Cataract Surgery - The whole Story

[CocoBolo]

I see a lot of shooters that are certainly old enough to have Cataracts. First for those that don't know the Lens in the eye becomes clouded limiting your vision. As they progress you will be getting new glasses more frequently. Your night driving will become more of a chore. 5 years ago I thought that my new Camary had the best headlights I ever had, lately I checked to see if my lights were on by turning the interior dome light on and then checking that the switch was in the on poisition.

Other little signs you got them is that when you look at street lights or about any lights some sords of light will stick out from the main shape of the light. Get an eye exam your Dr can tell you what is going on.

Ok, this morning at 10 am after being prepped for surgery, they put a bunch of drops in your eye to dialate it I think, then you get an IV. Of course they put a name tag on your ankle and ask you 20 times which eye the Dr is doing and the Dr comes by and initial over the correct eye. Next since I was getting TORIC lens (these are special for astigmatism) the DR takes a horse shoe shaped device and while you sit up straight and look straight and level ahead he marks the axis of your eye, and for me with a strong blink reflex it took 3 tries, hey my eyes are virgins never been touched.

Next I was wheeled into the OR (this is an outpatient faciltiy), and Nurse Nancy tells the tech got another right eye, and he says its a right day since I am the ninth right of the day. Next the Anesthia guy shows up and tells me happy hour will start in 10 minutes a few eye drops and a little something in the IV to relax you and you won't remember a thing tomorrow.

Following this the surgical nurse draped around the eye and put something on the right eye to hold it open. I don't recall the DR showing up but the next thing I recall is seeing this redish gray abiss with a whitish thing bouncing around in there and some pressure and a vibration. This was probably the ultrasound device breaking up the old lens. This only seemed to last a minute or two. Then I heard the greast thing "ALL DONE". As they removed the draping and the eye lid holder I could now see out of that eye, in fact I was suprised to see my name written in large letters on a paper hanging next to the IV bag. Wheeled back to post op and as soon as I got there the nurse tells me to get in the lounge chair, I set there for a few minutes while she filled out papers and then it was time to get dressed and leave.

I was wearing a clear protective patch over the eye and I've been testing out the vision in the operative eye. I can see out of it but it is a bit dark a blurry which is common for the first 24 to 48 hours. Tomorrow I go back the DR for a check up and will know more. I removed the right lens from my glasses and am operating rather well with the non operated eye, your brain will of course pick up on the better eye.

In summary the procedure last only a few minutes and is painless, a bit of anxiety is normal, yeah I was way nervous. After the surgery there is some discomfort not really pain in they eye. I am the worlds worst when it comes to eye drops, so those tend to bug me a bit, but my sweet wife is doing it for me, and I tell here who the heck put ground glass in those drops. Yeah it burns a bit and I am a cry baby when it comes to eye drops.

I am writing this up so those that may be considering getting it done can get real shooter first hand feed back on the process, the operation and the results, and how it may affect shooting.

I have hopes that my dominant eye will change to the right eye as I am cross eye dominant. The Dr says, aaah that would be unusual.

Will post follow up tommorrow after visitng the Dr.

Edited March 9, 2012 by CocoBolo

[HI5-O]

Keep updating this if you don't mind. I find it very interesting (the eye) and how they are able to fix most things that go wrong with it.

My eye doc was telling me there is work going on where they are using some flexible type of lens that will react very closely to the normal lens as in being able to change shape as it focuses on near and far. Said the natural lenses become less flexible with age but the muscles that control the lens still work pretty good.

Also said it will probably not be perfected in our lifetime

Edited March 9, 2012 by HI5-O

[sidnal]

Thanks for the details Ron. Knowing the details should help most people handle the fear better.

[Neomet]

Thanks for the info Ron. I just got diagnosed with developing cataracts this last month. Not my best day. Surgery is still a way off until they got a bit worse, but good to know the procedure is not that big of a deal.

[CocoBolo]

Keep updating this if you don't mind. I find it very interesting (the eye) and how they are able to fix most things that go wrong with it.

My eye doc was telling me there is work going on where they are using some flexible type of lens that will react very closely to the normal lens as in being able to change shape as it focuses on near and far. Said the natural lenses become less flexible with age but the muscles that control the lens still work pretty good.

