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Thread: Cataract surgery

  1. #1
    Craftsman Rolthai32's Avatar
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    Cataract surgery

    Due to have surgery on my right eye on Friday

    Anyone had it done recently , interested in your experiences

    Thanks in advance

    Update

    Surgery went well stressful and uncomfortable ,helped a little my surgeon was Thai totty early 30's patch off yesterday immediate miraculous improvement just have to take it easy for a while (which I do anyway)

    Thanks for all the replies
    Last edited by Rolthai32; 4th March 2018 at 10:40.

  2. #2
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    If you are at the Bangkok pattaya hospital, my mate had his done there end of last year, really well done and back to normal very quickly.


    mike

  3. #3
    Master ingenioren's Avatar
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    Quote Originally Posted by Rolthai32 View Post
    Due to have surgery on my right eye on Friday

    Anyone had it done recently , interested in your experiences
    My wife had it done last year at Optegra in Portsmouth and all went very smoothly (10 minutes...) - the surgeon emphasised she use the antibiotics to ensure no infection for the first 1-2 weeks

    Good luck
    Cheers, Peter

  4. #4
    Mum had both hers done in last few months nhs
    In and out in no time
    Amazing results v v happy

  5. #5
    Master sish101's Avatar
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    My 84 year old Mum had hers done on NHS in Sunderland. No problems.

  6. #6
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    Both eyes done on the NHS, the Moorfields in London. Previously severe short sight at -10, now no need to wear glasses, except occassionally for reading in dim light. As one of my friends who had the same operation said "I can see through walls".

    After the op, you can suffer from some glare in very brightly lit places, plus a growth over the rear of the lens is not unusual,but that is a quick zap with a laser (mine done at the Royal Free in Hampstead).

  7. #7
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    Cataract surgery

    Had both eyes done a couple of years ago, no problem at all, as long as you use the eye drops they give you post surgery for the required period. The op itself is very straightforward and afterwards my distance vision is fantastic but I still need my glasses to read. It’s a hell of a difference between pre and post op. Best wishes.

  8. #8
    Craftsman Rolthai32's Avatar
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    Thank you all for the replies and putting mind at rest , still. Bricking it though

  9. #9
    Master brigant's Avatar
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    I had both my eyes done last year. It's nothing to worry about. You must keep your head perfectly still (they will provide a headrest for this). Then you have to look into a very bright light whilst they do the op. It's painless but I can understand your concerns. Takes about 15 minutes and you'll see the difference immediately. Like stated above you need to use eyedrops for a couple of weeks again, painless. Don't worry you'll be fine and your vision will be excellent afterwards.

  10. #10
    Grand Master mart broad's Avatar
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    Interested to read the replies seeing the specialist on the 8th so feeling a lot more confident and if I do not have to wear glasses again that's a result.

  11. #11
    Craftsman Rolthai32's Avatar
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    Quote Originally Posted by seadog1408 View Post
    If you are at the Bangkok pattaya hospital, my mate had his done there end of last year, really well done and back to normal very quickly.


    mike
    Thanks Mike about 450 klicks north

  12. #12
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    Can I ask if those who have had it done went for standard monofocal lenses or some of the more advanced multifocal or trifocal lenses? In the UK it seems that the NHS only implants basic monofocal lenses but is there anything to be gained by having these other types of lenses?

  13. #13
    Quote Originally Posted by Mr Pointy View Post
    Can I ask if those who have had it done went for standard monofocal lenses or some of the more advanced multifocal or trifocal lenses? In the UK it seems that the NHS only implants basic monofocal lenses but is there anything to be gained by having these other types of lenses?
    Mrs Addicks had both eyes done at Benenden Hospital using multifocal lenses.
    What was gained? She is "glasses free" for both reading and distance. The multifocals also correct for astigmatism.
    Hope that helps!

  14. #14
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    Quote Originally Posted by Mr Pointy View Post
    Can I ask if those who have had it done went for standard monofocal lenses or some of the more advanced multifocal or trifocal lenses? In the UK it seems that the NHS only implants basic monofocal lenses but is there anything to be gained by having these other types of lenses?
    Spectacle independence. Around 5% of people with multifocal lenses have significant symptoms of glare/haloes afterwards but most settle within 6 months. Other 95% of people are happy with them. Contrast sensitivity reported to be slightly lower than monofocals so might be important for some people.

