[papillon]

The upgraded lenses are worth every penny. You will not regret your choice to upgrade. You can read your phone, watch TV, drive, and read a book without glasses.

[jedalton]

thank you for such a detailed report. I found it very informing.

[Sksommer]

I got the more expensive lense several years ago and am very glad that I did. I don’t need to wear glasses now except for teading and computer work. When I drive, go swimming or other activities my vision is perfect without glasses. I am happy I spent more for the better lenses.

[Travelhunter123]

Originally Posted by manaboutown

From a friend who had it done:

"Here's some info that you might find useful when you consider your cataract options.

As you undoubtedly know, Medicare will take care of the costs for a "vanilla version" of intraocular lens implants and the associated doctor's costs. As you mention below, this is only for a mono-focal lens and you have to choose the distance you want to be permanently set to. Of course, that probably isn't a big thing if you've already got really bad vision, anyway, and are used to wearing glasses so choosing one distance may be fine. I've been using reading glasses for a few years so didn't really care about continuing to use them and thought I'd get "infinity" to see all the pretty things nature offers and just wear glasses for books and the computer screen.

However, I started asking questions as to what was really available both here and around the world (knowing that the FDA is usually way behind in approving things that the rest of the world has used for a while). There are two additional lens categories – "accommodating" and "multi-focal". The "multi-focal" has two or more fixed foci on a flat plane that it can be set to depending on what you want. (See below about “ranges 1-5”). The "accommodating" lens is actually a "bendable" lens that can be distorted inside the lens capsule by using both the normal eye muscles and the attaching fibers called zonules so it's more of a progressive lens. You can search for these two types and get some great info online. I found them by searching for "multi-focal vs. accommodating lenses" to see some comparisons.

My surgeon explained that they (sort of unofficially) classify the sight regime as lengths 1 through 5. One is being able to read a book really well, 2 is computer screen distance, 3 is for most run of the mill things around the house (kitchen counter, cleaning the floor, looking in the mirror or inside cabinets, etc.), 4 is good distance outside (i.e.: normal infinity like driving) and 5 is being able to see the stars and moon clearly at night.

I was leaning toward the "accommodating" type because it seemed more natural in its implementation from the descriptions. However, when I asked them about it, they said that they used to do them but have gravitated toward recommending the "multi-focal" lenses because of better performance and fewer complications (which have to do with a rare potentiality for the lens, once implanted, to “fold backward” and make the vision very distorted). It’s actually a situation that is more easily portrayed visually as to what happens and is hard to describe in words so I’d have to draw you a picture or show a sample of how the “accommodating” lens can be “folded” into a compromising position.

BTW, when we made our first appointment with this Hilo surgeon, Dr. Daniel Driscoll, we figured it would be a perfunctory, courtesy visit because our GP recommended him and because the reputation of specialists here in paradise leaves a lot to be desired according to everyone. However, after seeing his facilities and reading about his history and capabilities that would make the Mayo Clinic proud, we said yes. He attended the Bascom Eye Institute in Florida, one of the best eye clinics/educational institutions in the US, right up there with the Jules Stein Eye Institute at UCLA. He had all the latest equipment and procedures.

So, I did some further research and heard about a new lens that had multi-focal capabilities AND could take care of astigmatisms as well in one lens. Apparently, it was only approved by the FDA 2 years ago to include the astigmatic correction. I was leery about the short track record and wasn't sure about the infant mortality possibilities so I was stalling. Then, I met a new neighbor here in Mauna Lani two weeks before the surgery who was one of the first guinea pigs for this new combo lens 2 years ago and he raved about it. Case closed.

The lens is called the TECNIS "Symfony" Lens from Abbot Labs. You can search for it on-line using those words - lots of information on its construction and efficacy. It’s made in Germany and is termed the "Extended Depth of Focus" lens that allows for both MULTI-focal settings AND astigmatic correction all in one lens (no more need for glasses). My ophthalmic surgeon and his optometrist both acknowledged that it existed but I don’t know if they would have recommended it unless I had asked because no one ever asks for these things. Most just assume that mono-focal is all there is because it's the cheapest, been around forever and insurance covers most if not all of the cost.

