Hi All - i have high myopia ( minus ten point five ) i have been diagnosed with cataracts i am a sixty five year old female - i have been offered National Health Service ( free) cataract op here in the United Kingdom - any advice on plus factors of early surgery or should i wait ? thank you for any advice here ?
Hi If your eye doctor says your eyes are suited for the cataract surgery, there really is no reason to wait. It all depends on how affected your vision is, it really is a matter of doing what feels right for you. But it is a difficult choice, we all know the feeling, personally I only regret I waited so long, I am really happy with my new vision. There are different types of lenses on the marked, there are also what is known as premium lenses, that can offer more independence from glasses, but premium lenses are very expensive and they do have more side effects as well, so they are not for everyone. The surgery in itself is the least part of it all, it is really quick and painless, I think it is worse to go to a regular check at the dentist. You will be instructed to use a lot of eye drops some weeks after surgery, I stopped with the drops 4 weeks after surgery. And there will be some things you will need to get used to with the new lenses, but being highly myopic I am sure for you the surgery will be one of the biggest thrills in your life, you will be able to do a lot of things without glasses after surgery :-)
Hi Aflower - Danish has provided good info so won't repeat. As I have lots of family in UK and was actually over there this summer I am somewhat familiar with National Health.
If having the cataract surgery done by NH you will not be given a choice of lens (IOLs) as they use monofocal lenses. That means you will see perfectly at one distance and need glasses for other two distances.
Distance vision = driving, watching TV etc Intermediate = computer distance Near = reading
Most surgeons like to correct for best distance but you can request differently. Some near sighted folks like to remain so after cataract surgery and continue to wear glasses for distance. Hopefully at your consultation your surgeon will discuss this with you. If you have astigmatism there is a toric lens that can correct that. In my opinion worth paying the extra for those or you would need glasses for all distances anyways after surgery.
You can decide to get more range of focus with monofocal IOLs but having one eye targeted for slightly nearer. This would cover 2 distances and you would only need glasses for near or distance depending on your preference. This is called mini monovision. Eyes would be about .50 to 1.0 diopters apart. If you vision isn't too bad now you can simulate that with contact lenses to see if your eyes adapt well to that setup.
Premium lenses if you want to look into those you would need done privately and the total cost would be yours. These provide the greatest range of vision and often times you do not need glasses at all after surgery. Drawback to premium lenses you do have more glare and halos at night with them due to their design. Some people are more bothered by those than others.
Good luck to you. Welcome to cataract forums. We are here for you if you've questions pr just needing support.. None of is are professionals or doctors that I am aware of (wish some would join if they were faced with cataract surgery). But we are at various stages of this journey. I had my surgeries 2 years ago.
There is a negative to waiting, the longer you wait the more dense the cataract becomes. It is easier for them to remove it earlier than later.Everything else I would have told has been said so I wont repeat! Good Luck!
I also have high myopia. At the time of my cataract surgery on my right eye, I was -13. I had surgery on my left eye five weeks later and it was -10. Because of my extreme myopia, my biggest fear going into the surgery was the increased risk of retinal detachment. I was so relieved and grateful that my surgery was successful with no complications. I had to see a retinal specialist prior to surgery and he advised me to not go with a multifocal lens so I choose a toric monofocal for both eyes. I did have to pay out-of-pocket for the toric option which was $1,000 per eye (seems to be a bargain compared to what others have said they paid). I also chose to go with mini-monovision with my left, dominate eye corrected for distance and my right eye for mid-range. This allows me to be glasses free for most of my daily activities but I do need readers for close vision. After years of not being able to see clearly beyond 6" from my face, I am amazed by my new vision. Good luck with whatever you decide!
A great outcome - perhaps best strategy to investigate AFlower.
Wasn't aware multifocals not advisable for those with high myopia. Learn something everyday!
I don't know if a multifocal is not recommended for all high myopics or if there was an issue with my eyes that made me a poor candidate. I do have a retinal membrane. Maybe that plays into it?
Could very well be. Did read that calculating the power is more difficult for patients with high myopia so might be one reason to be careful of IOL selection. Often they have had refraction surgery already so it is important to get those pre-surgery results/mapping of the eye if possible for cataract surgeon to review.
I also have high myopia (-15 and -10) and the first thing that I heard is that I'm not a good candidate for multifical IOLs because of this. When I asked "Why?" the answer was "because of higher risk of retina detachment". But then I asked "how come that the type of the lens impacts the risk of retina detachment?". No, really... the sizes and material of both types of the lenses are basically the same (well, they can be different, of course, but it is not a problem to find monofocal and multifocals of the same material and size). The procedure is also basically the same (correct me if I'm wrong). Why on earth it should have different physical impact on the retina? Then they have to admit that there is no difference. However, as far as I understand, multifical lenses gives less predictable results and high myopic eyes are also less predictable. It includes more difficulties with measurements and calculations. So the idea is that if you go with monofocals you can expect less surprises. On the other hand, there are also surgeons who think that while the low and moderate myopic eyes are not good candidates for multificals, the severe myopic eyes are good candidates (although there should not be other problems with the eyes, including retina degeneration). The reasoning for this is - the advantages of new vision will be so huge comparing with high myopic vision, that they will outbid all (most of?) disadvantages. So... After running in loops for few weeks trying to chose the lenses I decided to go with multificals after all. When we discussed the lenses with my surgeon first time he was also suggesting monofocals. But on the next appointment he agreed that multificals are probably not so bad for me. Let's see how it will work out. My operation is in 4 days.
