no way, Mandarin as well! World is too small.
Just got back. Will PM you in a little bit but wanted to put something in the public domain so others might provide additional insight.
You stated this is you non-dominate eye, which is important information. Is the dominate eye cataract free? This is where what IOL you decide on can make a difference.
If you are thinking about Vivity for both eyes eventually and your dominate eye sees 20/20 distance (corrected) and maybe has presbyopia, you might considering micro-monovision for that non-dominate eye. I would talk to your doctor and get her opinion on setting the dominate eye for Plano (when you eventual have it done) and the non-dominate eye for -0.75D. I want my dominate eye to have the best overall vision.
On the other hand if your dominate eye does not have the problems that the cataract eye has, maybe you could get the Tecnis Synergy IOL in that eye (assuming it is FDA approve and available by that time) and shoot for plano with the Vivity in the non-dominate eye.
I just want you to give thought to the mixing and matching of IOLs and monovision options and how the 2 eyes will work together to give you the best vision possible and discuss this with your Ophthalmologist.
Wish you well ClaudiaRM
report back on how it went. Helps others making that decision.
So let me get this straight. Your going to put in a new iol that is made of the exact same material as the the one that opacified ( so badly it made everything blurry ) in only 4 weeks?
To be clear, multifocal visual disturbances never “go away”. You can’t change physics. A more accurate thing to say is that the brain habituates to them. The visual disturbances are still there and if you THINK about it you will see then exactly the same as you always have. It’s just that if your DON’T think about it you don’t notice it. You brain learns to “filter them out”. But they’re still there.
I have Tinnitus and I think it’s the same kind of thing. For the first 2 years it drove me insane. I seriously thought I was going to lose my mind. But for the past 20 years it’s been like I don’t even have it. It’s still there though. I’m hearing it right this moment as I type this because I’m talking about it. It hasn’t gone anywhere. In fact it’s probably worse than it was 22 years ago on first onset. But as soon as I post this and go back to what I was doing before… it will be “gone” again.
No I am not going to use the same lens, absolutely not. This one I have there are too many things wrong, might be the lens, might be me or my eye. My eye actually is part of the problem as I have short eyes ( meaning there is more risk of refractive errors or the lens accommodate itself forward)sorry I don’t have fancy medical words to explain this. I am going for a monofocal for distance to avoid as much as possible side effects.
I know, so if I start from a very high point of disadvantages how many chances I have to adapt well enough that I can then drive or being comfortable? Plus lets not forget the refractive error. I cannot see well at distance, my vision gets blurry past 4 feet. That means I will need glasses or more lasik and YAG. It could be acceptable but no guarantees of results and we have not done the other eye yet. Tinnitus is terrible I have it in one ear that comes and go. Not fun but yes we get use to it. We have no choice so I think in the case of my eye/vision I do have a choice why I would want to live with this eye?
My frank thoughts are that if one did not like the PanOptix, then the Synergy would probably be worse…
If you have 100% decided on a monofocal, you might ask your Opthmalogist about the Light Adjustable Lens (LAL). Note all Opthmalogist have the special equipment. The LAL might be a great fit for you because it is possible your power was off on your last IOL. And with the LAL you get to change refractivity after surgery and from what I have read maybe more than once.
I have had several Opthamolgist tell me they think the LAL is the best invention ever.
I would not suspect the lens material as being the cause of the PCO. The PanOptix, the AcrySof Vivity, and the monofocal AcrySof IQ all use the same material. This material in studies has been found to have the lowest YAG rate. But there are no guarantees against PCO. It is still can happen. 4 months out with the AcrySof lens I have nothing resembling PCO, so my finger are crossed.
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I think what your surgeon is talking about with the term short eye is hyperopia or far sightedness. I recall you said you were far sighted. Before cataracts what was your eyeglass prescription? The higher the spherical + diopter in your prescription the more far sighted you are. Hyperopia can be caused by shorter distance from back to front than myopia (near sighted) which has a longer distance from front to back. See photo below.
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I found an article which talks about IOL issues related to a short eye or hyperopia. It is pretty technical and I don’t follow it all. However what I was able to understand from it is that it is much harder to accurately measure a short eye to determine the power of the lens needed to get plano distance vision. From what you describe your surgeon missed on this required power by quite a bit and left you myopic. The article talks about methods and instruments to get the most accurate measurement for a short eye.
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Another issue is the compressed space to insert the lens. This complicates the lens removal and insertion. In the article they recommend a AcrySof lens because it has the highest refractive index and as a result the thinnest lens. That is what you got with the PanOptix too.