    Can often have a degree of spectacle independance with NHS monofocals depending on prescription-discuss with your surgeon but likely to still need glasses for small print etc which can be avoided with multifocals in many cases.

    Main thing for cataract surgery is to stay still! People think they are being still but any slight movement of your leg etc has an impact on your eye...

  15. #15
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    I'm afraid I couldn't agree with that.
    Too many of my patients come back post multifocal implant generally disgruntled with the vision they have. It's "ok" but these people are aware they really can't see as well as they could pre-cataract with glasses/lenses. Yes they manage day to day without glasses and yes this is important but manage is the operative word. It is also very hard to provide effective spectacles if the initial surgery doesn't quite give the result planned or when things change. I am refracting a multifocal surface which doesn't work terribly well.
    I read a paper in the Ophthalmologist which spent 75% of its time discussing patient selection and 25% the lens choice.
    If you want to see "well" this probably isn't the way to go. Yet. But it has to be the way forward in the end but we aren't there at the moment.

  16. #16
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    Multifocal lenses are not for people who want the clearest near or distance vision. Sounds like the patients you mention expected to have "perfect" or near perfect near and distance vision without glasses after their surgery and therefore were given somewhat unreal expectations at a guess.

    You cannot have something for nothing and cataract surgery does and will not return your eyes to how they were when you were 20. Best vision will be obtained by monofocal lenses and glasses to assist with focussing at other distances. This is the reason why I said spectacle independance is the only reason to have multifocal lenses not best vision/fewest post operative symptoms etc. I would only suggest them for those who are prepared to compromise their vision to a degree in order to achieve that. I see loads of people who are quite happy with those lenses but I assume they were carefully selected and aware of the limitations before surgery.

  17. #17
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    Good luck and hope it goes well and you get the benefits!

    Jim


    Quote Originally Posted by Rolthai32 View Post
    Due to have surgery on my right eye on Friday

    Anyone had it done recently , interested in your experiences

    Thanks in advance

  18. #18
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    Quote Originally Posted by DavidL View Post
    I'm afraid I couldn't agree with that.
    Too many of my patients come back post multifocal implant generally disgruntled with the vision they have. It's "ok" but these people are aware they really can't see as well as they could pre-cataract with glasses/lenses. Yes they manage day to day without glasses and yes this is important but manage is the operative word. It is also very hard to provide effective spectacles if the initial surgery doesn't quite give the result planned or when things change. I am refracting a multifocal surface which doesn't work terribly well.
    I read a paper in the Ophthalmologist which spent 75% of its time discussing patient selection and 25% the lens choice.
    If you want to see "well" this probably isn't the way to go. Yet. But it has to be the way forward in the end but we aren't there at the moment.
    Quote Originally Posted by mmgg1988 View Post
    Multifocal lenses are not for people who want the clearest near or distance vision. Sounds like the patients you mention expected to have "perfect" or near perfect near and distance vision without glasses after their surgery and therefore were given somewhat unreal expectations at a guess.

    You cannot have something for nothing and cataract surgery does and will not return your eyes to how they were when you were 20. Best vision will be obtained by monofocal lenses and glasses to assist with focussing at other distances. This is the reason why I said spectacle independance is the only reason to have multifocal lenses not best vision/fewest post operative symptoms etc. I would only suggest them for those who are prepared to compromise their vision to a degree in order to achieve that. I see loads of people who are quite happy with those lenses but I assume they were carefully selected and aware of the limitations before surgery.
    Thank you for the responses. It does seem to indicate that there are problems with multifocal lenses & I think I would have issues if I ended up with halos at night in particular. Do you have any views on the newer trifocal lenses that are now available?

    My prescription is R -9.25 cyl -1.25 axis 20 L -8.00 so I am very shortsighted. Do you think this indicates monofocal are the best option or could I consider multifocal/trifocals?

  19. #19
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    I had worn glasses since I was two years old and my eyes were really bad. Contact lenses + reading glasses etc. Had lens replacement, which is basically the same as a cataract operation about 4 years ago and the results were fantastic. I had the multi focus lenses fitted and have not put on a pair of glasses since. My wife also had the same procedure, by the same surgeon, and was over the moon with the result.

  20. #20
    Master brigant's Avatar
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    So, Rolthai, how did it go??

  21. #21
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    Not entirely related but I had laser corrective surgery a few years ago. The procedure itself was pretty terrifying as I was awake throughout but the end result is amazing. Just make sure you keep with the aftercare

    Sent from my MI 5 using Tapatalk
    Last edited by bingobadgo; 3rd March 2018 at 01:45.

