frank,

 

I had IOL (intraocular replacement) surgery in Feb and Mar of this year. (Both eyes. The second eye was done 2 weeks after the first.) My optometrist advised not going with toric lenses because they often produce haloes around bright objects and I wanted my distance vision to be as clear and unimpeded as possible. The bottom line is that he doesn’t think the technology is quite there yet and I’m glad I heeded his advice. My distance vision is now 20-20, clear and bright, and I consider reading glasses to be a minor nuisance. I will say it’s great to have decent vision again. I say “decent” because 15 years ago (I’m 65), my distance vision was 20-8. ;)

 

Note that my optometrist recommended against toric lenses, though the ophthalmologist he recommended really pushed the toric lenses. My optometrist had no reason to push toric lenses, whereas the ophthalmologist who did the surgery may have been a bit more enthusiastic about the possibility.

 

Ruplanaik‘s comments were excellent, of course, and my experience mirrors his. I, too, opted for laser surgery and the ophthalmologist also fixed my slight astigmatism using laser techniques. After the first surgery, I spent a lot of time blinking from one eye to the other because the color difference (not to mention the brightness) was so striking. I expected that, but the reality was still interesting.

 

IOL replacement is a once-in-a-lifetime event and I wanted the results to be of the “no regrets” variety. Mine were. I have a colleague at work who opted for multi focal length toric lenses and she has slight haloes which would drive me nuts. In addition, the placement of one of her lenses was slightly less than optimal, which means that she needs a slight correction to achieve perfect distance vision.

 

YMMV, but I would highly recommend sticking to mono focal length replacements.

 

Regards,

 

Greg

 

From: main@ap-ug.groups.io <main@ap-ug.groups.io> On Behalf Of Frank Widmann
Sent: Monday, September 28, 2020 5:57 PM
To: main@ap-ug.groups.io
Subject: [ap-ug] Cataract Eye Surgery

 

I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.


Astronut
 

Hi Frank,
I had the luck to find a cataract doctor that was also an amateur astronomer (with of course, all A-P equipment.) who also 'wrote the book' (literally) on cataract surgery.
He mentioned repeatedly that not all replacement lenses are optimal for astronomy, some with significantly better results than others. I ended up with 'crystal lens', which has minimal night glare compared to others. PM me if you want Dr's info or more details about lens'.
Thanks,
Astronut Tim


Stewart Valentine
 

Hello, I would love the info. I have put it off for a couple years waiting for the best info . My dr is afraid I may be disappointed.

On Tue, Sep 29, 2020 at 8:36 AM Astronut <hg2u@...> wrote:
Hi Frank,
I had the luck to find a cataract doctor that was also an amateur astronomer (with of course, all A-P equipment.) who also 'wrote the book' (literally) on cataract surgery.
He mentioned repeatedly that not all replacement lenses are optimal for astronomy, some with significantly better results than others. I ended up with 'crystal lens', which has minimal night glare compared to others. PM me if you want Dr's info or more details about lens'.
Thanks,
Astronut Tim










David Albers <humealbers@...>
 

I also would be interested in this info regarding the doctor you used.


wes Bolin
 

FWIW I had cataract surgery on both eyes about 2 years ago.  One eye done, then several days later the other one.  We live 70 miles from the Doctor, so it was two trips.  This also gave me the chance to compare the new eye with the old eye.  Like the OP, the old eye was like looking through a beige filter; dimmer, less contrast, pale colors, etc.

My doctor is an amateur astronomer and we had a good discussion before surgeries.  I have no astigmatism, so we agreed on the long distance lens.  I do need reading glasses from walMart, etc. for close stuff, but the astronomical views are worth the hassle for me.

I have settled out at 20-20 or slightly better, and couldn't be happier.  When observing with friends about my age, I consistently see "more" than they do.  I have quit making comments about details cause in most cases they can't see them.  I hope your outcome is as good as this.

The biggest inconvenience was application of the drops.  I made a spread sheet of the times of day and which eye needed which drops.  Worked out fine.  So glad I did it.

Best of success to you.

On Mon, Sep 28, 2020 at 9:41 PM Frank Widmann <fjwidmann@...> wrote:
Thank you. My doctor will be using the Femto laser procedure. I was leaning toward the monofocal lens, but felt it wouldn’t hurt to ask.  

