I’m over month out from the second surgery. Only effect has been dry eyes which are gradually improving. I got the premium toric (astigmatism) and distant vision correction. I have worn glasses since early childhood for distant vision. I love now seeing far at 20/20 and use readers for close (over the counter type). It takes some getting used to, since it is opposite of what I am used to.
I guess my question would be if correcting the astigmatism (premium lenses) would help over all?
Not sure, but when I told him that my primary goal (other than being able to drive safely at night again) was to keep my ability to read without glasses he recommended the basic lenses. We did discuss the astigmatism briefly but it didn’t seem to be compatible with keeping my close vision. I’m hoping that removing the cataract in my right eye will help blurring overall since it seems to be what’s causing blurring in that eye (which until a couple years ago was my “good” eye since it doesn’t have an astigmatism) and that as we’ve done all my life we will correct the astigmatism in my left eye as well as possible. They can usually get it to or close to 20/20 but it’s always a bit blurry. I seem to be very sensitive to blur since I don’t hear others complain. The hot shot ophthalmologist actually said it was my choice to get the cataract surgery now or wait - didn’t push me at all - but I didn’t see any point in waiting since I’d have to do it eventually and maybe it will help.
Fellow blurry vision sufferer here!
My husband likes his implanted lenses, which allowed him to get rid of his contact lenses. They adjust to be ok for reading. So my thought is that I really like my current ability to read (or use computer) without glasses. Might just do standard lenses. Bonus is that my stable of glasses and sunglasses will still work.
@Youdon_tsay - Do you currently use eye drops for your glaucoma / high eye pressure? I do, but it’s interesting to know that when I do cateracts perhaps they would also be able to do procedure to further reduce pressure. (I thought it had to be a separate surgery. So far it has not been warranted due to success with the drops.)
Yes, they can…and I had that done in one eye (I had other surgery on my left eye to ease pressure before my cataract surgery). The pressure reduce they did when I had my right cataract done definitely reduced my pressures, and meant only on type of eye drop…one drop per day…as opposed to two kinds and twice a day. Whatever this is can only be done in conjunction with cataract surgery.
The procedure I had done on my left eye before was actually way better…no drops! And a significant drop in pressure.
@eyemgh might be able to explain these procedures.
I don’t mind the drops. (One drop Latanoprost in each eye at night, $7 every three months). However down the road if more mitigation surgery would be needed tis cool if it were in combo with cateract work. Recently I’ve decided to switch all my care to the group that includes my glaucoma specialist, have all my records same place.
Cataract surgery alone lowers pressure a little bit. While the eye is open though, a small device can be implanted. It’s a really easy addition. The process is referred to as MIGS, minimally invasive glaucoma surgery. The combo might not lower you enough to eliminate latanoprost though. It’s a strong drug, lowering IOP roughly 30%. Cataract surgery even with MIGS can’t typically hit that mark.
Yes, MIGS is what I had done on my right eye when I had my cataract surgery.
Trabeculectomy: A traditional surgical procedure where a surgeon creates a new drainage hole (a flap in the white part of the eye) to allow fluid to drain under the conjunctiva and be absorbed.
I had this on my left eye (way before cataract surgery) because that eye alone was resistant to the drops and I was having a systemic allergic reaction to the various drops they kept trying. Oddly, my right eye didn’t have the same issues…swelling, redness around the eye, etc. It was pretty awful! Since this procedure, I’ve needed no drops at all in my left eye.
How about suggesting an EDOF lens to your doctor? This has a better range than plain lens and doesn’t have concentric circles like those in multi-focals?
I would like to try a multi-focal in my right eye, having had the basic lens in my left eye years ago. I need to wear glasses for mid and near vision.
Husband was recently diagnosed with glaucoma in one eye and also has mild cataracts. Ophthalmologist started him on latanoprost but, as she said, why do you have to be my only patient who doesn’t respond to it? And his other eye increased in just a couple of months and now also measures as glaucoma. She said if it was her family, she would recommend proceeding with cataract surgery. Without glaucoma, cataracts likely wouldn’t need to be done for a couple of years at least. Husband isn’t ready yet so she prescribed Timolol instead for six weeks.
So husband decided to ask an old childhood family friend who is an ophthalmologist in the Boston area whose specialty is glaucoma. He also said cataract surgery is the best option or, at a minimum, glaucoma surgery. But it wasn’t so urgent that husband couldn’t try the new drops first.
Side note, the valedictorian from my high school is a really really big deal ophthalmologist in Boston. But (a) we don’t live in Boston and (b) haven’t talked to him since my five year reunion.
I hope husband doesn’t decide to have only the glaucoma surgery. Because why have two kinds of eye surgery in a relatively short time. But this is the same guy who put off his hip replacement until he could hardly walk, and also waited to have each of his rotator cuff surgeries (years apart, different shoulders) until he was in constant pain. To round out his four bodily quadrants, he also had a hamstring reattachment. That one he couldn’t put off!