  22. #22
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    Quote Originally Posted by Mr Pointy View Post
    Can I ask if those who have had it done went for standard monofocal lenses or some of the more advanced multifocal or trifocal lenses? In the UK it seems that the NHS only implants basic monofocal lenses but is there anything to be gained by having these other types of lenses?
    Go for monofocal. Multifocal implants use concentric fresnel-like patterns to project two images on top of one another - one corrected for distance, one for close-up. So you always have a slightly out of focus image over the in-focus one and your brain is supposed to 'get used to it' and filter out the unsharp haze. Often it leads to strong halos around bright lights (like oncoming headlights) in the dark, or even around bright spots in full daylight. For a long while multifocal implants were prohibited for pilots, having them automatically lead to being declared unfit to fly. Note that once the implants are in and set (the remaining lens membrane has grown/tightened around them), they are not easy to remove.
    Best is just to get optimal correction for distance. After that you will be able to get by with any cheap pair of readers for close-up work. It is the safest bet, and you don't gamble with something as vital as your eyesight.
    If you needed regular glasses for myopia before, you will be entering a new world.
    Just be very careful during the first few weeks, follow that eyedrop regime religiously, and the pre-operation eyedrop and disinfection schedule as well. Learn not to touch your eyes. Tip: buy a cheap pair of cyclist's wraparound safety goggles and wear those during the first ten days or so, so you just can't accidentally touch your eyes or get any dust or dirt in them. If you want to look cool, get them as sunglasses.

    (I have two cataract implants, and I fly hot-air balloons. I took some time to do my research and discuss my needs as a pilot and the official aeronautical medical requirements with my cataract surgeon, so he did his best to get me optimal distance eyesight. I am now just short of 200 percent for distance vision, like a hawk. I juggle cheap readers for close-up tasks because I prefer them to the small in-focus areas in varifocal glasses. I use + 1.5 for computer work as well as for the reading sections in my flying sunglasses, and +2.0 for most other stuff.)

  23. #23
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    Quote Originally Posted by Fschwep View Post
    Go for monofocal. Multifocal implants use concentric fresnel-like patterns to project two images on top of one another - one corrected for distance, one for close-up. So you always have a slightly out of focus image over the in-focus one and your brain is supposed to 'get used to it' and filter out the unsharp haze. Often it leads to strong halos around bright lights (like oncoming headlights) in the dark, or even around bright spots in full daylight. For a long while multifocal implants were prohibited for pilots, having them automatically lead to being declared unfit to fly. Note that once the implants are in and set (the remaining lens membrane has grown/tightened around them), they are not easy to remove.
    Best is just to get optimal correction for distance. After that you will be able to get by with any cheap pair of readers for close-up work. It is the safest bet, and you don't gamble with something as vital as your eyesight.
    If you needed regular glasses for myopia before, you will be entering a new world.
    Just be very careful during the first few weeks, follow that eyedrop regime religiously, and the pre-operation eyedrop and disinfection schedule as well. Learn not to touch your eyes. Tip: buy a cheap pair of cyclist's wraparound safety goggles and wear those during the first ten days or so, so you just can't accidentally touch your eyes or get any dust or dirt in them. If you want to look cool, get them as sunglasses.

    (I have two cataract implants, and I fly hot-air balloons. I took some time to do my research and discuss my needs as a pilot and the official aeronautical medical requirements with my cataract surgeon, so he did his best to get me optimal distance eyesight. I am now just short of 200 percent for distance vision, like a hawk. I juggle cheap readers for close-up tasks because I prefer them to the small in-focus areas in varifocal glasses. I use + 1.5 for computer work as well as for the reading sections in my flying sunglasses, and +2.0 for most other stuff.)
    Yes, I agree with all of that. I’ve had one done with a monifocal and will need the other eventually (cataract progression currently very slow in that eye).

    One point: halos around bright lights in dim overall lighting is not only a potential issue with multi focals, since I get some of this. Not a big issue (and enormously less so than the pre-op position).

  24. #24
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    Thank you both for your helpful response. I think I now need to find recommendations for a consultant or hospital & make an appointment.

