Cataract surgery
 

It looks like I am ready for cataract surgery. They are a 3 and I have started having issues with glare. I plan to have the surgery in the summer since that is when i least enjoy riding. I think I am springing for the Vivity lense in what they call they call the full range vision package.

Anyone have advice or comments to share?

Had both eyes done, and everything is much brighter. It is a quick procedure, nurses put drops in your eyes 3 or 4 times, then they wheel you into the doctor, and it takes less than 10 minutes, no pain at all. Your eye is covered over night, and they take the patch off the next morning and there you are.

It is important when selecting your implants to ask your Specialist if the lenses will affect your use of Rifle Scopes, Microscopes, Telescopes, Binoculars and other tools.

One of my friends, who delves deeply into Astronomy, had to have his lenses replaced after having image aberrations when viewing with his 14" Dobsonian. Here is a publication from 2022. There are new lenses that are specially developed to avoid this issue and the extra cost is worth it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866410/

The technology has come a long way since my grandmother had it done in the 1980s.

"Matching the Patient to the Intraocular Lens" from the American Academy of Ophthalmology

https://www.sciencedirect.com/scienc...61642020308435

Check with the surgeon about the medications that you have been taking. Flomax can slow down the eye drops at surgery.

I would not recommend the Crystalense. My father has had nothing but issues and he had no underlying conditions - other than cataracts.

I had the procedure done years ago with standard lenses and it was a relative snap. Was good to go in two days. Am not familiar with Vivity and beyond!

On the other side of the knife...

OK, so it's probably a laser instead of a knife. Still, if you've been riding with prescription glasses or sunglasses, start thinking about how you'll protect your eyes from clouds of gnats, or other things in the air, while you're riding. I ended up getting two more pairs of glasses, one clear (with 1.5 readers) and one sunglasses (with 2.0 readers; hey, it's what was on sale).

The week after my second eye was done, I stopped by Wally-World and bought three sets of reading glasses to figure out what I needed for reading and for computer work.

All five glasses together cost me less than just my last prescription frame. Lenses were much, much more.

FWIW, I went with the straight single-focus lenses, and my astigmatism disappeared. My wife got the conic lenses, and she's still trying to get glasses that'll fix the residuals in her prescription. YMMV.

My doc is recommending one eye at a time. The tech said, one eye, a week off from mtb riding, another week with no restrictions, then the other eye followed by another week off. I didn't ask the doc about time off because he left the room before I thought of it, but I assume that is his policy. He is a mountain biker too so, I am inclined to trust his judgement on that. Does that match what restrictions you guys had?

Here is my take on it. The best case is to have full vision and not have to wear readers, or only at times.

I had my cataracts done in 2018. I’m sure things have improved since then.

Everything went well. I have sort of a mono vision. Both eyes are fine for distance. But the close and mid length focal vision are slightly different between the 2 eyes. This gives me a pretty seamless focus.

The negatives are close up vision is not as good as I would like and I use readers more than I want because it makes things easier. But overall everything else is clear.

I always wear UV wrap around eye protection riding even if it is just clear.

John

I have the Vivity. Great vision near, intermediate, and far. The only problem is that I have to wear glasses at night for distant vision. After 50 plus years with contacts, I'd forgotten how much glasses suck. However, it is also good to be free from the hassle of contacts. Best of all, the world is amazingly bright and colorful. Cycling content: one of the above-mentioned hassles of contacts was getting a cinder in my eye and having to ride with great discomfort until the thing finally worked loose.

My last eye exam I was told I have a cataract in one eye , close to the pupil. It isn’t a problem ….yet. It will , at some point , start to affect my vision. I was told that I would first notice a “spot” in my vision . I work with a microscope and optical measuring equipment daily and still haven’t had any problems. When I ride my bike I wear good fitting sun glasses with a bifocal feature.

Schedule is normal. Idea is to let the implant settle in for a week (no shocks or knocks).

I think the "don't do both eyes at once" is statistically suspect, but it's probably driven by malpractice insurance.

I wore glasses for 69 years before getting cataract surgery. Couldn't tell you what lenses the doc and I chose, but we went over several and I'm very happy with the results. I do use readers for small print, but that's OK with me, considering on how bad my sight had been. Went and tried on some non-rx "readers" to see what strength I needed, the ordered some glasses off of Amazon that have a clear top portion with diopter bottoms for reading. They are working very well, and I use them with clip-on sunglasses for riding in and out of shadows. Plus, after 69 years, felt odd not to have glasses on my face! Do like not having to wear them if I so choose, though!! Everyone told me the surgery was a "walk in the park". It sure was!! Listen to your doc (assuming you have a good one), they will know what type of lense is best for you.

Well I did as much research as I could and he has done more of this surgery than anyone else in town. Reviews were good and people who I knew that were his patients were happy with him. He made a good impression as my regular opthamologist for the 2 years he has served in that role. He was thorough in discussing options and not pushy about choices including when it was time for the surgery. Oh, and he is a mountain biker. That is all I have to go on, but based on all that I do trust him.