I have cataracts, first diagnosed about 5-6 years ago, but so far only issue has been glare so it’s up to me when I feel they’re interfering in my daily life. I am near sighted and like to read in bed without glasses, so will be willing to use glasses for distance - but not close up. I’m hoping I can get those new lenses that get fine tuned after installation. But apparently I now also have a touch of astigmatism so who knows when the time comes.
He should actually be examined by a fellowship trained glaucoma specialist with repeat fields and OCT, not just have a conversation.
Did he recommend a lens that corrects your astigmatism? If so, that isn’t considered a basic lens.
Husband was just getting an opinion about his options from the friend; he’s been going annually to a board certified ophthalmologist who has been practicing for over 20 years. She did multiple tests on him although I don’t know the technical terms.
Is that ophthalmologist a fellowship trained glaucoma specialist? They exist for a reason, primarily for special glaucoma surgeries, but also to suss out atypical glaucomas and glaucoma mimicking syndromes. Failure of primary open angle glaucoma to respond to a prostaglandin as primary therapy is rare and should not be hand waved away.
Just because someone is an ophthalmologist doesn’t mean they see a lot of glaucoma, or that they are highly competent managing it. Glaucoma isn’t cataracts. The damage is irreversible. The best one can do is to slow it down. As someone who has seen thousands of primary, secondary and mimicking cases, I’d want a second opinion with blindness on the line.
If you get a fixed lens and correct for distance it’s true that your close vision is affected. I’d suggest to anyone to try it out with contacts prior to any surgery. I tried distance only with contacts and it drove me batty–I could see across the room but not read what was in front of me.
You can do monovision–one eye fixed for distance and one close up. I did this with contact lens and it was great. No glasses at all. I almost did this for cataract surgery. Before you choose an option such as this you MUST (in my humble opinion) try it out with contacts. It’s disorienting at first but after about three days the brain adapts and it’s seamless vision for close and distance. But about 20% of people never adjust–and you definitely don’t want to find out too late that you’re one of them.
It’s a lot more expensive than basic lens but they make lens that allow you to see close and distance. Multi-focal. That’s what I opted for. I love it. My doc warned that starburst could still exist some (usually goes away after about a year) but that didn’t bother me. My vision has never been this good in my entire life. Make sure your surgeon is great, not just good. Research your doc and don’t be afraid to go elsewhere.
My astigmatism was terrible along with great near-sightedness. I asked about it and doc just said “not a problem”. That surprised me because all I’d heard prior was I probably couldn’t do the multifocal type because of it. There are so many advancements in the lens. In fact between my initial appointment and the surgery time new improvements were introduced and I received a newer lens.
It’s important that you go somewhere for your surgery that does a TON of them. That stays on top of new developments and products. You’re going to live with this a long time so don’t settle for less than the best.
My surgeon had a glaucoma fellowship at The University of Texas Southwestern Medical Center at Dallas. Is that the kind of credential that is preferred?
I don’t want to give the impression that everyone with glaucoma needs a glaucoma specialist. That’s like saying everyone with a headache needs a neurologist. If things fall outside the typical pattern, AND you think a second opinion is warranted, then they have the most exposure to atypical things. Remember, atypical is often still normal.
Xalatan came out 30 years ago, but prostaglandin non-responders are so uncommon that it wasn’t described until very recently. There are things that inhibit uveoscleral outflow (inflammation, pseudo exfoliation, angle recession, etc.) that any doctor should see, but it’s rare for generalists to pick up a gonio lens anymore.
A glaucoma specialist will likely confirm, but if there’s something odd, they’ll find it.
I was diagnosed with narrow angle glaucoma and had laser surgery. It was in-office and I had no issues afterwards. I do have to take (daily) two medications (eyedrops)—Travoprost and Timolol.
Travoprost is a generic—I asked my doc if I could use a generic because the original drug she prescribed, Travatan Z, was a Tier 3 drug under my Medex (BlueCross/BlueShield) insurance and it cost me $250 a month at CVS. With the generic and a coupon (GoodRx) I pay much less; I also switched to a small non-chain pharmacy.
One side-effect of the Travapost that I experienced, which doesn’t bother me at all, is that my eyelashes are much longer!
I also had cataract surgery (three years later) and all went well. It was really startling because I felt like I went from looking at the world in black and white to looking at it in color. I chose the monofocal lens. I don’t mind reading glasses—I also found that I didn’t need the readers as much as before the surgery. I can read most everything except very small type.
wore glasses almost 50 yrs. had 3 eye exams in 2023 until they finally agreed it was time.
prescription was so strong that my frames were mistaken for children’s since they were quarter size to allow for high index and reasonable thin lens.
my father and sister also had the procedure with no issues, the latter paid for upgrade. my choice was basic simply to be able to order normal frames if necessary. mlk day 2024 was date of right eye.
instead the results were incredible. after first eye was done, i could read closed caption on tv. after the second was completed, no more glasses were needed. n = 1. ymmv