Cataract Surgery IOL recommendation

[rouoghleggedhawk]

Hello,

I may be undergoing cataract surgery later this year. Thank you all so much (especially to those doctors who respond) as I learned so much about cataract surgery from this site

I am 49yrs. My current Rx is OD -6.00-.75x95; OS -5.50-.75x40. Have been using soft contact lens for the past 27 years.

Birding is my life long passion.  So distance vision is my best interest and the ability to drive at night without the side effects after the cataract surgery. Perhaps I may have to accept the fact that I may need reading glasses 100% after the surgery.

If there are any birders out there who had gone through cataract surgery ?  Your recommendation is greatly appreciated in terms of "birder's" view.

[John C Hagan III, MD, FACS, FAAO]

Our practice in Kansas City uses as its prefered IOL the aspheric Technis monofocal IOL with excellent results.

Since they don't move it could be: something on your central cornea, the cataract (in which case it will not be there post surgery) or something in the macula.

Suggest you discuss with your surgeon. These tests might be appropriate: Amsler grid test (read about this and you can test yourself at home and Google amsler grids and you can put one on your computer, and a macular OCT.  It should be possible to find out where these come from. Good chance its the cataracts.

JCH MD

[rouoghleggedhawk]

I can not thank you enough for your kind reply. Thank you to achillea also.
I had my consultation and the dr. suggested I go with the Tecnis "single focus" IOL. Some folks here may refer them as Tecnis monofocal IOL here. Then I would have the option of with or without monovision. Reason for my choice of Tecnis "single focus" IOL is mostly based on reading prior posts and recommendations here, along with the consideration of additional cost for multi-focal IOLs and the reported side effects.

I am leaning towards monovision option. I have the "try-out" contact lens today to simulate the monovision effect and to make sure I have chosen the correct options for me, as avoiding the potential side effects of multi-focal IOL are much concern to me, more so than the additional cost. I am being realistic in that I may need reading glasses for close up view such as reading books and computer. They seemed to be OK on the first day of try-out. I have not looked through the binoculars and hoping there will be no issue there. Other concern is I may be giving up my distance vision that I desire so much (for example, searching for raptors in the distant sky).

I would like to hear response from someone who had the Tecnis "single focus" IOL, monovision option, and particularly not happy with their choice and reasons for it. Also from multi-focal IOL folks that are very happy w/ their surgery option.

Also, questions for Dr, Hagan. When I look through a spotting scope to view a very distant birds, I see two brown spots in the view (and they are not floaters), and they usually block the bird I am trying to view and these brown spots follow my point of interest. Best way to describe them would be two tiny gnats. What is the cause ? Any suggestions as to how to follow-up on this and find the cure ? I am told the cataract surgery will not correct this issue.

[John C Hagan III, MD, FACS, FAAO]

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[achillea]

roughleg, you're a high myope.  I was just the opposite.  But we both love watching those birds.

I had a superb--superb!--result with two multifocal lens implants, but your situation is different from mine, in that I was far-sighted all my life, having a 'short' eyeball, front to back, as well as relatively small pupils.  Also, I did NOT have high expectations, in that I was perfectly willing to accept the use of reading glasses for close work (which turned out not to be necessary).

I think the key is finding an experienced, objective doctor who is willing to measure every possible dimension of your eyes, who checks the health of your retinas, who is not madly in love with a particular lens, and who LISTENS.

You may have to talk with several doctors to find one who satisfies your criteria, but a good search is worth the effort.

[John C Hagan III, MD, FACS, FAAO]

I'm not a birder but I've traveled with them a lot.  Hope you've seen "The Big Year" about birders, when out in video this week.

There is a lot of discussion about your choices which you can access with search feature and archives.

Hope birders respond.

JCH MD