Frank

On Sep 28, 2020, at 4:39 PM, Ruplanaik Gourishankar <gnayak48@...> wrote:


I had cataract surgery in my right eye 3 weeks ago with a Monofocal lens with wonderful results. I had no astigmatism and did not require a toric lens. It took several days for the blurring and glare because of the dilating drops to go away. Now I have a 20-20 vision in that eye and am able to see faint stars that I haven't seen in years. My other eye has a slight astigmatism and may require a Toric lens. Before the surgery, I thought my left eye had good vision, and even my surgeon had said it was very early and that I could wait for at least another year before getting it done. Now my right eye with the new lens has an extremely clear vision with vivid colors, whereas the vision in my left eye looks like I am looking through a 70-year-old lens with dull colors, the whites are faded white, unlike my right eye where it is bright white. I want to get my left eye done as soon as possible. If the results are nearly as good as my right eye, I should be able to see so much more at night with both eyes and enjoy my hobby as a visual astronomer. I was blaming the increase in light pollution for not able to see much and now realize that it was my eyesight and this has given me new hope to get out there and enjoy the heavens. And to top that I just received my brand new A-P Stowaway last week!

My understanding of multifocal lenses is that the intraocular lens that is implanted after the removal of the cataract has a fixed focal length, just like a prescription for corrective eyeglasses or contact lens. The natural lens in the eye is pliable and the muscles in the eye are able to change its shape to change the focus to various distances. As we age we lose that ability and need reading glasses. What the doctors have started to do is give one eye distance correction lens and closeup correction for the other eye. So one eye is for seeing distant objects and the other eye is good for reading and closeup work.  Apparently our brain is able to adapt to this fairly quickly, and most people function very well as though they have good vision in both eyes. This has been done with Lasik surgery as well and I know people in my own family who are functioning very well without needing glasses or glasses for distance. I also know someone who has trouble adapting to this and gets headaches.

In my case, my doctor knew of my astronomy hobby and I explicitly told him that I wanted to be able to see distant objects clearly and didn't mind wearing reading glasses. I am very pleased with the results. Another common thing most doctors are performing these days is a Femto laser procedure just prior to the cataract surgery. This takes 2 to 3 minutes and performs the initial incision and softens up the lens and makes the removal of cataract easy and more precise. It takes away some critical human error part of the surgery and from talking to anesthesiologist friends of mine, it has markedly reduced the complication rate of cataract surgery and has made even some average surgeons look like superstars. You may want to discuss this with your doctor. Wish you the best.

Ruplanaik Gourishankar, M.D.

On Mon, Sep 28, 2020 at 6:00 PM Frank Widmann <fjwidmann@...> wrote:
I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.



--
Gouri
Ruplanaik Gourishankar


David Albers <humealbers@...>
 

In addition to the cataract surgery has anyone done a vitrectomy? https://www.asrs.org/patients/retinal-diseases/25/vitrectomy

I have a lot of floaters in my observing eye..so was planning to do this first.  Typically once you do a vitrectomy it accelerates cataracts.


Ruplanaik Gourishankar
 

For me, a Monofocal lens specifically corrected for distance vision is the best choice for astronomical purposes. If you have significant astigmatism, you will need a toric lens with appropriate correction, placed meticulously in the correct axis inside the eye. All the premium lenses seem to have some compromise in terms of the amount of light that passes through the lens and the clarity at any particular focal point. They try to satisfy all situations by minimizing wearing eyeglasses, giving very good vision at most focal lengths while not being the best for one particular situation.
There is a ton of good information on the various intraocular lenses on the internet, especially on YouTube.

Ruplanaik Gourishankar, M.D.

On Tue, Sep 29, 2020 at 10:59 AM wes Bolin <k5apl41@...> wrote:
FWIW I had cataract surgery on both eyes about 2 years ago.  One eye done, then several days later the other one.  We live 70 miles from the Doctor, so it was two trips.  This also gave me the chance to compare the new eye with the old eye.  Like the OP, the old eye was like looking through a beige filter; dimmer, less contrast, pale colors, etc.

My doctor is an amateur astronomer and we had a good discussion before surgeries.  I have no astigmatism, so we agreed on the long distance lens.  I do need reading glasses from walMart, etc. for close stuff, but the astronomical views are worth the hassle for me.

I have settled out at 20-20 or slightly better, and couldn't be happier.  When observing with friends about my age, I consistently see "more" than they do.  I have quit making comments about details cause in most cases they can't see them.  I hope your outcome is as good as this.

The biggest inconvenience was application of the drops.  I made a spread sheet of the times of day and which eye needed which drops.  Worked out fine.  So glad I did it.

Best of success to you.