  25. #25
    Quote Originally Posted by Fschwep View Post
    Go for monofocal. Multifocal implants use concentric fresnel-like patterns to project two images on top of one another - one corrected for distance, one for close-up. So you always have a slightly out of focus image over the in-focus one and your brain is supposed to 'get used to it' and filter out the unsharp haze. Often it leads to strong halos around bright lights (like oncoming headlights) in the dark, or even around bright spots in full daylight. For a long while multifocal implants were prohibited for pilots, having them automatically lead to being declared unfit to fly. Note that once the implants are in and set (the remaining lens membrane has grown/tightened around them), they are not easy to remove.
    Best is just to get optimal correction for distance. After that you will be able to get by with any cheap pair of readers for close-up work. It is the safest bet, and you don't gamble with something as vital as your eyesight.
    If you needed regular glasses for myopia before, you will be entering a new world.
    Just be very careful during the first few weeks, follow that eyedrop regime religiously, and the pre-operation eyedrop and disinfection schedule as well. Learn not to touch your eyes. Tip: buy a cheap pair of cyclist's wraparound safety goggles and wear those during the first ten days or so, so you just can't accidentally touch your eyes or get any dust or dirt in them. If you want to look cool, get them as sunglasses.

    (I have two cataract implants, and I fly hot-air balloons. I took some time to do my research and discuss my needs as a pilot and the official aeronautical medical requirements with my cataract surgeon, so he did his best to get me optimal distance eyesight. I am now just short of 200 percent for distance vision, like a hawk. I juggle cheap readers for close-up tasks because I prefer them to the small in-focus areas in varifocal glasses. I use + 1.5 for computer work as well as for the reading sections in my flying sunglasses, and +2.0 for most other stuff.)
    Could different lenses (distance/close-up) be used for each eye, as can be used for contacts?

  26. #26
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    Quote Originally Posted by Kingstepper View Post
    Could different lenses (distance/close-up) be used for each eye, as can be used for contacts?
    Yes but can have issues in those who aren’t used to it i.e haven’t tried it with contacts before

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    Quote Originally Posted by Mr Pointy View Post
    Thank you both for your helpful response. I think I now need to find recommendations for a consultant or hospital & make an appointment.
    I can highly recommend professor David Gartry. Both my wife and myself along with several friends have had the benefit of his expertise. He is based at Moorefield's eye hospital but has a private practice. As mentioned before, I opted for the multifocal lenses and have had absolutely no problem whatsoever.

  28. #28
    Quote Originally Posted by coredriller View Post
    I can highly recommend professor David Gartry. Both my wife and myself along with several friends have had the benefit of his expertise. He is based at Moorefield's eye hospital but has a private practice. As mentioned before, I opted for the multifocal lenses and have had absolutely no problem whatsoever.
    Small world!!
    He did my 80 year old Mum’s left eye last Monday....right eye scheduled for tomorrow.

  29. #29
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    Quote Originally Posted by coredriller View Post
    I can highly recommend professor David Gartry. Both my wife and myself along with several friends have had the benefit of his expertise. He is based at Moorefield's eye hospital but has a private practice. As mentioned before, I opted for the multifocal lenses and have had absolutely no problem whatsoever.
    Thank you. As I'm not eligble under the NHS I may have to look at going privately. I wonder if I could swap one kidney for two new lenses?

  30. #30
    Grand Master mart broad's Avatar
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    Had my right eye done last week result total discomfort, mild headaches and one eye doing one thing the other doing something else difficult to read and view TV and will still need variofocal glasses no real difference from previously the other eye will be done in about 5/6 weeks not happy and will be calling the surgeon it was done privately
    Last edited by mart broad; 18th March 2018 at 14:19.

  31. #31
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    Quote Originally Posted by mart broad View Post
    Had my right eye done last week result total discomfort, mild headaches and one eye doing one thing the other doing something else difficult to read and view TV and will still need variofocal glasses no real difference from previously the other eye will be done in about 5/6 weeks not happy and will be calling the surgeon it was done privately
    I'm sorry to hear the results of the operation aren't good at the moment. Is this partly due to the imbalance between your eyes at the moment ? If I had it done I will have one eye perfect & the other at -8.00 which I think will be a problem.

    Would you care to share where you had it done & who the surgeon was? Maybe by PM is best.

    I hope things improve & you end up happy with the result.

  32. #32
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    I’m no expert, but isn’t a week too soon to assess this? It’s normally advised you wait a month before getting refracted, and as has been said there may be problems of merging two very different images at the moment.
    I was still in quite a bit of discomfort at 5-7 days, but things settled quickly after that.

