Cataract surgery

[88V8]

Good vision at night and in low light, but when the sun comes out I'm bothered with glare, and headlight halos especially on wet roads. I also noticed returning from Devon last week that I can read the satnav perfectly well until the sun appears...

So although my optician says my cataracts are 'not ready' (I presume this means not bad enough for NHS treatment) I'm inclined to have them done. This is reinforced by speaking with two other oldies over Christmas both of whom had glare problems but now say their sight is better than it's been for years.

Our local private hosp has five consultants all with much experience, they use the phacoemulsification procedure.

Any thoughts or experience?

V8

[Sobraon]

I had my one done (only needed one) in a large teaching hospital as the consultant had recommended it over having it done privately. The anesthetic was via injection but I *think* the anaesthetist said it would have been topical if it had been a private procedure. Bottom line - perhaps worth checking?

[scrumpyjack]

I had it done privately by a senior consultant. No problems, sight much better and glasses prescription dramatically reduced.

[AsleepInYorkshire]

Good vision at night and in low light, but when the sun comes out I'm bothered with glare, and headlight halos especially on wet roads. I also noticed returning from Devon last week that I can read the satnav perfectly well until the sun appears...

So although my optician says my cataracts are 'not ready' (I presume this means not bad enough for NHS treatment) I'm inclined to have them done. This is reinforced by speaking with two other oldies over Christmas both of whom had glare problems but now say their sight is better than it's been for years.

Our local private hosp has five consultants all with much experience, they use the phacoemulsification procedure.

Any thoughts or experience?

V8

Mum had both eyes done not long before she died. The first was no problem, but the second had recurring issues. Sorry I don't know much more than that, other than I was taxi shuttling her back and forth

I hope you find a solution that helps

AiY(D)

[Lootman]

I had my one done (only needed one)

I was told that having only eye done would lead to having different fields of view in the two eyes. That could be corrected by the use of a special type of contact lens in one eye. Did you experience anything like that?

I only have a cataract in one eye but figured I would get both yes done, a few weeks apart, which I believe is the standard practice.

[Eboli]

For what it's worth I had both eyes done (the worst eye in Dec 2021 and the better one in Feb 2022). Both were done in a private clinic on referral from the NHS. I understand the only main difference from going private was I could have chosen varifocal lenses had I gone private from the start (costing about £3,000 each) whereas on referral from NHS you have to have the fixed lens inserted.

Both operations went without issues and each took about 15 minutes. I was given anaesthetic by drops and was fully conscious during the process. I fell nothing with the second operation and a very minor discomfort with the first (though this might be because they also had to remove a small flap of skin). The biggest bind was the insistence that some is there to take you home as they will not let you use public transport.

The transformation from having to wear -7.5 lenses to correct vision to having 20/20 in both eyes was amazing. Also I notice a certain vibrancy in colours that had eluded me before. The only downside for me is that I am now reliant on reading glasses for close work (whereas before this was the one thing I could enjoy without glasses).

I am so glad that I had them done.

Eb.

[stewamax]

There has been another recent post on this subject: see viewtopic.php?p=525180#p525180

[88V8]

Consultant's appt arranged.
About £3k a pop.
Amused to see that all fees are lower if one is self-funding.

The practice manager - 16 years experience - commented that mulitifocal lenses tend to cause headlamp glare, given that this is one of the issues I wish to resolve I will probably opt for single focus. I already wear specs for reading, and indeed a different pair for the computer, so no great hardship if I have to continue.

I see that there is a greater risk of retinal detachment after cataract op. It's too easy to head down a rabbit hole of potential worries, so I shall try to put that aside fttb.

V8

[servodude]

Amused to see that all fees are lower if one is self-funding.

Standard practice anywhere "insurance" is involved (sometimes by significant amounts); it's almost as if it's a bit of a scam

Good luck

[Lootman]

Amused to see that all fees are lower if one is self-funding.

