Cataracts

I don't know what I have, but I had lens implants 20 years ago and have had no problems. I would leave it up to the physician's recommendation.

I am not sure which brand,( I assume it is a generic ), is the standard.Have the final (2nd) consult tomorrow and should have the brand that is considered std.The one that is considered std. is apparently the only one Medicare will pay for (lens). I will be required to pay $900.00 above the Medicare limit on the "standard" lens. I don't mind paying it, I was/am just curious as to any response to the Toric lens. Thank you for your input. Points well taken, for sure and quite helpful. Thanks, again.

Standard lens has same power/curvature in every direction (spherical). Toric lens has different curvatures along perpendicular axes (like a inflated tube/tyre). If your Dr. suggests you a toric lens, it could be that you may be wearing prescription glasses already (with spehrical and cylindrical power along a particular axis, which means you probably wearing toric lens in form of presciprion glasses for one or both eyes) and the Dr. wants to correct that visual error by IOL, so that you do not need prescription glasses anymore. If this is the case, from optics point-of-view as well as from considerations of comfort, toric lens should be better choice.

Without a doubt, absolutely do not base your decision from what you hear from us here. Tor ic lens are to correct astigmatism, so he would have this all mapped out for your specific condition therefore if placed properly corrective lens (glasses) would not be needed, again he is the doctor not us. What I can comment on is that my father @ 70 yrs had cataracts removed and his vision corrected with Bausch and Lomb lens as he opted for the more expensive ones. His prescription was around -8 (I think but I know he could not see a thing without his glasses). It's been a couple of years now and he only uses glasses to read. One other thing he noted was that everything appeared brighter, (less yellow). As for side effects he has had none, the surgery was quick and relatively painless only itchy for a day or two. Oh yeah they only do one eye at a time!

Good luck!

I have no knowledge in this field, but, if there are any disadvantages to the toric lenses then the $900 would probably pay for the astigmatism to be corrected by laser treatment of the cornea.

Do the lenses have multiple focal distances, or, are they flexible so that you can focus in the normal way.

Here's a description of the two types of lens.

scroll down to Lens replacement and follow the links to the three makes (the first two look the same to me):-

http://www.docshop.com/education/vision/eye-diseases/cataracts/treatment/

I asked about the procedure and was told that I would never have to worry about getting cateracts.

However I'd be making a trade off. My vision would be far sighted and would still need glasses for upclose.

Now that I think about it, I'm getting to the point that my next pair of glasses will probably be bifocals anyway.

I couldn't afford to get the procedure done but if I could, it would eliminate the need to being dependent on wearing corrective lenses all the time.

I don't have IOL implants, and I am not a doctor, but I am familiar with some aspects of IOLs. I make it a point to talk to everyone I come across who has had this surgery, and I have yet to meet anyone who is not wildly ecstatic at having their failing eyesight restored. A few points to consider:

• The AcrySof like most high end IOLs has good image quality, probably better than the natural lens you were born with, and certainly better than the diseased lens you are having removed. I believe that from an optical standpoint even the 'standard' spherical lenses are better than a natural lens.
  
• Most negative side effects of IOL implants are due to problems with the surgery, and such problems are very rare. This is about as close to a 'production line' surgery as you can get. The surgeons that specialize in this operation might do more than a dozen in a day, and they get really good at it. In my work I occasionally come across a situation in which a lens with the wrong power has been implanted. While this is unfortunate it can be corrected with either a second surgery (to remove the wrong lens and replace it), or in mild cases by eye glasses.
• Sometimes when the the small incision in the cornea used to insert the lens heals, it changes the curvature of the cornea slightly. The lens power selected by your surgeon is based on the pre-surgical curvature, and if the post-surgical curvature is different, it will not be possible to focus. Low power eye glasses will fix the problem.
• Common lens related problems are glare and haze, which can be due either to reflections from the edges of the lenses or from multifocal IOLs. Edge glare can come from a lens that is not properly centered on the iris, of from a lens that has an optic diameter that is smaller than your iris. Multifocal IOLs work like bi-focal, tri-focal, or progressive eye glasses. The difference is that with glasses the zones of the lens that focus at different distances are in different directions, usually with the higher powered zones toward the bottom of the lens. In an IOL the zones are usually located in concentric rings, so when you focus on an object, the light from the out of focus zones falls right on top of the portion of your retina occupied by the thing you are looking at, and the image contrast is reduced by this defocused light. For most people the signal processing circuits in the retina, optic nerve, and the brain work well to minimize this problem. Since you are getting a toric lens (which is not a multifocal) you won't have this problem.
• The toric lens you are getting should provide the overall refractive correction you need, and should also correct for your astigmatism. Unfortunately it will not provide any accommodation (ability to switch focus between near and distant objects) so you will probably still need reading glasses.

The risks are real but very small. Your options are to have the surgery which will almost certainly correct your problem, or keep looking at the world through a diseased lens which will continue to deteriorate. If I were in your situation I would go for it. Whatever you decide, I wish you the best of luck. If you do chose surgery, I hope you will update us on this thread.

What about the option of a standard multifocal IOL and laser surgery to the cornea to correct the astigmatism: which should come out at about the same total cost. Or am I missing something.

I think that the lasik surgery to modify the cornea has a much worse track record than IOLs. I personally would not hesitate to get an implant, but I would need some serious persuading to even consider lasik.

Hi Tony

I have had astimatism in my left eye since being very young and could not read further than the 2nd line on a chart. I had a IOL implant which has a degree of flexibility allowing some focussing and was chosen to correct the astigmatism. My vision was until then basically monocular since the brain ignores the bad data. However after 1 yr from having the IOL I have regained quite a bit of binocular vision. Previous theories suggest this is not possible at my age 54 but more up to date data suggests it is possible. I would go for it without hesitation if the advice from the doctor suggests it would not have any problems. All operations carry risk but this one is one of the commonest and most successful around. I had the other eye lasered and to be honest the IOL was more successful and even less discomforting. I drove home the next morning with no problems after being passed fit to drive.

I would strongly suggest you visit this group and post some questions here