Also said it will probably not be perfected in our lifetime

I researched the adaptive lens and the bummer is that it is listed a temporary. Meaning it is not permanent. If you don't have astigmatism you could go for the multifocal lens which have been getting pretty good results. This will of course take a little more light to operate and be a bit of a compromise at each distance as well as time for your brain to learn the focal planes.

[CocoBolo]

Thanks for the info Ron. I just got diagnosed with developing cataracts this last month. Not my best day. Surgery is still a way off until they got a bit worse, but good to know the procedure is not that big of a deal.

I was fisrt diagnosed with cataracts 10 years ago. I did well up until about 2 years ago when I started having to go to the eye dr more often for glasses. About a year ago I got my first set of glasses the didn't get me 20/20 only 20/30. Three months ago I got new glasses that went 20/30+. Two week ago they were 20/40. So it seems to grow slowly till it gets big then a small percent of growth is much bigger.

So you got some time. If you smoke quit, that is one of the factors. Quitting will give you more time, for you eyes and maybe other body parts as well.

[CocoBolo]

Early morning update.

Still no pain, the good news.

I think my pupil is still confused, when I first opened my eyes this am it took the right pupil a couple minutes to adjust, once adjusted I could see pretty good out of the operative eye, almost as good as the one with glasses. This only lasted about 5 minutes then it was back to the little bit dark and blurry.

While this is a bit disappointing it isn't alarming. It is expected that it is going to take some time for the eye to heal and recover from the surgery. After all they poked a 3 mm hole next to the cornea and inserted an ultrasound hammer and broke up the original lens vacummed it outthen inserted a made made lens. A little un-nerving when you think about it.

More after the follow up visit with the DR.

[Neomet]

Thanks for the info Ron. I just got diagnosed with developing cataracts this last month. Not my best day. Surgery is still a way off until they got a bit worse, but good to know the procedure is not that big of a deal.

I was fisrt diagnosed with cataracts 10 years ago. I did well up until about 2 years ago when I started having to go to the eye dr more often for glasses. About a year ago I got my first set of glasses the didn't get me 20/20 only 20/30. Three months ago I got new glasses that went 20/30+. Two week ago they were 20/40. So it seems to grow slowly till it gets big then a small percent of growth is much bigger.

So you got some time. If you smoke quit, that is one of the factors. Quitting will give you more time, for you eyes and maybe other body parts as well.

Apparently I am developing them earlier/faster than most because I've been type 1 diabetic for over 40 years. Ah well. They couldn't quite get my right eye to 20/20 this time. We will see how long this takes. They told me to wear sunglasses like I was Ray Charles. The sun here in AZ does not help at all.

[CocoBolo]

Post Operative Follow up Visit #1:

My vision is 20/50 in the operated on eye at this time. The Dr explained that at the end of surgery he uses a drug to close the pupil and on some patients like me it shrinks it down to a pin point and then the lens is defracting instead of refracting. So my eye looks good and in another day or so as the drug wears off my pupil will open up and I will be able to see like I should.

I ran into another guy that had surgery right before mine and he was wearing no glasses and seeing just fine in his operative eye, apparently the drug did not effect him like it did me.

So everything is normal and just need to be a little more patient.

The vision on the eye before surgery was 20/400, but correctable to 20/40+ or almost 20/50. When the pupil de-toxis the drugs it should get much better.

Next appointment is Tuesday for 2nd Follow up. Drops in the eyes 3 times a day. No heavy lifiting, no bending below the heart, and no water in the eyes etc.

[CocoBolo]

Day two right eye still a bit dark a blurry, the pupil is still the size of a pin head. No pain. Just waiting for it to open up.

[Aggieddad02]

Ron, I have been following your thread to see how things are going with you. I know everyone I talk to that has had this procedure done tells me what a difference it makes. I have my initial consult a week from Tuesday. I am tired of not being able to see well in low light. Keep the news coming and good luck.

Walter

[CocoBolo]

Ron, I have been following your thread to see how things are going with you. I know everyone I talk to that has had this procedure done tells me what a difference it makes. I have my initial consult a week from Tuesday. I am tired of not being able to see well in low light. Keep the news coming and good luck.

