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A tale of two implants


stargazerlily
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There are many many causes of cataract - trauma can bring one on rapidly.

They tend to cause a blue shift in colour perception and it is often colour that people report afterwards.

The fact that surgeons can aim to make the final prescription as near zero for distance vision as possible is great for  us types. 

Most cataract operations are carried out under local anaesthetic (drops sometimes), rare for full general.

(maybe info overload, but I am a retiring Optometrist !)

 

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On 09/02/2019 at 18:17, Unklewhale said:

There are many many causes of cataract - trauma can bring one on rapidly.

They tend to cause a blue shift in colour perception and it is often colour that people report afterwards.

The fact that surgeons can aim to make the final prescription as near zero for distance vision as possible is great for  us types. 

Most cataract operations are carried out under local anaesthetic (drops sometimes), rare for full general.

(maybe info overload, but I am a retiring Optometrist !)

 

 

Yes ... very true about the blue colour.  Before my Op, the gas flame in a cooker was a pale, washed out blue colour.  Now it is vibrant lilac colour.

I had my Ops done under local ... several rounds of drops to dilate the eye followed by several rounds of local anaesthetic drops.

The hardest part is to lie perfectly still looking into a light ... knowing full well what is going on.  Luckily I had a nurse to hold my hand :)

Pete

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  • 1 month later...

Finally had the cataract operation on my right eye last Thursday (21 March), it had originally been scheduled for 15 March, but this got cancelled supposedly due to a power cut in the operating theatre at the treatment centre on that day. I had arrived there (by taxi as you can't drive afterwards), and had been waiting 15 minutes before being informed.

The operation was not a particularly pleasant experience but not painful, one of the other patients described it as not being as bad as the dentist, although I wouldn’t quite agree with that. Immediately after the operation I could see distant objects through my right eye a bit clearer than before, but then my vision deteriorated for a time and I could see little other than blurs and flashes of purple light, about which I got quite worried.  Fortunately after a few hours things started to improve, although there was still a halo of light around bright objects.

By the following morning the vision through my right eye had improved dramatically, I could now see distant objects clearly and could still focus on objects down to about 50cm away, so don’t need glasses for a computer screen, but as anticipated, I am now more dependent on glasses for reading. The sensation was similar to having a contact lens (which I used to wear) permanently inserted in my right eye. Prior to developing the cataract I was just slightly short sighted in both eyes (about -1 dioptre), but subsequently became very short sighted in my right eye.

Comparing the vision in my right to that in my left eye, in addition to distant objects being clearer, whites seem a lot brighter, and the view through my left now appears to have a slight brownish hue in comparison. I am therefore probably getting a much higher percentage of light transmission through the implant than in the natural lens in my left eye, so I am hoping that I will now be able to see fainter stars.

As I mentioned previously they have inserted a mono focal (optimised for distant vision) implant, I did enquire about multifocal implants, but was told that they are not generally available on the NHS, and that if I wanted a multifocal implant, I would have to pay for the entire operation privately (elsewhere), and that it is not possible just to pay for the extra cost of the multifocal implant. Having read several articles on line, although some people do end up with both good distant and near vision with multifocal implants, more people have problems with the latter, in particular with car headlamps when driving at night, which is probably another reason besides costs why the NHS generally does not fund them.

Incidentally so far at least (touchwood), although I’ve experienced slight discomfiture, I’ve experienced no pain whatsoever, this compares to my daughter who suffered quite a lot of pain after less drastic laser eye surgery.

John

Edited by johnturley
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Yes, multifocal implants have 'ghosting' issues, due to the fact that the Distance & Near focussing areas are (usually) in alternate circles radiating out from the centre. The brain is constantly receiving 2 images and has to sort them out. Usually not bad in brightly lit conditions, but more difficuly when dim. Some people have no issues, some don't sem to cope well with it.

An alternative (and more modern) design has the implant lens actually flex within the eye, something similar to normal 'accommodation', but it appears the effect seems to diminish with time.

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This thread is an interesting read for any-one likely to have cataracts operated on in the near future.  I have to have this done in a few years time I am told, but on a recent eye visit I was told I have narrow angles in my eyes, this is the corners where there is a natural drainage channel for the fluid in the eye.  I was referred to Ophthalmology and I am going to have to have eye surgery to make a hole in my Iris's to provide extra drainage (Laser Iridotomy).  If I don't get this done it could lead to glaucoma.   

The one thing that was reassuring from my Ophthalmology examination, was the gel put in my eyes, I didn't realise this was to numb them, and while I was being examined, I thought, "hang on a bit, he's got a dirty great plunger thing stuck right on my eye (that he was looking through) and I can't really feel it".   I asked about it afterwards, and he said yes, I would not have been able to tolerate it without the gel.  So this at least has given me some reassurance that the numbing gel does actually work.

Must chase up my "being put on the waiting list" for this as it is being done at Kings College Hospital, and I was seen at Lewisham.  Must check that my referral has gone through OK.  