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The last conclusion I came to was that dealing with a short eye requires a very experienced and skilled surgeon that knows how to deal with the issues. It is obviously much more complex than a standard cataract surgery.
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In any case here is the name of the article that you could google to find it. You have to read it carefully as they keep switching back and forth between short eyes and long eye issues!
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eyeworld october 2015 considerations in long and short eyes ellen stodola
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Hope that helps some
I had progressive lenses but I don’t know my prescription. As I aged I became far sighted, as today I cannot read anything, very blurry even if I squint. At this very moment I am not using glasses because of 1 eye with Panoptix. The near vision…very near is good but still a bit blurry so I am keeping my computer very close. I did read too of how more difficult is to calculate the power of lenses with short eyes. My doctor/surgeon is part of a clinic that treat only glaucoma and cataract I am assuming they know what they are doing. They are well known and people come from many places to see her and another doctor but yes mistakes can happen. They have all the instruments and two clinics with different purposes. Lasers and such . I talked to her today saying that I was not willing to try a new lens like Vivity even if she is so fond of it. She told me that just today had a patient explanting a monofocal to match the other eye that already had a Vivity since he loved it. Note that she wears glasses lol. I probably don’t have the personality for such lenses and I have no more bullets for this eye and I want to play safe so it is decided for monofocal at distance most likely for both eyes. Glasses here they come. Seeing well is my goal, I’ve been wearing them for long time I know what it means, the good and the bad. I do well with contacts so that is an option too.
A monofocal set for distance is probably the lowest risk option. Being far sighted you already know what it is like to need glasses to read. It should be no change from that. I would count on getting progressives for reading. They are better than simple reading glasses. And, they can correct any residual distance error as well.
i suffer from tinnitus too and it drove me nuts - still does at times. wish there was a cure but you are right if I don’t think about it brain tunes it out but that takes time
Regarding having the “personality for such lenses”… just to be clear the Vivity in nothing like a multifocal. It is a refractive lens so there are no weird dysphtopsias. It has been shown in two different clinical trials to have the same rate of visual side effects as a monofocal. So there is no neuroadaptation with Vivity. No weird effects to get used to. It’s a very natural type of vision apparently. The only real downside as far as I can tell is the reduced contrast sensitivity in dim light. That said, a monofocal will give you the absolute best quality vision and is a very safe way to go. The safest way to go. You just may not get the greatest close range vision but you never know. Some lucky people (maybe 10%) get monos and can read fine without glasses!
I got into hearing aids two years ago, and followed a hearing aid forum for quite some time. Some tips, if you are thinking about it. One is that some hearing aids have tinnitus programs. Most however are not satisfied with how it works. It really just is an additional noise to try and mask the tinnitus. And, what most find is that simply having hearing aids significantly reduces the tinnitus effect. They amplify background noise that is there, but if you have high frequency hearing loss, you are not hearing it. I am in the same position that when I am in a quiet place and don’t have my hearing aids in, and think about it, I have tinnitus. With aids in, not really a problem.
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And if shopping or thinking about it, Costco is the best place to start. They have much better prices, and have a Kirkland “brand” that can be a very good buy. The warranty and return policy is excellent of course.
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It is nice now with hearing aids to not have glasses. Too many things banging around behind the ear at the same time can be an issue…
First, there is absolutely nothing wrong with going with a monofocal. They are the dominate IOL used for cataract surgery in the US and the World. And the safest most true and tested IOLs out there.
I started to read up on high hyperopia or short axial lengths or as you call them, “Short Eye” and personally I would want some question answered by the Ophthalmologist as I am still unclear on exactly what happened.
If you have high hyperopia, obtaining accurate refractive power is more difficult, but here is what I would want answers to for at least you are aware for the other eye.
1)You stated the Lens Moved forward and proper placement is important - I read on High Hyperopia eyes there can be issues, but if a monofocal had been used, why would it be any different. Was the Ophthalmologist planning to use a monofocal of different material or characteristics that would have made a difference? Or would the monofocal been more forgiving of movement. Bottom line – I would want an answer on how a monfocal would have produced a different results than the PanOptics in regards to IOL movement.
2)Power Level - Again I am confused if the IOL movement is causing the problem or the power was just off. If it was off, I would think it would equally be off if you had a Monofocal implanted. I would want an answer to this.
3)Dysphotopsias – From what I have read the more myopic you go the more dysphotopsias you get, which is one of the reason I always suggest micro-monovision only. I just think you cannot truly tell evaluate dysphotopsias with all the other problems you mentioned as they might be the main cause for the dysphotopsias.
My hopes and prays are with you. But before you do anything with the other eye, I would want to get clear answers to exactly why there was an issue with the PanOptics and how a monofocal would have made any difference.