Walter

Ok lets get some of the mystery out of the cost. Medicare or your insurance will cover the procedure and the standard lens. It gets very interesting when you select an optional lens. Now the procedure has become elective and the DR's costs are not covered.

For me with Toric the Dr fee cost $1500 an eye. This includes the follow up visits and any Laser fine tuning. Yes fine tuning. With the Multifocal IOL's there is a one year followup period with Laser touch up as needed and that may be a bit higher.

Costs of Lens EACH: Actual from my CO's out patient surgery center:

Standard $165, Toric: $554.50, Restor: $984.50 Resume: $984.50, Tecnis: $984.50, Crystalens HD $1204.50

So the total cost when I have both eyes done to me using TORIC is @ $4200. YMMV as my Outpatient surgery center fee was a co-pay of $75.00. Physician charge I am sure vary but this is one time I would suggest not looking for the lowest bidder.

Medicare patients pay a bit less of the lens Toric $394.50 and this may be due to some medicare reimburisment etc. The $984 goes to $834.50, and the $1204 goes to $1054.50.

You will also need to fill perscriptions for 3 kinds of eye drops prior to the surgery and with my pharmacy plan that ran $162.00 and I'm sure my deductable had an effect on that.

[CocoBolo]

WOW ok in the last hour my vision in the right eye has started improving, still a little darker in the room than the other eye but not blurry any more. Outdoors and it is overcast rainey day here, it makes little if any differance which eye I use, in artifical light its a bit darker. Visual acuity in the right eye is almost as good as the left with correction and way better than the left eye without correction. Without correction the astigmatism in the left eye starts to show cover it up and the right vision is very clear still need a bit more light and as the pupil opens up that problem should dissapate.

This morning I was begining to think about canceling the left eye surgery, I can't proceed with the other eye till this one is 100%, ok that is still true but it is now looking like it is going to happen. It is kind of exciting. I've been wearing glasses for 43 years, going to be neat wear my Rudy's without inserts!

I am very happy the Dr was right just give it a day or so and it will start improving, well look like he was right.

[Youngeyes]

Most excellent!

[Sparky]

I had my left eye done in 2005 with just a plain lens. I even got a video

of my surgery. I do not remember all the issues you are having, but everyone

is a little different. So far I have not had to have any laser adjustments

to my eye and my vision in that eye is 20/25 and 20/20 in the right eye.

I had RK done to both eyes and AK done to the left eye because of a stigmatism

in 1994. These were done with scapels, as it was before laser surgery. Do need

reading glasses though.

I wish you the best with your recovery and future surgery on the other eye.

[CocoBolo]

I had my left eye done in 2005 with just a plain lens. I even got a video

of my surgery. I do not remember all the issues you are having, but everyone

is a little different. So far I have not had to have any laser adjustments

to my eye and my vision in that eye is 20/25 and 20/20 in the right eye.

I had RK done to both eyes and AK done to the left eye because of a stigmatism

in 1994. These were done with scapels, as it was before laser surgery. Do need

reading glasses though.

I wish you the best with your recovery and future surgery on the other eye.

Wow you had some tough work done.

So far the only complication I have had is that the drug to undialate my pupil after surgery had a much more profound effect on mine and it has take a couple days for it to start wearing off.

My vision continues to improve in the right eye. This morning I could not read the numbers on the wall clock from 7 ft away tonight I can read them from the same distance in dim light. I can read them with good light from 24 ft away almost as well as with the 20/20 corrected eye. My astigmatism in the right eye does not appear to be present, looking at things with the left eye uncorrected the astigmatism is apparent but covering it lets the operative right eye give a clear view.

I am starting to notice that things are brighter, like my computer screen now seems very bright, while it is still a bit hard to read with the operative eye I can do it where this am it was not possible to read even the text around the icons on the desk top.

I've also started to notice that the colors on the screen are more vivid.

I hope that it continues to improve.

With the corrected 20/20 eye I can read the clock numbers from 28ft away just 4 more feet for the operated eye, then it will be a 20/20 but I expect more since the left does have a level II catract, so the new lens and the Toric is superior to mother natures lens as an optic should be better, Bionic!

Thanks for the best wishes.

