Cataract surgery--lens choice experiences? (1 Viewer)

Hi all,

There have been several past threads on cataract surgery, but none of these focus on the question of the type of artificial lens to choose to replace your natural lens. So with cataract surgery in my future, I wanted to ask for any positive or negative experience with the three main choices:

Monofocal with superior distance vision

Monofocal with superior near vision

Multifocal

I have been nearsighted most of my life with astigmatism and currently wear bifocals. My inclination at this point is to opt for monofocal lenses with superior near vision. Though I am a birder, most of my time is spent looking at things close up, e.g. reading, computer work, television, etc. I am hoping that I can still get good distance vision by having it corrected through glasses. (Not sure if I should also try to get the astigmatism corrected through the artificial lens as well though.) I know people rave about how good their distance vision is when they opt for multifocal lenses that emphasize that distance, but think that benefit will be less significant in my case because of the greater use of near vision in my life.

Any comments on lens choice welcome, but would especially like to hear how good the (corrected) distance vision is of those who opt for monofocal lenses optimizing near vision.

My partner had one eye done with near vision and one with far vision. She really likes the result; although she says she did goof and had her dominant one to near and it should have been the far for focusing while shooting.

I had cataract surgery last year and the recommendation was to go with prioritising distance vision, which is what I did. The surgeon said that many people don't cope well with having rather different results for the two eyes, and he also said that the multifocal lenses currently available have a comparatively high number of people unhappy with the result (but the latter are not available on the National Health Service in the UK). I don't have any data to back up either of these claims, but this was a very experienced surgeon who works in the public as well as private health sectors.

Like you I have been short-sighted for many years, and it was a bit disconcerting at first not to move things closer in order to be able to make them out. I am very happy with the result though - no more fogged up glasses, or glasses slipping when I'm sweating, or rain blurring my vision. Yes, I do need reading glasses for just about anything at close range, but I just bought a lot of cheap pairs and keep one everywhere it might be wanted. I think it's preferable to use glasses inside, where I don't have to worry about rain, etc. By getting reading glasses of different strengths you're getting the ability to focus at different distances (so eg I have weaker ones for sitting in front of the computer than for reading). Reading glasses are also a lot cheaper than distance ones.

My vision is better now than any time since my mid teens or so, and I have found this very liberating. (The fact that my cataracts were unusual and were not diagnosed for some time while my vision deteriorated meant that in my case matters had got pretty bad prior to the operation.) I see more detail on birds and am more likely to spot them than I was with glasses (even before the cataracts set in), and using binoculars or a camera is easier without glasses than with because one achieves a better seal.

My vision is now good enough to drive without glasses (when I first got my license I already needed them), but here one doesn't get a formal confirmation of one's vision after the op. Next time I go for a routine eye check I'll have some numbers, I assume. I've certainly been surprised that in seminars I was able to read text that students in their twenties were struggling with.

I am completely convinced that I made the right choice for myself. I'd be happy to answer any additional questions if I can.

Andrea

I have had cataract surgery in both eyes and opted for "monofocal with superior distance vision" even though I do spend lots of time reading, writing and working with a computer. It is easier to use glasses for those tasks rather than dealing with glasses while birding. In fact, in my case, I can use those cheap reading glasses sold in drugstores to read, so I keep a few of those around (car and a couple of places around the house) for reading "emergencies". I use prescription glasses for more extend reading, writing and computer work. In fact I am able to read most of what I need to in my iPhone (such as apps like iBird and eBird) without any glasses but with a bit of straining.

I was also told that there is a number of people who cannot cope with multifocal lenses - and the second drawback with those is that you need to have both eyes done at the same time according to what I heard. A friend of mine opted for those and is happy, I have monofocal and it works for me. Unfortunately, my astigmatism was not corrected, so I am still a full time user of glasses.

Niels

Thanks all for the reports. Please add more if you have them. Interesting that no one has so far reported going for monofocal lenses with superior close vision in both eyes. Not sure if that is a reflection of a general trend, or a reflection of a specific trend among birders in particular.

Jim M. said:

Thanks all for the reports. Please add more if you have them. Interesting that no one has so far reported going for monofocal lenses with superior close vision in both eyes. Not sure if that is a reflection of a general trend, or a reflection of a specific trend among birders in particular.

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Hello. Can you give me some update on how your cataract surgery went? Did you finally opt for monofocals with excellent near vision? What are your experiences? I'm considering the same option as you were, having worn glasses for distant vision since I was 11. I would appreciate your report. Thanks.

Es Agnes said:

Hello. Can you give me some update on how your cataract surgery went? Did you finally opt for monofocals with excellent near vision? What are your experiences? I'm considering the same option as you were, having worn glasses for distant vision since I was 11. I would appreciate your report. Thanks.

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I chose monofocal lenses with superior distance vision for both eyes. It seemed like the safe choice based upon recommendations from people who had gone through the surgery. My vision without glasses is now good enough for me to drive without corrective lenses. But my distance vision was not quite perfect, so I still wear glasses pretty much full-time to correct the imperfections and also bifocals to give me good near vision. (I can also use non-prescription reading glasses to correct my near vision.)

So all in all, I am happy with my choice and my vision now. My distance vision with glasses is now very good, and close vision with glasses is as good as it was before the operation.

Good to hear that your procedure went well.

Is your new lens cool or warm and did you get a choice? I had surgery about 17 years ago (in my 40's) after a blow to the head resulted in a cataract. Although it wasn't discussed at the time, I realised a few months after the procedure that my implant was cool, while my natural eye was relatively warm. It's only a small difference, but I guess it's an insight (excuse the pun) into how we each might perceive colours differently.

I also has a laser treatment to burn a small hole in the rear of the lens sack, after it frosted over a couple of years after the replacement lens surgery. This isn't uncommon and it's been fine since. It's quick and done without anaesthetic... that needle they use for the cataract surgery felt like it was coming out of the other side of my head!!!

As for distance vision, I find mine is pin sharp from about two feet to infinity. At a pinch I can read without glasses, but only in good light. The great thing about using scopes and binoculars is that all the little vagaries between one eye and the other are catered for!
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