The "Extended Depth of Focus" lens can handle roughly 3 of the 5 ranges described above. You have to pick the set that fits your lifestyle. I still picked 3 to 5 (basically infinity) as my favored range because we are more outdoors people than indoors and we wanted to see all the vibrant colors and scenes in mother nature and all the road signs when driving on a trip. I figured if I was lucky, I'd see some of the computer screen if I sat far enough away. Well, after using them for 3-4 weeks now, I can certainly see infinity but I can also use the computer with no glasses AND I can see most printed matter to read, too. The fine print is a bit difficult but plain old Costco readers are just fine for that but, if I really squint, I don’t even need them from time to time. Haven't needed my prescription glasses (that had the astigmatic correction in them) at all and will now donate them to the Lions Club, used glasses program.

OK, for every set of good news, there's always the "yeah, but……..". These Symfony lenses cost an additional $2,500 per eye (depending on the surgeon but they all seem to be about the same). Even my friend paid that 2 years ago so the price hasn't gone up yet but inflation could kick in someday. Maybe it'll go down eventually but I couldn’t wait that long. Being 68 now, I figured that, with an additional 40 years of life expectancy left ������ ������, the amortized cost would be minimal.

There are two recognized surgical techniques for cataract surgery – the blade and a laser. I looked for the benefits and the pitfalls of both before deciding on whether to have surgery here or elsewhere depending on the technique used. Turns out, after reading some detailed, medical journals, that there really is no great consensus that one is better than the other. There are a couple of small things that may favor one over the other depending on what the surgeon recommends after your exam but the preponderance of evidence seemed to say that either one is just fine. It's up to the preference of the surgeon and his expertise. Driscoll uses the blade for now but is getting the laser early in 2019 so he can do both. The blade has been fine for me and I’ve not noticed any complications AT ALL. He thought that both procedures were just fine.

I did a lot of research on how the cornea actually heals and it was really educational. The eye is amazing at healing itself – and quickly. One of the best websites I found for real detailed references was a professional one at Review of Optometry – The Magazine Read Most by Optometrists. Lots of information there at very detailed, medical levels with all the jargon so you have to have Medical Terms and Abbreviations: Merriam-Webster Medical Dictionary up on another screen while you're reading the articles.

And, you can be awake for the whole procedure with lots of really strong numbing and dilating agents all over your eye so that you don’t feel anything; however, that’s your choice as to how to proceed. I was talking to the doc during the whole procedure while watching the shadows of the implements go in and out of the eyeball. It only took about 15-20 minutes. An anesthesiologist has an IV ready with instant sedatives to be used if the BP or nerves kick up but I didn't need anything so I just got up and walked out of the OR and had a cup of coffee within minutes - and I could see the cream floating in the cup with both eyes!. The really strong dilation medicine lasts for about 30-36 hours so the first night and following morning are weird but not bad at all.

There is one slightly negative thing about the Symfony lens. The construction of this circular lens (which is about 6mm in diam) is such that there are multiple, progressively wider diameter, embedded annuli (separated by microns) that allow for various distances of vision by having these microscopic, annular rings transmit numerous, different foci to the retina. Because these molded annuli have relatively "hard" edges from one diameter out to the next, there is an abrupt "edge transition" that also gets transmitted to the retina from these ever-wider-diameter, sequential annuli. Because of this, there will be microscopic, concentric "halos" that appear around bright lights but you can only detect anything at night or with a really dark background in a dark room while looking directly at a dim light (like a night light). I was warned about this effect but didn't find any images on-line as to what it actually looked like.

After my sight calmed down a day or so after surgery, I didn't notice these halos and thought the glare from bright lights at night was just that: glare which I'd been seeing for decades anyway when looking right at a bright light. BTW, this is only at night or in a dark room, not when there is any ambient backlight visible such as daylight or lamps. Even in a well-lit room at night, they aren't visible. So, I purposely tried to find some halos by squinting and concentrating on trying to find them. I finally recognized very slight, concentric rings around a bright light when the night sky is really dark. They seem more pronounced with orange-ish light like certain street lamps rather than white light. But, when I don't look directly at any bright light (and why would I normally, anyway?), it just looks like a bit of undefined glare that seems to be what I've normally seen all my life when looking at a bright light (OK, maybe 10-15% worse). People told me that it would affect my night driving because of the "halo effect". If I don’t look directly at oncoming headlights, it's business as usual and I haven't noticed any detriment at all. Just don't stare at the headlights!! (Why would I, anyway?). Driving at night has been no problem at all. Even if I look at the headlights, it's more of a glare problem, anyway, and not a halo effect which gets overpowered by the high intensity glare, especially from these new LED headlights.