Tomorrow it may be time to get the limited gun out and find out if I can get a sight picture. Today I check out my distance vision at 400 yards and it was pretty good, not as good as the 20/20 eye but almost there, just need that pupil to open up a bit more and let more light in.

Edited March 11, 2012 by CocoBolo

[CocoBolo]

Vision about the same this am. I am finding out lots of things about my new lens/eye. Rediscovering white, the color diffierence between my left and right eye is amazing, well now exactly WOW but very noticable. The left eye which has some cataract has a beige tint, but the new lens in the left eye picks up a bright white. I also notice the left eye provides more contrast. Still dealing with the very reduced pupil but at the same time the lights in the house seem to be much brighter than before. A bit confusing at best.

I've constructed a theory that the retina behind the new lens was behind a very large and dark cataract and it probably didn't see much light for the last several years so maybe it just needs time to adjust. Nothing to do but put drops in and wait to see what happens.

[CocoBolo]

Afternoon update. My Bionic eye really likes real sun light. I think there is much we don't understand about vision. Now this will provoke some thought.

Taking my carry gun out in the yard with my correct lens in the left eye (took right lens out of glasses) I throw the gun up and I see the sights like I never saw them before wow. Ok I close the Bionic eye and the picture is not nearly as good. Then I try with just the right eye again not nearly as good so nothing works like two good eyes. Ok so I take the glasses off, now there is no hope of seeing the sights, but why the Bionic eye is still there but the weak left eye image is killing the good eye image, go figure. I am begining to understand that my right eye with the bad cataract was causing the combined view to be worse than the better of the two eyes, if that makes any sense.

Ok what about the open gun and the dot, the sun is out good and bright normally I just turn it all the way up, well that don't work anymore it is too bright. With the Bionic eye even turned down it is brighter than with the correct left eye. More contrast and brighter colors with the Bionic eye (operated right eye).

I put my Rudy Reds on with the insert with only the left lens and try things again, nice and clear. There is a Lane Ends Merge Left sign about 150 yards from my Welding Shop door so I take the eye test on it. With the corrected left I can't read it, I try the Right (Bionic) bingo I can read the thing, with both eyes it is even better and with the Rudy Reds awesome clarity.

I can now read this post with the operated on eye (right) a bit of glare but I can read it. Oooh well wait I'm not supposed to be able to do that without glasses of course the Left eye corrected with Progressive lens reads it just fine, and that is to be expected, but it isn't much better. With both yeah boy its easy money even the fine print.

[CocoBolo]

End of day 3 post surgery on left eye.

My pupil has opend up from the size of the head of a pin to about the diameter of a #8 machine screw, but still a third less diameter than the non operative eye.

With the sun out I took a nice drive down to the Drug store to check out the reading glasses since readi with the operative eye is not good. On the way I expieremented covering each eye in turn approaching highway signs. The corrected eye (left) still reads the signs a bit better but the right (cataract free Bionic) has much more vivid color. With both eyes my vision is excellent.

Arriving in the shopping center I noticed how vivid the signs are, then I noticed some and I go there all the time that had a 3d effect so it was time to test again, the Bionic eye picks up the contrast and you notice the edges of the letters. Again very vivid colors and clarity.

After a nice nap I woke up to the dark world again, all of the lights in the house are florecent, the Bionic eye does not appear to pickup the light as well. This could be due to the UV and blue light filters in the new lens. I looked out at the light on my welding shop and with the Bionic eye it has halao's, those horizontal bars, I hope that goes away. With the left eye and glasses no halo but it now appears to be more yellowing than white, so I take a look at the hallway light with both and yes the Operated on eye I get a nice white light and good detail of the bulb in the globe, but the left with glasses and they are not tinted and have minimal coating it is again yellow. This is the same affect as the white on the wall being beige. This is I assume because that eye has a rusty red colored cataract, not nearly as bad as the one that was in the right eye.

Conclusion - I'm seeing about 90% in the operated eye, with no correction or glasses, the eye is improving.

Tired some reading glasses in CVS and found that 2.75 to 3.25 gave me very good reading ability in the operated on eye, however since the other one has Astigmatism plain glasses don't work for it. This is interesting as many of you will agree you take your glasses off to read, well with the Toric replacement lens that don't work anymore, can't take it out.