I am far sighted and my near vision started to deteriorate at 40ish now being 60 I cannot read anything or even see the food in my plate well. Low level of astigmatism. Of course I need glasses! The lens is centered . PCO and forward position. I read that can happen quite easily and sometimes with YAG you get two birds with one stone, as the laser hit the tissue it creates some space and the lens might settle a bit back improving the vision. ( I read this in another article) I found a very interesting article I don’t think I can post links so here is the title: “The effects of different shapes of capsulorrhexis on postoperative refractive outcomes and the effective position of the intraocular lens in cataract surgery” it is recent, 2019.from BMC ophthalmology. My doctor confermed a myopic shif so this could have been the problem but I could have had a low power lens as well. This I don’t know. but I know for sure that to improve the near vision you have to give away some of distance. It happens with contact lenses too. It is a compromise some people don’t mind because maybe they don’t need a lot of correction. ( my guess here) Also she confirmed that myopia aggravate dysphotopsias I told her I was not willing to stand the bad side effects without getting the benefits from this lens and I was not thrilled to have lasik. She asked me to draw my starbursts and halos, to give an estimate of dimension ( mine are big enough to cover more than half of the highway and at that point she said it shouldn’t be that difficult , offered an explant and the two lenses options. I am so glad I denied Vivity as I just recently saw a post of a young guy with both implanted and having lots of problems similar to mine. I know she is going to clear CPO during surgery in this eye to prevent blurry vision and such. This is just my experience but I know a lot of people is happy with both Panoptix or Vivity. But wearing glasses is not the end of world!We are not all equal. That is what I blame the most in doctors. They should know better who is the best candidate.
I have heard from others that hearing aids greatly reduce tinnitus. A couple of years ago I had a sinus issue and had sensation of wars always being full. Doctors prescribed nasal sprays but still felt that sensation of ears full - particularly the left one and the doctors could see fluid. I developed tinnitus at that time - drove me nuts. Took 18 months to see ENT specialist and he sent me to an audiologist for hearing test and there was hearing loss but not enough for them to prescribe hearing aids. For now it will be something I just have to live with. Most of the time I learn to tune it put. First several months it was awful. I dis go on the tinnitus forums here (as the cataract one was very supportive and helpful) but that forum very depressing. A lot with suicidal thoughts - no helpful suggestions or answers. Many doctors dismiss it. With insurance coverage I have i would be covered for hearing aids if they were prescribed. Maybe next visit. For now i use a white noise app or set TV timer so that there is other noise on. Getting older not much fun and I seem to be 20 years ahead with cataracts and tinnitus. Both my parents are still living and experience neither of those issues.
Thanks for sharing about hearing aids. Hoping they eventually help
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I have seen the latest hearing aids. So much tinier than they used to be. Controlled by an app on your phone so at least. Unlike cataracts and IOLs one can try out various brands.
Hearing aids are a very technically complex subject, and the manufacturers go out of their way to make it difficult to evaluate what you are actually buying. They all have their own self invented feature naming library. There are far fewer actual manufacturers of them than what it appears to be, as they are creative with making multiple brands out of one basic model. At the end of the day what they say they will do tends to be somewhat inflated. The current trend is closer and closer integration to a smart phone. It all sounds good in theory, and I have those features but I mainly just run the aids in the Automatic mode which at least in theory determines what you are doing, with help from the smart phone and self adjusts.
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A couple of tips. First is that most people wait far too long to get aids, and then have trouble adjusting to them. I messed up my left ear when I was younger and enjoyed shooting large caliber rifles (without hearing protection of course). It mainly affected my left ear. When I finally decided to go with aids I thought I just needed one for my left ear. It turned out that my left ear was so bad that a hearing aid did not help all that much. My “good ear” however responded quite well to a hearing aid, and that is the ear I get the most benefit from. The second tip would be that you really only know how well they work by trying them. Costco gives you an in store demo pair, but to take a pair home you have to buy them, with a 90 day return policy. The cost differences between Costco and small specialty shops are huge. Costco prices are 1/2 to 1/3 the cost. The premium level Kirkland Signature 9.0 aids they are currently selling, I believe, are $2000 a pair. They are premium level Phonak aids, and you can easily pay $6000 for them in a specialty shop. It varies from province to province, but in Alberta we get about $800 from Alberta Health Car. Providing you are a member, you can get a free hearing test, and they should give you a fair opinion as to whether or not you could benefit from them. They do not operate on a commission basis like most small shops. Costco does not sell aids that have a tinnitus program. I suspect they know it does not work effectively or at all and don’t want to deal with unsatisfied customers.
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Hope that helps some,