Shooting after cataracts surgery

[baldhunter]

I just went to schedule my cataract surgery a couple of weeks ago.I have a real high astigmatism in both eyes.I looked into what type of lenses would be good for me,along with some help from here too,before I saw the doctor.I was hoping he would do the Toric lenses.They did the final evaluations and measurements and the doctor suggested the Toric lenses.He said I was not a candidate for multifocal lenses,but the Toric would give me very good regular and distance vision.He said I still may need some readers for close up work and reading.My surgeries are scheduled for the last week in July and one week later the first week of August for the second eye.My cost for the surgery,lense and eye drops that I purchased from their office that was a premix of three type of drops came out to $1320.00 per eye with Medicare and United Health Care PPO insurance.The drops were $75 out of pocket expense.I could have had a prescription for the eye drops,but it would have been three prescriptions and insurance may or may not cover it.I went with theirs because I only had to put one drop in my eye instead of three drops each time.After wearing glasses with astigmatism correction for 62yrs,I am so ready to have this surgery.I have been having my cataracts checked for the last three years.The doctor said I had them but they weren't quite ready.This past April he said they were ready and whenever I wanted it done just let him know.I started noticing a small change in my vision around January.When I saw the doctor in April,I could tell it had become a little worse.Since then I can really tell it's getting worse.I was taking with the girl that was scheduling my surgery.I was telling her how quickly my vision is changing.She said a lot of people tell her the same thing,once it starts changing it can change fast.If I can see without glasses with the Toric lenses like in the picture,I'm going to be very happy.It will be a life changing event for me to see clearly without glasses.You also have to put drops in your eyes for three days prior to surgery and four weeks there after.It also comes with post surgery instructions:
NO stooping,bending,lifting over 10lbs.Avoid strenuous activity.Rememberto keep your head above your heart for 2 weeks.

 

[Rick Richard]

I just went to schedule my cataract surgery a couple of weeks ago.I have a real high astigmatism in both eyes.I looked into what type of lenses would be good for me,along with some help from here too,before I saw the doctor.I was hoping he would do the Toric lenses.They did the final evaluations and measurements and the doctor suggested the Toric lenses.He said I was not a candidate for multifocal lenses,but the Toric would give me very good regular and distance vision.He said I still may need some readers for close up work and reading.My surgeries are scheduled for the last week in July and one week later the first week of August for the second eye.My cost for the surgery,lense and eye drops that I purchased from their office that was a premix of three type of drops came out to $1320.00 per eye with Medicare and United Health Care PPO insurance.The drops were $75 out of pocket expense.I could have had a prescription for the eye drops,but it would have been three prescriptions and insurance may or may not cover it.I went with theirs because I only had to put one drop in my eye instead of three drops each time.After wearing glasses with astigmatism correction for 62yrs,I am so ready to have this surgery.I have been having my cataracts checked for the last three years.The doctor said I had them but they weren't quite ready.This past April he said they were ready and whenever I wanted it done just let him know.I started noticing a small change in my vision around January.When I saw the doctor in April,I could tell it had become a little worse.Since then I can really tell it's getting worse.I was taking with the girl that was scheduling my surgery.I was telling her how quickly my vision is changing.She said a lot of people tell her the same thing,once it starts changing it can change fast.If I can see without glasses with the Toric lenses like in the picture,I'm going to be very happy.It will be a life changing event for me to see clearly without glasses.You also have to put drops in your eyes for three days prior to surgery and four weeks there after.It also comes with post surgery instructions:
NO stooping,bending,lifting over 10lbs.Avoid strenuous activity.Rememberto keep your head above your heart for 2 weeks.

View attachment 583821View attachment 583822

And don’t forget to shake the heck out of the medicine bottle to ensure good mix prior to application into the eye.