It's all in how much negative aspect the owner of the lens wants to make out of it. Some people complain and moan about the halo effect and want to make it their center of focus by concentrating on it while others just ignore it and look at it as a byproduct of restored vision. Nothing is perfect and for every positive, there's usually some form of negative tradeoff. Personally, I'd do it again without hesitation if I had to. Can't believe the colors that pop out now. Didn't realize how bad things had gotten over the past 3 years or so."

Thanks for that information, I’m going to save this

[Professor]

Get the upgrade. My wife did in both eyes when she had cataract surgery and has never regretted it. A good friend had hers done with the standard lens and has had issues. She ended up having to wear glasses afterwards. You only have one pair of eyes...treat them well and pay the difference is my advice. However, if you are thinking of the bifocal lens, which is an even more costly option, I would pass on that. Too many problems as they require exact placement or vision will be permanently off.

[spofford]

Have had multi focal lenses for 8 years from Ocala eye. Dry eyes is only complaint, warm wash cloth alleviates dry eyes for hours. After several years, eyes have adjusted to bright lights. I would recommend multi focal if a candidate.

[Joanne19335]

Originally Posted by DimondAngels

Is it worth getting the upgraded lens at $3300 each eye or to just have the standard lens put in which your insurance company will cover the cost???

I got the Crystalenns and have never regretted it.

[Dot Rheinhardt]

I was practically legally blind due to astigmatism. No one in town could make my glasses. They had to be sent out of town. I had worn glasses since age 5. I opted for the Toric lenses. Best thing I ever did. I'm not bothered driving at night. If you have astigmatism, I highly recommend Toric. I didn't like anyone near my eyes, so very fearful of surgery, but all went well.

[Kathryn Putt]

YES. I've worn bifocals then bifocals for 50 years and had the multifocal lens 5 years ago and still do not need glasses

[Lindaws]

I love my multi focal lens. Worth every penny. Included in the cost was using laser to correct astegmatism(?)

[NotGolfer]

I had worn glasses since I was 9 then got the cataract surgery about 5 or 6 yrs ago, when I was 70-ish. I was going to go for the most expensive lens' as it sounded like a great option but in talking with friends who got the least expensive lens' and did fine I decided to go that route. Good thing too as when I went in for the app't to measure for the lens', I told the technician my story and she said it was good that I did that because one of my eyes has a "wrinkle" in the cornea and I'd have not had a good result. I only wear "cheaters" now for reading and have had no issues with my sight otherwise. Currently I'm having my eyes checked, because of a medication I'm on for something else that can affect my sight. So far, with that I'm fine too. ALWAYS be sure to go to an opthalmalogist for your eye checks.

[virtualcynthia]

WOW, thank you so much for all that research. You’ve inspired me to research macula holes and distorted vision.

[mydavid]

I develop a cataract in my left eye after a motorcycle accident back in the 70s. had surgery and had to ware soft contact lens's. a couple years later I had Laser surgery for a tare in in the same eye. I had quit waring the contacts because I was a welder and they would stick to the eye and make it hard to remove. I had no vision in the left eye without the contacts, some time later I had eyes checked to get new contacts only to find the retina detached and at that time their was nothing they could do. Moving a head some thirty years I have a cataract on my remaining eye. The VA has been looking after it for that several years, no one wants to fix it because I have only one eye, not the VA. I cant drive at night, and have a hard time seeing any thing that,s not in a lighted area.

[Carol T]

Originally Posted by DimondAngels

Is it worth getting the upgraded lens at $3300 each eye or to just have the standard lens put in which your insurance company will cover the cost???

I have the Restore lenses and love them. Need no glasses whatsoever. WARNING however, I am one of those who see halos around lights after the surgery. It happens (or at least did some years ago when I got my lenses) to some people, making night driving very tiring. Imagine seeing not one set of headlights coming at you but rings and rings of lights. Either it has subsided somewhat or I am getting used to it because it doesn't seem quite as bad now. I do avoid most night driving (but who doesn't as we get older?)

[rmd2]

I thought I might get the upscale lenses. My eye doctor recommended getting the regular distance only lenses and I'm glad he did because shortly after that I developed a macular problem and if I had my good eye in close up (not distance) vision I would have had a real problem then.