Standard practice anywhere "insurance" is involved (sometimes by significant amounts)

It is not universally the case. At least with some US healthcare insurers and HMOs, the out-of-pocket costs to a patient can be lower if you have insurance, even if the insurance doesn't cover that specific treatment, or all of it. The reason being that hospitals negotiate standardised group rates with insurance networks that are lower than the walk-in rate for an uninsured individual.

In much the same way as the cost of a group policy is lower than the cost of an individual policy. A volume discount, if you will.

[88V8]

The op this afternoon.

Now sitting here at home with a slightly transparent eye cover, but no parrot.

Attended at 1300h, had my own wardroom. Consultant came for quick chat and write a marker X above the appropriate eye, and to collect consent form which I had forgotten. Signed something else which might have been a cheque for £1,000,000.

Nurse took BP and checked my id and what they were doing. Put a pellet in the bottom of the eye to dilate it.
Foodlady took order for post-op snack.
About 1530h a chap with copious tattoos came to gown me over my clothes, put on socks, checked my id and what they were doing.
Walked to theatre.

Arrived at theatre, same chap checked my id again.
After a short wait, went into theatre, where they checked my id again.
Lay on table, given pulse thing to hold which was useful as I was able to concentrate on keeping pulse slow rather than worrying about what was happening.

Consultant put anaesthetic in eye and massaged it for a while.
Then taped gauzy cloth over my face leaving just the eye free.
Huge microscope positioned over me.
Thing inserted to keep eye open.

The actual op was quite quick, perhaps 8-10 mins. Flashes of light, buzzing, some water running down the eye, no great discomfort.
Wheelchair back to the wardroom, will see the consultant in 2-4 weeks.

Post-op snack arrived promptly and a freebie for the wife.
Given gauze for cleaning eye, and four weeks of two lots of eye drops.

Keep the shield on until morning, and wear at night for next week.
Must not bend over, or more so must not tip face downwards for two weeks. No heavy lifting. Keep eye dry when washing face.

No coherent vision in that eye yet.

V8

[88V8]

Already just 22 hours after surgery, the eyeball is not painful.
It no longer feels as if I'm being poked in the eye when I look around, and the 'dry eye' problem and gritiness I expected has not materialised.
The eyeball is slightly red, but not so as to really notice.

This morning I removed the eye shield, and wiped the eye using boiled/cooled water and a (supplied) piece of gauze, having previously washed my hands but not dried them because the hand towel is not sterile.
I could have dried them with a fresh paper towel but I didn't.

Eye drops... for over 70 years I have managed to avoid eye drops. Now I have to put in two different lots, three and four times a day and I'm finding it difficult.
A random search threw up this video with some useful tips, including spacing out the two lots of eye drops when they are supposed to be put in an the same time ie the first dose in the morning and the last at night. Space them by 5-10 minutes so they don't sabotage one another.
There are a lot of potential side-effects from eye drops, as I discovered once I had put on my glasses so I could read the leaflets.

But how is the vision. My left eye was far the worst; fuzzy distant or close, only partially corrected by specs, and suffering badly from glare. Now, that eye is still poor for close work but I knew it would be as I opted for a distance lense. Across the room and beyond, it's brilliant. I thought my right eye was still pretty good, but the left eye now is much sharper.
No difference in colours, I didn't have any greying, but the sharpness is excellent.

I will need new glasses for reading and the computer. I have different glasses for those things, the computer glasses are focused about an arm's length. This will have to wait four weeks or so for the eye to settle.

I haven't yet ventured out in the sun to see whether the glare has gone or diminished - one of the eye drops says to avoid sunshine, so it will be sunglasses for the next four weeks. Glare was the key driver in having the surgery, but I must say even if it is no better the gain in visual acuity has been worthwhile.

Incidentally, I mentioned that there had been no pain during the surgery, I've had much worse at the dentist. This morning however it was pretty painful removing the eye shield, pulling off the tape, as it had been taped across my eyebrow which got an unscheduled plucking. I'd hate to be one of these fashion-victim women who's had their eyebrows plumped up to look like Groucho Marx.

