which doctor to use for my near future cataract surgery

[mb0329]

I am trying to decide on a ophthalmologist who will do my cataract surgery when I decide to have it done. A few weeks ago I had a first meeting with an ophthalmologist at my HMO regarding cataract surgery. He spent much of our time together telling me about possible dangers of the surgery, I guess, for legal reasons. When I tried to ask him some specific questions he would most often reply that it is the patient who has to decide. In any case, when I noticed he was kind of young looking, I asked him how many cataract surgeries he had done and he said about 4-500. I believe he is about 40 yrs old or maybe a little less. He was the doctor my HMO set me up with when I asked for an appointment to discuss my possible cataract surgery. He also told me that he did cataract surgery but that his specialty is glaucoma. In fact, when he checked my right eye, which is the worst myopically, he said he saw what may be the beginnings of glaucoma and set me up for a more detailed glaucoma exam in about a month.

In any case, I asked him who he would recommend for cataract surgery there. He was honest and told me that although he could do it, if he was setting up his mother for this surgery, would use doctor X whose name he gave me who was older (in his 50s) and had done over 10,000 such surgeries. During our discussion he also mentioned that my eyes were more complicated than average (probably in the 20th percentile) in that 1. I am very myopic in both eyes, 2. That my eyes are pretty 'long', 3. The the difference between my myopic eyes was large.. my left eye is -5 diopters and my right eye is -9.25 diopters.

In any case, I know I probably already answered my own question but would like some feedback as to whether I should ask to use the other doctor (the one he mentioned) who has more experience. He seemed pretty nice, but I want the best for my eyes.

[JohnHaganMD]

The first. One eye set for distance (greater than 20 ft) in one eye and the other with -1.00 which works good for intermediate and in good light and good print most people can read with out glasses. Plus the glasses RX  Plano (distance)  -1.00 (intermediate  with +3.00 Add both eyes in progressive bifocals balances both allows excellent vision at all distances and is not too big of a difference to be difficult to adjust to

JCHMD

[mb0329]

"I'm not making a recommendation I'm just saying that for most people going for 0.00 (or -0.25) for distance and -1.00 makes for a happier patient"

Do you meen 000 (or -.25) in one eye and -1.00 in the other?...or either of these in both eyes?

[JohnHaganMD]

Do discuss that with your surgeon.   Going for 0.00 in both eyes and having 20/20 without glasses means that things are clear 20 feet away and more. However things like a TV at 15 feet, using a computer, iphone, seeing yourself in a mirror are not clear and reading is out of the question.

I'm not making a recommendation I'm just saying that for most people going for 0.00 (or -0.25) for distance and -1.00 makes for a happier patient.

JCH MD

[mb0329]

So far,based on what I've read, including what you have written, I am thinking of going monofocal long distance in both eyes and wear progressive eyeglasses for near/mid range distances..and any long distance correction..if needed, after cataract surgery. I am planning on looking into contact lenses to where for awhile until i finally decide and schedule the cataract surgery..and also to wear a contact on the 2nd eye until it too is eventually done as I believe there can be a 1-2 month period between getting the eyes done.

Thanks for answering my questions.

[JohnHaganMD]

Once again: read this


http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You  ;

and the discussions that follow. The Eye HMO doctor is not necessarily wrong in saying its your choice and he/she won't make those choices for you. It's really up to you to decide when you need cataract surgery, whether you want a toric IOL or a multifocal IOL and what you want the target uncorrected refractive error to be after surgery.

JCH MD

[mb0329]

Also, I seem to have a problem when I ask my HMO eye doctor questions about cataract surgery and for his advise. when I last saw him his usual response was "it's up to the patient to decide what they want"...so he would not give me any suggestions...and since I am totally new to this ordeal..am lost in the woods.

[JohnHaganMD]

Yes there is a huge shortage of physicians in the USA; seeing a physician and getting tests, procedures, medications, etc. will continue to become more and more difficult. Best of luck to you.

JCH MD

[mb0329]

I will be seeing the glaucoma specialist first probably...because of timing issues. It seems that whenever I want to set up an appointment at this HMO, which is my health insurance, that it usually takes a couple of months. My guess is that there is a growing doctor shortage in this country.

I will probably seek to make the cataract surgery appointment after I get and familiarize myself with contact lenses...so I will have them ready when I get the cataract surgery...and be used to them. I never wore contacts before and frankly, don't look forward to putting something on my eye and taking it off daily..etc.

I will probably get the cataract surgery because of the big diopter difference between my eyes... -5.0 in one and -9.25 in the other...which seems to negate my use of proper eyeglasses at this point.

[JohnHaganMD]

Yes you pretty much have answered your own question. You would do well to return to the glaucoma specialist after the cataract surgery for a glaucoma evaluation.  Also read this carefully:


http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

JCH MD