On Mon, Sep 28, 2020 at 9:41 PM Frank Widmann <fjwidmann@...> wrote:
Thank you. My doctor will be using the Femto laser procedure. I was leaning toward the monofocal lens, but felt it wouldn’t hurt to ask.  

Frank

On Sep 28, 2020, at 4:39 PM, Ruplanaik Gourishankar <gnayak48@...> wrote:


I had cataract surgery in my right eye 3 weeks ago with a Monofocal lens with wonderful results. I had no astigmatism and did not require a toric lens. It took several days for the blurring and glare because of the dilating drops to go away. Now I have a 20-20 vision in that eye and am able to see faint stars that I haven't seen in years. My other eye has a slight astigmatism and may require a Toric lens. Before the surgery, I thought my left eye had good vision, and even my surgeon had said it was very early and that I could wait for at least another year before getting it done. Now my right eye with the new lens has an extremely clear vision with vivid colors, whereas the vision in my left eye looks like I am looking through a 70-year-old lens with dull colors, the whites are faded white, unlike my right eye where it is bright white. I want to get my left eye done as soon as possible. If the results are nearly as good as my right eye, I should be able to see so much more at night with both eyes and enjoy my hobby as a visual astronomer. I was blaming the increase in light pollution for not able to see much and now realize that it was my eyesight and this has given me new hope to get out there and enjoy the heavens. And to top that I just received my brand new A-P Stowaway last week!

My understanding of multifocal lenses is that the intraocular lens that is implanted after the removal of the cataract has a fixed focal length, just like a prescription for corrective eyeglasses or contact lens. The natural lens in the eye is pliable and the muscles in the eye are able to change its shape to change the focus to various distances. As we age we lose that ability and need reading glasses. What the doctors have started to do is give one eye distance correction lens and closeup correction for the other eye. So one eye is for seeing distant objects and the other eye is good for reading and closeup work.  Apparently our brain is able to adapt to this fairly quickly, and most people function very well as though they have good vision in both eyes. This has been done with Lasik surgery as well and I know people in my own family who are functioning very well without needing glasses or glasses for distance. I also know someone who has trouble adapting to this and gets headaches.

In my case, my doctor knew of my astronomy hobby and I explicitly told him that I wanted to be able to see distant objects clearly and didn't mind wearing reading glasses. I am very pleased with the results. Another common thing most doctors are performing these days is a Femto laser procedure just prior to the cataract surgery. This takes 2 to 3 minutes and performs the initial incision and softens up the lens and makes the removal of cataract easy and more precise. It takes away some critical human error part of the surgery and from talking to anesthesiologist friends of mine, it has markedly reduced the complication rate of cataract surgery and has made even some average surgeons look like superstars. You may want to discuss this with your doctor. Wish you the best.

Ruplanaik Gourishankar, M.D.

On Mon, Sep 28, 2020 at 6:00 PM Frank Widmann <fjwidmann@...> wrote:
I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.



--
Gouri
Ruplanaik Gourishankar



--
Gouri
Ruplanaik Gourishankar


Jack Stone
 

Tim

Please forward your physicians contact info
I as well have had issues which I’ve put off for some time

Thanks

Jack


On Sep 29, 2020, at 09:05, Ruplanaik Gourishankar <gnayak48@...> wrote:


For me, a Monofocal lens specifically corrected for distance vision is the best choice for astronomical purposes. If you have significant astigmatism, you will need a toric lens with appropriate correction, placed meticulously in the correct axis inside the eye. All the premium lenses seem to have some compromise in terms of the amount of light that passes through the lens and the clarity at any particular focal point. They try to satisfy all situations by minimizing wearing eyeglasses, giving very good vision at most focal lengths while not being the best for one particular situation.
There is a ton of good information on the various intraocular lenses on the internet, especially on YouTube.

Ruplanaik Gourishankar, M.D.

On Tue, Sep 29, 2020 at 10:59 AM wes Bolin <k5apl41@...> wrote:
FWIW I had cataract surgery on both eyes about 2 years ago.  One eye done, then several days later the other one.  We live 70 miles from the Doctor, so it was two trips.  This also gave me the chance to compare the new eye with the old eye.  Like the OP, the old eye was like looking through a beige filter; dimmer, less contrast, pale colors, etc.

My doctor is an amateur astronomer and we had a good discussion before surgeries.  I have no astigmatism, so we agreed on the long distance lens.  I do need reading glasses from walMart, etc. for close stuff, but the astronomical views are worth the hassle for me.

I have settled out at 20-20 or slightly better, and couldn't be happier.  When observing with friends about my age, I consistently see "more" than they do.  I have quit making comments about details cause in most cases they can't see them.  I hope your outcome is as good as this.