V8

[Lootman]

Consultant put anaesthetic in eye and massaged it for a while.

Did they offer you Valium or equivalent for anxiety, either orally or IV?

[88V8]

Consultant put anaesthetic in eye and massaged it for a while.

Did they offer you Valium or equivalent for anxiety, either orally or IV?

Not on the day.
I had discussed the options with the consultant when first I saw him.
Years ago I had a wisdom tooth out under local and compared to that I was assured this would be a doddle. The worst thing in fact with the tooth was the running commentary to the students, but that's what you get for being treated at a teaching hospital.

V8

[88V8]

Just to add that I have removed the left lense from my computer glasses as I find that arms-length upwards the eye now sees better unaided.

Will still need reading glasses.

V8

[stewamax]

Two suggestions:
- wait for several months before getting a new prescription for custom reading and possibly VDU glasses. In the meantime buy some instant reading/VDU glasses from Superdrug or similar.
- there is usually a certain amount of retinal swelling after the operation. If after a couple of weeks distance vision is 'clear' but there is a rippling effect on distant surfaces noticeable in bright sunlight (rather like the shimmering of hot air rising from a road on a hot day), get an OCT scan from a high street optician (£10 or so). This will show up significant swelling, for which you need prescription-only bromfenac drops (trade-name Yellox)

[88V8]

Two suggestions:
- wait for several months before getting a new prescription for custom reading and possibly VDU glasses. In the meantime buy some instant reading/VDU glasses from Superdrug or similar.
- there is usually a certain amount of retinal swelling after the operation. If after a couple of weeks distance vision is 'clear' but there is a rippling effect on distant surfaces noticeable in bright sunlight (rather like the shimmering of hot air rising from a road on a hot day), get an OCT scan from a high street optician (£10 or so). This will show up significant swelling, for which you need prescription-only bromfenac drops (trade-name Yellox)

Thankyou.
I had wondered whether to get new glasses yet. Some of my reading glasses are OK for left or right eye eye but not both. Ten weeks on now, the consultant said that new glasses would be in order.

Fortunately I have had no adverse symptoms so far. I have an annoying number of floaters some days, in both or either eye, but that's just one of those things.

Over the last two-three months I've been surprised at the rate of deterioration of my former 'good' eye. I think if I had still been relying on that, especially for driving, it would now have been rather difficult.

V8

[servodude]

I have an annoying number of floaters some days, in both or either eye, but that's just one of those things.

Ah floaters!
The tinnitus of the eye.

Apparently you're born with them but I first really noticed mine about 30 years back working in a top floor office with nothing to see but sky... well sky and this persistent slide of ebola viruses that would sort of track my vision.
I swear that's why subterranean pubs were popular in Glasgow during summer

Good luck

[stewamax]

There are floaters and floaters! Most of the usual dark pinhead or larger and translucent jelly-like ones will settle down, and the residue you will get to ignore. Any larger black ones should be examined professionally because they may be a tiny blob of blood from a tear in the retina.

The latter can also happen as a result of an otherwise harmless age-related 'posterior vitreous detachment' (PVD) where the eyeball jelly detaches from the retina. Cataracts and PVDs are unrelated but retinal tears need to be looked at by a specialist ophthalmic registrar (not your local optometrist).

[scotia]

I had an NHS cataract operation on my right eye earlier this year, and I suffered a capsular rupture - so the operation lasted around 45 minutes, rather than the usual 15 minutes. The registrar performing the operation was joined by the consultant who provided encouragement, while I was grateful that I had taken some diazepam before the op! I get the other eye done next week and I have been advised that both eyes are usually similar in structure, so I may be in, once again, for the longer experience. I'll remember to take some diazepam!
(I understand that around 2% of cataract ops involve capsular rupture).