Best wishes for your upcoming surgery mak73. Look forward to your updates.
Well Mak, you struck my nerdy side here, so sorry, but now I am going into nerd mode for moment :-) Thing is, you are absolutely right.
I spend several hours each day for a couple of month reading about lenses, outcomes and everything I could find, I was kind of obsessed. When you get to site 100+ in google search result, there comes up sites that nobody ever see, except me I guess. I have seen slideshows from eye doctors congresses, where manufacturers explain to eye doctors, how they select patients for premium lenses. And it has in fact little to do with eye conditions (in most cases) and a lot to do with protecting their brand. There is a lot of money in these premium lenses, and the manufacturers will go a long way to protect their brands. If I wanted to sell Rolls Royce cars, I would have to live up to whatever Rolls Royce demands, and at the same time as a seller, I would probably want to keep their good name for making the most money. And you do this by selecting costumers you now will be happy with the product, don´t sell a Rolls Royce to a costumer that you know on forehand will not be satisfied, you would rather not sell that one car and protect the brand from unsatisfied costumers and bad publicity. These lenses are the same, eye doctors are instructed to only sell them to people that will have good results, and to people that are not too demanding. I have seen text that says, if you know on forehand that the costumer is hard to satisfy, only offer the costumer a monofocal. Or if you are unsure of a near perfect result, offer the costumer a monofocal. Added from my own opinion - regardless if the costumer might would be satisfied with less than a perfect result, it is not about the costumer, it is about their brand. It is not only in the state of Denmark. that something is rotten, to almost quote Shakespeare :-)
So you are absolutely right, whether you go for monofocals or premium lenses, measurements are the same, it is equally difficult to hit target, lens are physically the same, risk for complications are the same, surgery are the same, it does not matter to the surgeon what lens he/she is installing.
That said, there are somewhat bigger contrast loss in the multifocals, and if your vision is really bad beside the cataracts, multifocals will probably not bee good idea. And in worst case scenario, if you get a really bad retina detachment, that can not be sorted with laser as most can, then in few cases it may be necessary to remove the iol to fix the retina, and then you can loose the expensive iol, but I assume that would be the least concern at that point.
Damn! I knew it! This is a pure commerce after all. Thank you for confirming it. I'm also nerdy a bit but not as much as you, obviously :) As for the difficulties with measuring and calculating of high myopic eyes I'm still puzzled. I found it in few articles that looked pretty trustworthy (they didn't try to sell me anything at least). However I'm still not sure why the size of the eye should make a difference. I'm not on the level to understand their explanations yet :) I asked my surgeon about this and he said that this is not completely true. Yes, there are some difficulties but they know very well how to handle them and do precise calculations. Well... I can only hope that they really know how to do it.
hi cazms, have you had PVD (posterior vitreous detachment) or the YAG? that combination can sometimes cause the epiretinal membrane.
i think the multifocal is not recommended for high myopes because the calculations for multifocal would be off if they suffered from a retina detachment for which they are at a high risk at.
at 65 at least the OP has lower risk of RD as the vitreous is naturally drained.
Hi soks...I have not had PVD or the YAG. I was 66 when I had my surgery.
To elaborate it a bit. The more dense/cloudy the cataract become, the more difficult not only to measure your eyes but even check the state of your eyes. It doesn't let the light through in both directions so it is difficult to see what is going on behind the cataract.
My piece of advice would be - if the surgery is inevitable in next 1-2 years, I don't see much sense to wait for these 1-2 years to end up with near 0 vision. If it is in 5-10 years then may be no need to hurry up. One of the reason to wait - maybe we will have some real revolutionary lenses in 5 years. But may be we will not, who knows... Anyway, the lenses we have now are pretty advanced and work very well for vast majority of people. I hope I will confirm it in few days. The biggest problem is to pick the type of lenses among of few. It is really tough choice I must admit.
Another reasoning for early surgery of high myopic eyes - you will get rid of myopia once and forever. This is HUGE bonus to getting rid of the cataract. I was terrified when I realized that I have to do the lens replacement. But now I can't wait when it happens. I want sharp vision instead of the thing that I have now and I can even barely call a vision.
Overall our bodies (including our eyes) do not get younger, better and stronger with the time. So the recovering after any kind of trauma or surgery should be more and more difficult (even though the cataract replacement is considered as one of the safest operations). The risk of "something goes wrong" during or after a surgery will always exist, no matter when you decide to do it.
I can only wish you good luck with your eyes.
cazms53 may I ask you what you did with your left eye between the surgeries? A contact lens? How difficult is it to handle such huge difference between the eyes?
i am a 64 year old high myopic woman. i would wait until vision is at least 20/40 before I touched an eye. i did my right eye at 20/25 and had cornea edema. could not see my hand in front of my face for 4 days. it was terrifying. i'm ok now but not doing my left eye until I absolutely have to. there are risks to everything
my right eye is corrected to -.50 after cataract surgery my left eye is -4.75 glasses are not an option as you will get double vision i wear a toric contact in my left eye and no problems with eyes working together but i still merd readers
Thank you Hudsongrl, yeah, I was told by one optician that glasses will give me a double vision. A contact lens is obviously an option. I just wonder how bad is it to be with one eye near to 100% and another <50% or even <20%?