Carole 

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Well folks, I am into hospital on Tuesday morning at 8:45 to have my left eye procedure.
I am really looking forward to it. If the result is as successful the first one, I can't wait to see a  world
twice as clear ?.

Ron.

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14 hours ago, carastro said:

 

The one thing that was reassuring from my Ophthalmology examination, was the gel put in my eyes, I didn't realise this was to numb them, and while I was being examined, I thought, "hang on a bit, he's got a dirty great plunger thing stuck right on my eye (that he was looking through) and I can't really feel it".   I asked about it afterwards, and he said yes, I would not have been able to tolerate it without the gel.  So this at least has given me some reassurance that the numbing gel does actually work.

 

Hi Carole

They used some sort of anaesthetic gel on my eye, although uncomfortable I can assure you that the procedure is not painful.

John

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3 hours ago, barkis said:

Well folks, I am into hospital on Tuesday morning at 8:45 to have my left eye procedure.
I am really looking forward to it. If the result is as successful the first one, I can't wait to see a  world
twice as clear ?.

Ron.

Good luck, Ron. Please let us know how you get on.  :)

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15 minutes ago, Beulah said:

Good luck, Ron. Please let us know how you get on.  :)

Thank you kindly Sam. I'm pretty excited about the probable improvement, although I'm really over the moon with the improvement the first procedure has made to my sight.

Best Wishes..

Ron

 

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Well, I'm feeling a bit down today. I  had my appointment at the Hospital this morning expecting my left eye to
be fixed via a cataract procedure, only to be told it was only to do more tests. I went from one room to another
for a good two hours before being told that there was no Op. today. I was stunned.
My final  interview was with the Eye Specialist, who merely confirmed after blinding me with with some  
piece of equipment he had, that my left eye indeed required attention. 
The jaw dropping news was that it would be a few more months  wait, due to the numbers in the queue.
One of the nurses tried to ease the blow by saying there's always the possibility of a cancellation, and I would be called in much sooner.
Without wishing any harm to anyone, I hope it is sooner, rather than later.
I feel a right Pillock after telling all my friends today is  the day. One even gave me a lift to Hospital, and told me to ring  him when 
I was ready to go home. ?

Ron.

 

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Hi Ron

Sorry to hear about that, as I mentioned my original appointment was for for 15 March, only after I arrived at the treatment centre (and paid a £20 taxi fare to get there as you can't drive afterwards) did they tell me that the operation had been cancelled, supposedly due to a power cut in the operating theatre, allthough I suspect that the actual reason might have been staffing issues.

Originally they offered me an alternative date of 17 April, some five weeks later, but then the next day they rang me back offering 21 March, probably due to a cancellation, so you might get yours done sooner.

Good luck

John

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I sincerely hope so John, I was so excited  it was going to happen, but  the frustration is still bugging me. Anyway, just have to be a patient patient.

Ron.

Edited by barkis
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Pete - Welcome back. Now you have views I'm sure you are going to be looking in the 'for sale' section for something sky related.

Ron. Good luck and remember your are a PATIENT. You have to be PATIENT?
I once took my wife to hospital for planned surgery. A 30 miles drive through snow. We got there on time.
The surgery was cancelled. The (obviously angry) surgeon reported they had too few staff in that day to run the theatres.
He completely agreed with my comment that the theatre staff should be thoroughly ashamed of themselves.

To everyone else. Fascinating reading. It is certainly making me wonder about my eyes.
As catarcts are a gradual phenomenom usually, we don't notice.
Carole's comment on colour reminds me of reading about the artist Monet.
Apparently his work changed colour gradually as his cataracts progressed, then returned to bright colours after surgery.

A high street opto probably looks at lens condition against age and adds in comments from the patient.
Referrals only being made if the patient reports issues.
Then not all high street optometrists speak English. I once had to translate for someone who was told they were suffering 'lenticular opacities'!
The opto man even wrote it down when asked.

 

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On 23/03/2019 at 21:17, carastro said:

This thread is an interesting read for any-one likely to have cataracts operated on in the near future.  I have to have this done in a few years time I am told, but on a recent eye visit I was told I have narrow angles in my eyes, this is the corners where there is a natural drainage channel for the fluid in the eye.  I was referred to Ophthalmology and I am going to have to have eye surgery to make a hole in my Iris's to provide extra drainage (Laser Iridotomy).  If I don't get this done it could lead to glaucoma.   

The one thing that was reassuring from my Ophthalmology examination, was the gel put in my eyes, I didn't realise this was to numb them, and while I was being examined, I thought, "hang on a bit, he's got a dirty great plunger thing stuck right on my eye (that he was looking through) and I can't really feel it".   I asked about it afterwards, and he said yes, I would not have been able to tolerate it without the gel.  So this at least has given me some reassurance that the numbing gel does actually work.