The biggest inconvenience was application of the drops.  I made a spread sheet of the times of day and which eye needed which drops.  Worked out fine.  So glad I did it.

Best of success to you.

On Mon, Sep 28, 2020 at 9:41 PM Frank Widmann <fjwidmann@...> wrote:
Thank you. My doctor will be using the Femto laser procedure. I was leaning toward the monofocal lens, but felt it wouldn’t hurt to ask.  

Frank

On Sep 28, 2020, at 4:39 PM, Ruplanaik Gourishankar <gnayak48@...> wrote:


I had cataract surgery in my right eye 3 weeks ago with a Monofocal lens with wonderful results. I had no astigmatism and did not require a toric lens. It took several days for the blurring and glare because of the dilating drops to go away. Now I have a 20-20 vision in that eye and am able to see faint stars that I haven't seen in years. My other eye has a slight astigmatism and may require a Toric lens. Before the surgery, I thought my left eye had good vision, and even my surgeon had said it was very early and that I could wait for at least another year before getting it done. Now my right eye with the new lens has an extremely clear vision with vivid colors, whereas the vision in my left eye looks like I am looking through a 70-year-old lens with dull colors, the whites are faded white, unlike my right eye where it is bright white. I want to get my left eye done as soon as possible. If the results are nearly as good as my right eye, I should be able to see so much more at night with both eyes and enjoy my hobby as a visual astronomer. I was blaming the increase in light pollution for not able to see much and now realize that it was my eyesight and this has given me new hope to get out there and enjoy the heavens. And to top that I just received my brand new A-P Stowaway last week!

My understanding of multifocal lenses is that the intraocular lens that is implanted after the removal of the cataract has a fixed focal length, just like a prescription for corrective eyeglasses or contact lens. The natural lens in the eye is pliable and the muscles in the eye are able to change its shape to change the focus to various distances. As we age we lose that ability and need reading glasses. What the doctors have started to do is give one eye distance correction lens and closeup correction for the other eye. So one eye is for seeing distant objects and the other eye is good for reading and closeup work.  Apparently our brain is able to adapt to this fairly quickly, and most people function very well as though they have good vision in both eyes. This has been done with Lasik surgery as well and I know people in my own family who are functioning very well without needing glasses or glasses for distance. I also know someone who has trouble adapting to this and gets headaches.

In my case, my doctor knew of my astronomy hobby and I explicitly told him that I wanted to be able to see distant objects clearly and didn't mind wearing reading glasses. I am very pleased with the results. Another common thing most doctors are performing these days is a Femto laser procedure just prior to the cataract surgery. This takes 2 to 3 minutes and performs the initial incision and softens up the lens and makes the removal of cataract easy and more precise. It takes away some critical human error part of the surgery and from talking to anesthesiologist friends of mine, it has markedly reduced the complication rate of cataract surgery and has made even some average surgeons look like superstars. You may want to discuss this with your doctor. Wish you the best.

Ruplanaik Gourishankar, M.D.

On Mon, Sep 28, 2020 at 6:00 PM Frank Widmann <fjwidmann@...> wrote:
I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.



--
Gouri
Ruplanaik Gourishankar



--
Gouri
Ruplanaik Gourishankar


Alan Friedman
 

Just a few thoughts from my experience with cataract surgery (one eye done in June, the second delayed until August by travels to celebrate the arrival of our first grandchild). I wore toric contact lenses for many years to correct moderate astigmatism in both eyes. With one eye being farsighted and my dominant eye being nearsighted, my brain was well used to a form of “mono-vision”, where one eye predominantly sees distance and the other closer vision. This worked quite well until I became more dependent on reading glasses for close work as I got older. 

There was a good article in Sky & Telescope some years back on an astronomer's journey with cataract surgery. It remains available on line and is a good read. Standard IOLs are 6mm in diameter. If you require dark adaptation for astronomy and your eyes are able to dilate wider than 6mm, you are likely to experience diffraction effects from the edge of the lens coming into the field of view. You will notice this in a big way for a day or more after surgery, where your eyes have been dilated big time pharmacologically. I believe the second issue they experienced involved the lens capsule in the months following surgery. The rear of the capsule can develop wrinkles and opacification. These issues can be addressed (the docs say easily) with a laser treatment in the office once the IOL has become secure in its placement (six months or so). 