I have a choice of the following:

1. The standard covered by medicare package, This is pretty basic.
2. ORA Custom Package ($540 per eye) - Choice 1 plus extra interop measurements, monovision, and up to 6 refractions during pre-op/post-op period,
3. Full Range Custom Vision Package ($3,000 per eye) - All of the above including the ORA stuff, plus Panoptix or Vivity lens (he reccommends Vivity), Correction for residual astigmatism and distance, intermediate, or near vision, Lasik touchup if needed, and 6 months of clinical care.

Based on his description of the results with the choices I am leaning toward spending the $6k for the Full Range Custom Vision Package and the Vivity lens.

Edit to add that I have a while to think about it. I have my appointment to get all the measurements done on the 15th of this month (march). Then I have 6 months to get the surgery done without having to redo the measurements. I am least fond of summer weather here so will most likely schedule for June, July, or August.

I got Vivity "extended range" lenses for about $1500 per eye above what the insurance covered. I can see pretty well mid and distance without glasses (which was completely new for me), but now I need readers for anything computer distance or closer which is kind of a pain. They offered me a version called "adjustable range" or something like that which was kind of like progressive lenses for your eyeballs, but I found too many stories of people who didn't like them. I think I made a good choice.

For the optimum choice, gaze into your crystal ball and see how things go a year after your surgery. For a large fraction of prospective patients, #1 is all they'll need. (Myself included, I don't even need the astigmatism correction I had in my glasses!) #2 might be the optimum for most of the rest, if there are some lingering problems with the eye settling and the prospect of buying multiple glasses, even with the fancy in-eye measurement (my wife is in this group). I'm not sure what the clinical evidence you'd need #3 looks like -- personally, sounds like your ophthamologist may be paying for a sailboat.

Yeah, good points. To be clear... He isn't pushing hard for any particular choice. He was pretty objective on the merits of each. He likes the Vivity the best of the premium choices. The supposed advantage as I understand it is that it has an extended range without the diffraction rings that other earlier lenses used to do that. The diffraction rings caused flare and loss of contrast. So the Vivity is supposed to give a better chance for no or at least less need for glasses with less glare/flare issues.

I'll hopefully be living with whatever choice I make for a lot of years, if so $6k isn't all that much money when weighed against any improved results if they are really improved over the cheaper choices. I still have time to mull it over, but as I said I am leaning that way. I may flip flop a few times between now and then.

I just had mine done. wonderful. I went for the straight lenses, both distant. They work fine down to about 3', when I start to need readers. I heard several not-good things about progressive lenses and am very happy with what I have. They refracted me and had my lenses ground to that prescription, which didn't turn out perfect, just very close. I might or might not get progressive glasses like I wore before, just ground to the new refraction/prescription.

My wife had hers done for mono-vision, one eye far, one eye near, came out perfect, no need for glasses at all, except for the piano, a little too far for her near lens. She had mono-vision contacts and loved them, so is totally used to that.

I am hoping to not need a prescription to ride. The doc thinks this is likely especially if I go with the Vivity premium package. He is a mountain biker so at least he has some idea of what riding requires. I have a pair of expensive prescription sunglasses that I saved the original lenses from so for when I need dark glasses I can use them with the original lenses if I can get by with no prescription.

I will need some clear or photochromic lenses for night riding. I often start in the dark and ride into the daylight, so it is tricky to have the right lenses. Sometimes I just rely on my super bright lights and use the dark glasses even for the dark portion of the ride. That way I only take one set of glasses and can manage the blinding glare when the sun is low. Hopefully that glare will be greatly reduced after surgery.

I am not going to make any plans until I know for sure how the surgery works out. The need or lack of need for some correction would make a difference in my choices.

I am a little concerned about the week where I have one eye done and one not and am able to ride. Folks apparently take out one lense from their glasses for the eye that has had the surgery. I guess that means taking great care about riding when/where there are clouds of gnats and what not.

BTW, I am even more likely to feel okay about splurging on nice glasses if I don't have to worry about them no longer having the correct prescription next year. $200+ for a pair of glasses that might last the rest of my riding career is more palatable than the same price for ones that will be the wrong prescription next year.

After thinking about it I guess the answer is obvious. I can take the prescription lens out for the one eye in my sunglasses and put the original lens in after one eye is done. Then when the other eye is done swap the other lens. That ought to get me going, If I need further changes I can attend to those after I figure out what I need. I am glad I have the original lenses that came with my riding sunglasses. Also it is a bonus that I opted for the same lens and tint as original.

Good move.

I didn't have that problem, since my doc told me not to ride for two weeks after surgery -- by that time, I'd had the other eye done. FWIW, I'm still using the dark glasses I got to wear out the door -- really good quality. I started wearing that as cycling sunglasses after the second eye until I got proper cycling shades.

So that would mean a month off of riding, right? Or did you have the second eye done sooner than 2 weeks after the first?

I'll do what the doc says, especially since he is a mountain biker, but I am used to riding every day and would be climbing the walls with a month off from riding.

I assume that would mean no trail running either. I'd guess that might actually be worse. Maybe hiking is okay. At least I'd be able to hit the trails. If it was a month I'd ask definitely.

Mine were a week apart, a fringe benefit of being blind as a bat. I got out the pedometer and started walking around the neighborhood -- it was still a relief to get back on the bike.