 

[Frog4aday]

@Frog4aday
Hi! I am 77 yo with PSC in both eyes, Astigmatism of; Right = 1.07 D @ 0* and, Left = 0.48 D @ 96*. I will be having Cataract Surgery and am trying o decide between regular lenses with LRI as part of Cataract Surgery for Right and the same for Left or, a Toric Lens for Right. I have choice of Lenses with Technis Monofocus being my current inclination. Your "Off-the Record" remark / comment would be sincerely appreciated. Thank you for reading!

Hey @stever88
Sorry for the slow response.
I am not a doctor and I don't know your ocular history so of course the best decision is to go with what you and your doctor agree suits YOUR situation best.

Hypothetically, if it were me with the astigmatism you indicated, I would get a toric IOL in my right eye to correct the one diopter of astigmatism.

In the left eye, I would go w/a simple monofocal IOL (the Tecnis lens is very good) and NOT have the LRI due to the less than half diopter of astigmatism in that eye. Some of that astigmatism could be lens based (vs. being in the cornea) and after surgery you may only have a quarter diopter remaining and that won't even be noticeable, especially if your surgeon makes the phaco probe incision in the optimal location.

LRI is a valuable tool in the eye surgeon's "tool kit" for correcting astigmatism but I think a toric lens in the right eye and a standard monofocal lens in your left eye will be just fine to give you great post-op vision w/o risking any complications that come with doing an LRI.

Again, you and your doctor know your eye history & pre-op exam results so hopefully the two of you come up w/a plan that best works for your eyes & post-op goals. Good luck!

 

[Frog4aday]

Had my right eye done May 15th along with a Vitrectomy. My vision is jot as good (blurry) at distance as prior to the surgery. Doctor says give it a couple of months more to stabilize and he will tweak it to get rid of the residual astigmatism.

Hey Rick,
I'm bummed to hear your vision is worse now than before the surgery (did I read that right?)

Has your surgeon mentioned "macular edema" (macular swelling) to you? Are you still using the "milky" looking eye drops (prednisone), several times a day?

Doing a vitrectomy on top of the cataract extraction means more surgical time in the eye and that can make the macula angry. In time, and with medicine (anti-inflammatories, like prednisone) , that edema can go down & vision will (should) get better.

You could also have a posterior capsular opacity (PCO) and they will be able to clear that up w/a YAG laser treatment 90 days after your surgery.

The comment about waiting several months then correcting residual astigmatism is odd to me, but I will trust your surgeon is keeping a close eye on you and has a plan to get you fixed up. Maybe he was hoping the cataract surgery would fix more astigmatism than it did & there is enough left over to need an LRI at some point to sharpen your vision up? He will hook you up w/whatever you need to get you seeing as good as possible, I'm sure! They want you happy.

 

[Frog4aday]

Had surgery last week in the left eye. LRI and standard lense. Been a rough week with 3 days of major irritation and currently distance vision is blurry with close vision crystal clear. Oddly my follow up apt shows I’m 20/20 but was told to chill out and be patient. Next apt is 2 weeks. Hoping it settles in and my far vision is good. My right cataract is beginning to be more evident.

Hey @BrentM
Three days of post-op irritation is not the norm, but when you get LRI, those are extra incisions to the cornea that can take 24 to 72 hours to heal, so that's likely what was going on. Hopefully you are past the worst of it now.

You said your NEAR vision was "crystal clear" but far was blurry, then reported that your visual acuity was 20/20. Was that your DISTANT visual acuity? Or NEAR? Regardless, the good news is it means your macula is fine (not swollen.)

But if your DVA (distant visual acuity) is poor & your NVA (near visual acuity) is really good, the question becomes - was that the goal (i.e., planned outcome)?

Some people get monovision (one eye set for good DVA, one eye set for good NVA). And if that was the plan and this was meant to be your good NVA eye, then all is well. If not, and if things don't get better, your surgeon owes you an explanation. I guess we'll see how things look for you in two weeks. I'm hoping things improve and you just keep seeing better w/more time and healing. Keep us posted.