Must chase up my "being put on the waiting list" for this as it is being done at Kings College Hospital, and I was seen at Lewisham.  Must check that my referral has gone through OK.  

Carole 

Interestingly (possibly), another way to open the 'drainage angle' is to carry out cataract surgery with an implant intraocular lens (because the new lens is flatter). Was this considered at all, especially as you say you already have an early cataract?

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This corrective  eye treatment is certainly beneficial to astronomers, and in my opinion, moreso to the observers, who's eyes are quite precious in the study of stellar objects. For imagers, there are focusing aids to ensure maximum accuracy, so although not imperative,  better checked anyway.

Perhaps this thread will be an encouragement to those who have troublesome sight, which cataracts are the main culprit. Anyone who feels their sight is not what it used to be, see your optometrist to see if cataracts are developing in your eyes. Believe what you've read here, you be glad you did.

Ron.

 

 

 

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Quote

Interestingly (possibly), another way to open the 'drainage angle' is to carry out cataract surgery with an implant intraocular lens (because the new lens is flatter). Was this considered at all, especially as you say you already have an early cataract?

No there was no mention of this.  I now have a date for my laser surgery.  I guess I could mention it beforehand.

Carole 

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One issue I think, particularly if you have the operation under the NHS, is that there is very little discusssion (if any) about the various types of implants, and the advantages and disadvantages of each type. The attitude of the NHS appears to be very much of 'this is what is available', take it or leave it.

John

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On ‎23‎/‎03‎/‎2019 at 21:17, carastro said:

This thread is an interesting read for any-one likely to have cataracts operated on in the near future.  I have to have this done in a few years time I am told, but on a recent eye visit I was told I have narrow angles in my eyes, this is the corners where there is a natural drainage channel for the fluid in the eye.  I was referred to Ophthalmology and I am going to have to have eye surgery to make a hole in my Iris's to provide extra drainage (Laser Iridotomy).  If I don't get this done it could lead to glaucoma.   

The one thing that was reassuring from my Ophthalmology examination, was the gel put in my eyes, I didn't realise this was to numb them, and while I was being examined, I thought, "hang on a bit, he's got a dirty great plunger thing stuck right on my eye (that he was looking through) and I can't really feel it".   I asked about it afterwards, and he said yes, I would not have been able to tolerate it without the gel.  So this at least has given me some reassurance that the numbing gel does actually work.

Must chase up my "being put on the waiting list" for this as it is being done at Kings College Hospital, and I was seen at Lewisham.  Must check that my referral has gone through OK.  

Carole 

I find anything to do with medical interventions on the eyes very scary! I'm sure my cataracts are slowly getting worse but I know I won't even get an NHS look-in until they are really bad.

Louise

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I find anything to do with medical interventions on the eyes very scary! 

Me too, not looking forward to it.

Quote

I know I won't even get an NHS look-in until they are really bad.

The optician said to me that because of my astronomy hobby, I would probably get mine done sooner than most people, so hopefully it will apply to others on here.

Carole 

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44 minutes ago, Thalestris24 said:

I find anything to do with medical interventions on the eyes very scary! I'm sure my cataracts are slowly getting worse but I know I won't even get an NHS look-in until they are really bad.

Louise

Oh Louise, banish such fears from your mind. I'll admit to some trepidation before mine, but believe me, you are in good hands, and there is no pain at all. 

Ron.

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1 hour ago, Thalestris24 said:

I find anything to do with medical interventions on the eyes very scary! I'm sure my cataracts are slowly getting worse but I know I won't even get an NHS look-in until they are really bad.

Louise

The present criteria for cataract operations is visual acuity worse than 6/9 and THAT YOUR QUALITY OF LIFE IS BEING AFFECTED. Clearly the latter statement is very different for many people. Having visual requirements for something like Astronomy would count I am sure. Other people are happy to walk around in a total blur without an issue to their happiness.

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13 minutes ago, Unklewhale said:

The present criteria for cataract operations is visual acuity worse than 6/9 and THAT YOUR QUALITY OF LIFE IS BEING AFFECTED. Clearly the latter statement is very different for many people. Having visual requirements for something like Astronomy would count I am sure. Other people are happy to walk around in a total blur without an issue to their happiness.

I suffer from the effects of glare and have poor low light vision, but things aren't too bad otherwise, so I'm unlikely to get any interest yet.

Louise 

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39 minutes ago, barkis said:

Oh Louise, banish such fears from your mind. I'll admit to some trepidation before mine, but believe me, you are in good hands, and there is no pain at all. 

Ron.

I do read horror stories about eye ops going wrong. I don't need any urgent work yet so at least I can be relaxed about it for the moment.

Louise

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45 minutes ago, carastro said:

Me too, not looking forward to it.

The optician said to me that because of my astronomy hobby, I would probably get mine done sooner than most people, so hopefully it will apply to others on here.

Carole 

That's exactly what they said to me in December, and had my right eye done last week.

John

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