Cataract Surgery-success with multifocal implants?

Parent Cafe
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<p>I read some of the older cataract surgery threads that convinced me not to be frightened of the surgery. Thanks to all who posted! Now, I’m hoping to hear from those who picked multifocal IOLs and if you are happy. My dr is strongly suggesting that I get the Technis Multifocals. </p>

<p>I’ve done some research and it seems that these multifocals allow you to see far and near with a compromised intermediate range. There are trifocals under review and widely used in Europe but not approved for the US yet. I’ve made some calls and there is no “due date” for when/if these will be available in the states so that’s a bummer and since I can’t see now to drive in the day, waiting 6 months might be bearable but waiting a year is not really an option. I don’t live in an area that is doing the trials.</p>

<p>I mainly want to see my computer and see to watch tv. I haven’t been able to drive at night for years so I’m not as concerned with the halos often reported but I would like to be able to drive in the day. Wearing readers to see a menu is no big deal, wearing contacts and readers almost all the time is maddening having to have one hand free to constantly pull the readers on and off. </p>

<p>Is not being able to see peoples faces, see yourself in a mirror, see the computer screen or see merchandise on grocery store shelves what they consider intermediate vision loss with the multifocals? If so, wouldn’t one have to wear glasses all of the time anyway even just to see the curb to cross the street? </p>

<p>I am really nearsighted and have tried all different contacts to narrow down which type of lens to get. The price in my area for the premium lens is $2700 per eye and I have to get both eyes done so naturally, I wanted to try and go for the non premium ones. I tried one eye near and one eye far and couldn’t really adapt. If I were to get both eyes done with the standard lenses to see distance, I would need glasses for intermediate and close. I am on the computer all day so virtually, I would need glasses all of the time and be pulling them on and off depending on what I needed to see. </p>

<p>Thanks in advance for any tips or experience. This is a very difficult decision for me and the cost is a big factor since I have a freshman in college. Our EFC is less than the cost of premium lenses so coming up with the money is going to be tough but I’ll sacrifice anything if the multifocals work well.</p>

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<p>I don’t have any experience to add, but relate to much of what you wrote. I do the contacts and readers thing, work on a computer all day long, struggle with contacts bugging me, etc. Would consider doing cataract surgery soon, but still on the fence. Doesn’t insurance cover at least some of the cost?</p>

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<p>Thanks rockvillemom. Yes, insurance covers the entire cost except for whatever co-pay one has, the eye drops (~$300) but they do NOT pay the difference for the premium lenses which in my case is an additional $5,400. I think most people get them when they are older so medicare pays for the surgery but medicare also won’t pay for the premium lenses.</p>

<p>Because the cost is so high, I was hoping people who had the multifocals would chime in here with their experiences. Maybe not many people do them? </p>

<p>I finally tried the multifocal contacts out of frustration with contacts/readers and I think it might have worked if we had not found the cataract. Maybe that is an idea for you? I could see all ranges but there is some give and take. For example, for me to be able to see great up close, I had to give up seeing distance great. That was fine unless I had to drive! </p>

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<p>Would it work to have implants to see close and then use glasses to drive?</p>

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<p>Hi emeraldkity4, that’s a good idea but I was told “close means close” and I wouldn’t be able to see the tv 6 ft away and then still have to wear glasses all of the time to see intermediate and far taking them off when I want to look at something close. Those are my 2 “free” choices=either see far and need glasses for intermediate and close OR see close and need glasses for intermediate and far. No wonder someone invented the multifocals and found a way to charge a premium for them.</p>

<p>I’m finding some more information researching and the literature all says that I will be able to see all 3 levels with the multifocals but the middle level is not going to be great. It might be great to me since I can’t see much now so I’m going to try to get them if I can. Thanks again.</p>

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<p>Eyes can change after surgery.
Six years ago, I had cataract surgery with “one speed”–not multi focal-- lenses. I had been severely myopic and had lost my night vision.<br>
Immediately after the surgery, I could see all the way to China. Amazing! I have not maintained that level of visual acuity. I now wear “normal” progressive lens glasses. I can see across the room and watch TV without my glasses. I can drive at night in familiar areas.
However, I have had several prescription changes, including developing strabismus, since the surgery. I do not know how frequently others’ prescriptions change, but I cannot imagine how it works out for people with multi-focal lenses if part of their prescription changes.
Perhaps a discussion to have with the doctor?</p>

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<p>My prescription changes about every time I go in (1-2 years)
My current prescription is -12, with some astigmatism & progressive lenses for reading, but I don’t think that spot on the lens is big enough because I find it easier just to take my glasses off & hold what ever I am trying to read under my nose!</p>

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<p>Thank you so much, Merlin, for your post. This issue of changing prescriptions after surgery was never mentioned. I can’t imagine how they could do progressives after having multifocal implants so that is a question I will need to address. I also found out that only about 5% of people pick multifocals and I was surprised but with the lack of responses here, I believe it now. </p>

<p>Since so few pick them, there isn’t a lot of data about how to adjust changes down the road. I also read that of the small percentage of those who do pick multifocals, around 5%, have them removed so those are not great odds IMHO. They say it can take up to 6 months to adjust but if you can’t adjust and require a lens exchange, they want you to do it within 3 months. All of this is scary to me! Even though they were approved earlier in Europe, there aren’t that many done there either. Most of the countries make the patient pay for the entire surgery instead of just the cost of the premium lenses like we do in the US. </p>