Acuity in distance vision was my goal in treating my cataracts. I knew that I wanted monofocal IOLs to correct for distance in both eyes. I am happy to wear glasses for close work. Astigmatism can be addressed with incisions during the surgery or by selecting toric IOLs. The latter are not covered by most insurance plans and there is an additional cost to the surgery which will be a la carte as well. I believe the out of pocket tab for both eyes came to $3600. Toric IOLs require very accurate placement by the surgeon. In terms of correction of astigmatism, better results are seen overall with toric implants over limbal relaxing incisions, but this is in large studies… individual results may vary of course.

I am very happy with the result. I am three months out on the first eye and one month on the second. As with other posters, my vision is 20/20 in each eye and somewhat better with both eyes working together. I have dryness in one eye by the end of the day - something I hadn’t experience prior to refractive surgery. As a youngster (second half of my sixties) my likelihood of developing opacification in the lens capsule is greater than with an older patient. And my Facebook news feed is constantly filled with companies that sell fashion eyeglasses and readers.

On the comment about the complexity of using three different eye drops for three weeks - there are companies that combine them into one medication (check Imprimis). Also outside of most prescription coverages, but the cost isn’t much and the simplicity was well worth it for me. My doc also does not do the eye covering patch after surgery unless you sleep with pets in your bed. I could experience my new vision immediately. It’s quite a remarkable experience.

Best of luck!
Alan




On Sep 28, 2020, at 5:56 PM, Frank Widmann <fjwidmann@...> wrote:

I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.


ROBERT WYNNE
 

Stay with the monofocal lens its optics will always be superior to a toric lens. Then use reading glasses as you may require. Laser surgery to correct astigmatism is still in its infancy. -Best, Robert

On 09/28/2020 7:49 PM Frank Widmann <fjwidmann@...> wrote:


Thank you. My doctor originally recommended a Monofocal lens because of my astronomy hobby. He planned on doing a laser procedure to correct my mild astigmatism. After the eye measurements were done he suggested a monofocal toric instead. The price difference between the two lenses wouldn’t cover a boat payment, so I don’t think there is any adverse incentive. I plan to meet with him one more time, and your information will be very helpful.

Frank

On Sep 28, 2020, at 5:27 PM, Greg Hartke <ghartke@...> wrote:

Hi, Frank,

 

I had IOL (intraocular replacement) surgery in Feb and Mar of this year. (Both eyes. The second eye was done 2 weeks after the first.) My optometrist advised not going with toric lenses because they often produce haloes around bright objects and I wanted my distance vision to be as clear and unimpeded as possible. The bottom line is that he doesn’t think the technology is quite there yet and I’m glad I heeded his advice. My distance vision is now 20-20, clear and bright, and I consider reading glasses to be a minor nuisance. I will say it’s great to have decent vision again. I say “decent” because 15 years ago (I’m 65), my distance vision was 20-8. ;)

 

Note that my optometrist recommended against toric lenses, though the ophthalmologist he recommended really pushed the toric lenses. My optometrist had no reason to push toric lenses, whereas the ophthalmologist who did the surgery may have been a bit more enthusiastic about the possibility.

 

Ruplanaik‘s comments were excellent, of course, and my experience mirrors his. I, too, opted for laser surgery and the ophthalmologist also fixed my slight astigmatism using laser techniques. After the first surgery, I spent a lot of time blinking from one eye to the other because the color difference (not to mention the brightness) was so striking. I expected that, but the reality was still interesting.

 

IOL replacement is a once-in-a-lifetime event and I wanted the results to be of the “no regrets” variety. Mine were. I have a colleague at work who opted for multi focal length toric lenses and she has slight haloes which would drive me nuts. In addition, the placement of one of her lenses was slightly less than optimal, which means that she needs a slight correction to achieve perfect distance vision.

 

YMMV, but I would highly recommend sticking to mono focal length replacements.

 

Regards,

 

Greg

 

From: main@ap-ug.groups.io <main@ap-ug.groups.io> On Behalf Of Frank Widmann
Sent: Monday, September 28, 2020 5:57 PM
To: main@ap-ug.groups.io
Subject: [ap-ug] Cataract Eye Surgery


I believe there was a discussion on this topic at one time. I have to have a cataract removed in one eye. I was leaning toward a Monofocal Toric lens that would also correct some mild astigmatism. The alternative is to opt for a Multifocal Panoptic lens. Based on discussions with my doctor the Monofocal is less likely to produce artifacts around stars. However, the ability to easily do closeup work on telescopes and cameras is also a consideration. I have an astronomer friend who received the Multifocal lens in both eyes and has experienced clear vision with no problems. Any comments from individuals who have had a lens replacement would be greatly appreciated.