Unless something breaks next update after Tueday afternoon visit with Dr. At that time I'll make the Go or No Go decision on the Surgery for the Left eye, which is scheduled for Thursday morning.

[CocoBolo]

Day Post Op 4:

I printed the Snell eye exam chart and put it on the wall in the hallway at work.

Left Eye with Correction (glasses): 20/30 easy read

Right Eye Post Cataract Surgery: 20/30 little more difficult to read.

This is a good improvement from 20/50 on Friday with the right eye.

One of the young guys in the office steps up and he scored 20/10 with no glasses or contacts.

[Sparky]

You mentioned reading glasses from CVS. I mentioned earlier about my surgeries

and the need for reading glasses. Years ago and still today, I asked my eye

surgeon what type of reading glasses should I use. He said go to Wal-Mart or

any place like that and buy them there. I'm at 3.0 right now and I'm 62. But,

he said when your at the computer you can cut that number by a third or more.

So at the computer I use 1.75 and they work fine.

Sounds like you are improving a little every day. Thats great news. Wait till

you have the other eye done. You'll be like a kid at Christmas

[Youngeyes]

Ron, Put a hole in a card(business card type) with a thumbtack and look through it at the chart. Your vision should be better. Remember, they had you do it at the Dr's office. Pinhole optics. Works for guns as well, called peep sights. Without the cataract in the way, you should beat the other eye even with glasses. Sounds like everything is going great.

[CocoBolo]

Ron, Put a hole in a card(business card type) with a thumbtack and look through it at the chart. Your vision should be better. Remember, they had you do it at the Dr's office. Pinhole optics. Works for guns as well, called peep sights. Without the cataract in the way, you should beat the other eye even with glasses. Sounds like everything is going great.

I am sure that is correct but you can't go around looking at the world thur a pin hole. One of the things I couldn't find on the internet is a detailed account of what goes on after surgery. I think there is a lot going on if you observe the details.

Yesterday afternoon I was almost 20/20 it was very close, this morning that eye before any drops in the eye is 20/40. This goes along with my observations that vision seems to improve as the day goes on. My thought is that the drops Steroid help the eye as you put them in during the day then they wear off at night. Just my theory, we will see if that holds true today as well.

What I have not talked about is driving at night. WOW and I do mean WOW it is much much better. With my bad right eye (big dark ugly cataracct) when I would make a right hand turn at night I could not see anthing on the right well I can now. You notice things like the street lights are actually bright, you can read signs further away and you can actually see the reflections of the head lights on the signs a you move past them, even under bright street lights.

The Led tail lights still have a little fuzz around them, but then again it was foggy. I've also noticed I need to clean my windshield, again somthing you don't see when wearing the Cheap Dark Glasses called Cataracts. My first night drive was foggy but it was so much better than before.

I see the Dr this afternoon and if nothing changes I'm going for eye #2, while the operative eye still is not stable, my overall vision is very much improved. With Cataracts is is not all about the eye chart, I think you could be 20/25 with Cataracts and still have significant visual loss, you are ust are not seeing the contrast and colors that are there because you have those cheap dark glasses on all the time. Nothing brings this out like having one with Cataract and one without.

Speaking of drops, I've adopted the text book method on the drops. Of course for the dorp to work you have to taste it, else you missed. I put the drop in and close my eyes for about 2 minutes. I wait about 10 minutes before I put the next drop in (different kind), as one drop will just was the other drop out, you have to give it time to be absorbed. This of course takes more time but I think you can't go wrong doing it right.

Edited March 13, 2012 by CocoBolo

[Youngeyes]

Put the drops in the fridge. Your eye feels the cold.

[TwoShot]

Coco Bolo,

I sincerely appreciate you sharing your experiences with the cataract surgery. I need it done in one eye and am getting there in the other. I need to see if it is bad enough that my insurance will pay. I have extreme astigmatism. The correction in my left eye with the cataract is -21.5 and that gets me to 20/45 at best. I am left handed, left eye dominant. If you wonder what a 6 minute Cmore dot looks like with 20/45 and astigmatism, I compare it to a 20 minute grape cluster of dots. My right correction is -17.0 but that get;s me 20/20. My retinal specialist told me that if they removed the lense in my left eye and didn't replace it, I would see better. I wish you the best in your continued quest for good vision!

TwoShot