<p>There is a “protocol” for picking the idea patient, too and wouldn’t you know, it says don’t select patients that have a lot of questions, will be demanding and expect good vision, wth?! If you ask too many questions, then the drs decide you are not an “ideal” candidate! Not sure what to do but I really have to think this over. I have my preop apt next Wed. Once they do all the measurements, I might not be able to get them anyway. You have to have low astigmatism, (don’t know what mine is), the proper pupil size (don’t know this, who does?) and a bunch of other guidelines so they might tell me no anyway. Then I would have to decide if I want to wear glasses to see far or near, bummer. I can’t even decide that! The normal recommendation is to see distance and then use glasses for close up but if you’ve always seen close up, like me, it would be odd to make the switch. I can’t imagine what that would be like.</p>

<p>emeraldkity, you are pretty blind at 12, poor thing. I am around 6 but I also take off my progressive to see up close and hold the book about 2 inches from my face and it’s a pain. I got a piece of glass in my foot and now that I am getting older, I couldn’t get my foot up to my eye and had to go to the dr to get it out! My prescription was pretty stable, went a few years between increases but this last year, I had a change in Aug, Nov, Jan and then finally, we were unable to make my left eye see well with any prescription so that’s when I went and found the cataracts.</p>

<p>Thank you both for your comments.</p>

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<p>Thank you so much, Merlin, for your post. This issue of changing prescriptions after surgery was never mentioned. I can’t imagine how they could do progressives after having multifocal implants so that is a question I will need to address. I also found out that only about 5% of people pick multifocals and I was surprised but with the lack of responses here, I believe it now. </p>

<p>Since so few pick them, there isn’t a lot of data about how to adjust changes down the road. I also read that of the small percentage of those who do pick multifocals, around 5%, have them removed so those are not great odds IMHO. They say it can take up to 6 months to adjust but if you can’t adjust and require a lens exchange, they want you to do it within 3 months. All of this is scary to me! Even though they were approved earlier in Europe, there aren’t that many done there either. Most of the countries make the patient pay for the entire surgery instead of just the cost of the premium lenses like we do in the US. </p>

<p>There is a “protocol” for picking the idea patient, too and wouldn’t you know, it says don’t select patients that have a lot of questions, will be demanding and expect good vision, wth?! If you ask too many questions, then the drs decide you are not an “ideal” candidate! Not sure what to do but I really have to think this over. I have my preop apt next Wed. Once they do all the measurements, I might not be able to get them anyway. You have to have low astigmatism, (don’t know what mine is), the proper pupil size (don’t know this, who does?) and a bunch of other guidelines so they might tell me no anyway. Then I would have to decide if I want to wear glasses to see far or near, bummer. I can’t even decide that! The normal recommendation is to see distance and then use glasses for close up but if you’ve always seen close up, like me, it would be odd to make the switch. I can’t imagine what that would be like.</p>

<p>emeraldkity, you are pretty blind at 12, poor thing. I am around 6 but I also take off my progressive to see up close and hold the book about 2 inches from my face and it’s a pain. I got a piece of glass in my foot and now that I am getting older, I couldn’t get my foot up to my eye and had to go to the dr to get it out! My prescription was pretty stable, went a few years between increases but this last year, I had a change in Aug, Nov, Jan and then finally, we were unable to make my left eye see well with any prescription so that’s when I went and found the cataracts.</p>

<p>Thank you both for your comments.</p>

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<p>You have probably read my story from a year ago. I am the SEVERE eye phobic. Here’s my update:</p>

<p>I don’t have multi-focal lenses, but the lenses I got gave me great distance and 3-6 feet vision. Up close, terrible. I have had 3 prescription changes in the last year and am still not happy with my vision for work. My astigmatism is back fully in the right eye and partial in the left (hence the lens change). I also now have floaters and white arc flashes in both eyes. I am assured that these are from the surgery and not detached retinas. They should eventually resolve, but they are large enough to be very annoying. I have the beginnings of the film starting, but I am tolerating it. I believe I will need another procedure in a few years to correcdt this because I feel it is progressing. My eyes are dryer than ever before.</p>

<p>I wear my glassses all the time. I have progressive lenses at all three distances due to the astigmatism.</p>

<p>However, I LOVE to wake up in the morning able to see the clock and check the weather outside without wearing glasses. I can watch TV without, but I wear them all day. I also can drive without them, but don’t.</p>

<p>I had NO choice about cataract surgery as my vision was declining rapidly. Am I happy? I am happy that I have my sight and I tolerate all the complications.</p>

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I’m bumping up this thread to see if anyone has any updates on their vision. I’ve scheduled surgery for multifocal lens implant and now I’m wondering if I should call and change. I’ll be paying about $3,000/eye for the lens, plus a few extra hundred for lasering the cornea for astigmatism. Has anyone done this?

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I also had cataracts surgery. I my case, I still needed correction for both distance and close up vision. I wear progressive lens. Due to eye phobias, I never went the contact route. As you make your decision, keep I’m mind that if all goes well, you will need minor to no distance correction. Your eyeglass lens will be very light compare to what you need now. Also, you will have a greater selection of frames to choice from since lens thickness will not limit you.

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My wife’s vision since having multi-focal lenses put in both eyes has been both fine and stable.

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I had surgery for both a cataract and glaucoma in July. I opted for the distance only lens since I didn’t have to pay extra (although I did choose to have a laser do part of the surgery and that added $1500 out of pocket since most health insurance doesn’t cover that. That wasn’t mentioned until closer to my surgery date, so you might want to ask about that).

Anyhow, my glasses prescription was fairly weak at -1.75 with an astigmatism correction, but the difference after surgery for middle (computer) and farther distance (TV and driving) has been amazing. Part of it is getting rid of the cataract, which was very bad due other medical issues. The near closeup reading is a problem, however. That lens simply cannot focus on near things, basically reading for me. But readers completely take care of that problem.