  33. #33
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    I recommend 6 weeks post op for refraction. Anisometropia caused surgically is always a pita until you can be refracted. Sometimes taking one lens out of your old specs helps.
    Last edited by DavidL; 18th March 2018 at 23:21.

  34. #34
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    If you presently wear contact lenses be sure to take them out for your eye examination, I did not and the wrong strength implant was inserted .
    It was picked up when I went back for the one week check up ,the correct implant was then fitted and I have had no problems since .


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  35. #35
    Quote Originally Posted by Kitz View Post
    If you presently wear contact lenses be sure to take them out for your eye examination, I did not and the wrong strength implant was inserted .
    It was picked up when I went back for the one week check up ,the correct implant was then fitted and I have had no problems since .


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  36. #36
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    Quote Originally Posted by Kitz View Post
    If you presently wear contact lenses be sure to take them out for your eye examination, I did not and the wrong strength implant was inserted .
    It was picked up when I went back for the one week check up ,the correct implant was then fitted and I have had no problems since.
    That's negligent to the point where it should have been reported to the local authorities. I've been told not to wear my lenses for two weeks prior to my assesment so that the true prescription can be measured.

  37. #37
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    Quote Originally Posted by Mr Pointy View Post
    Can I ask if those who have had it done went for standard monofocal lenses or some of the more advanced multifocal or trifocal lenses? In the UK it seems that the NHS only implants basic monofocal lenses but is there anything to be gained by having these other types of lenses?
    I had both my eyes done in 2014 as I had severe cataracs at the age of 57. Monofocal. Get corrected for distance only (infinity). Multifocal or trifocal lenses are a no-no. These use fresnel type rings to project two or three differently focused images on top of each other and 'your brain will sort it out and learn to neglect the fuzzy ones'. Yeah, right. Whatever you look at the image will never be as sharp as with monofocals, and in situations like night driving they cause halos and reflections all over the place. When I gor my implants, bifocal or multifocal implants were prohibited for pilots - if you were stupid enough to get them you would end up declared unfit to fly any aircraft for life.
    The only 'complex' lens that is useful is one with a cylindrical correction (toric) to correct astigmatism, if you had that before the operation. With severe astigmatism, you can't see sharp at any distance, which is even shittier than straight myopia (at least in the latter case you can see very small things in close-up, like splinters in your finger).
    The goal of any eye surgeon should be to get you the best possible distance vision with the least distortion, halos etc. possible. If that succeeds, the only thing you will ever need after the op is a pair of cheap off-the-shelf reading glasses for the distance you prefer (I use +1.5 for computer work and as a reading section in my driving/flying sunglasses, and +2.0 for reading books and small print, and have close to 200 percent vision at infinity - 6 metres/20 feet and further. At 3 metres/10 feet I'm still at about 100 percent and in bright daylight I can read newsprint without glasses at arm's length).

    BW, I get the impression that one or two posters in this discussion confuse cataract implants (i.e. replacing the natural lens in your eye with a plastic implant lens) with lasik laser surgery to reshape the cornea and thus make you 'glassless'. The same problem with the fresnel effect for multifocal exists there as well, but it is not the same procedure at all.

  38. #38
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    Quote Originally Posted by Mr Pointy View Post
    I'm sorry to hear the results of the operation aren't good at the moment. Is this partly due to the imbalance between your eyes at the moment ? If I had it done I will have one eye perfect & the other at -8.00 which I think will be a problem.

    Would you care to share where you had it done & who the surgeon was? Maybe by PM is best.

    I hope things improve & you end up happy with the result.
    I understood that any difference beyond 2 diopters in correction between the two eyes is too difficult for the brain to process, so yes, one eye operated on and one still at -8.00 would be pretty horrific. You'd have to get a contact lens for the -8.00 eye, so the image would not be smaller - it happens with glasses, not with contacts. (some people get laser refracted in the second eye instead, which has its own disadvantages; better go for the contact lens and see if that works for you).
    If you need to wait 6 weeks before the second eye gets operated on, that is just temporary. Once the second eye also gets an implant corrected for distance both images will be the same size and there will be no discomfort. I think that once a patients needs cataract surgery and it concerns someone with more than a 2 diopter correction in their glasses, that should be sufficient medical reason to operate both eyes, not wait for years until the second eye gets a sufficiently thick cataract as well. Good vision is important to quality of life and safety. But I guess health insurers just hope that the patients will keel over before they need a second procedure. :-(

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