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Old 12-08-2020, 08:20 AM
 
1,677 posts, read 2,526,445 times
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peral2014,

Thanks for your post. I had never heard the term scieral lenses. I had to look it up. I see that they are contact lenses. I did try wearing contact lenses before I had RK/AK surgery. I had issues with both hard and soft contact lenses. Not the vision, but, the difficulty of putting them in and taking them out each day. I would take wearing glasses over contact lenses any day of the week - so it would not have been an option for me.

On a positive note the stability of my vision is improving every day . Neither eye is perfect, but, between the two my vision is very good for distance and close up work. I don't need glasses for driving during the daylight hours or close up/reading work at any time as long as I have good lighting. The only issue is driving in low light conditions when the pupil expands to let in more light and the RK/AK scars cause the light to fracture like a prism. (it causes multiple very faint "ghost" images as well as the star burst you describe.)

I don't think correcting for astigmatism when having cataract surgery is an issue for most people who have never had previous eye surgery. However, if you have had RK/AK surgery or any other type of eye surgery prior to cataract surgery you should be prepared for a longer recovery period.
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Old 12-14-2020, 02:36 AM
 
Location: San Francisco Bay Area
7,665 posts, read 5,380,733 times
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Quote:
Originally Posted by terracore View Post
I had cataract surgery in October. I had astigmatism in one eye, bad nearsightedness in both eyes, and also needed reading glasses. I had progressive bifocals when I wore glasses and multi-focal contact lenses when I wasn't. Then the cataracts started. I had the PSC variety that come on very quickly.

I got the Alcon Panoptix trifocal lenses implanted, a regular one and one that corrects astigmatism for that eye.

As of my checkup last week vision was 20/20 in one eye and 20/25 in the other. Surgeon said the results were 'remarkable' and my vision should continue to improve over the next 3+ months.

I don't need reading glasses, or glasses of any kind anymore, in fact I was able to lower the font size on my phone to a super small setting so that text displays properly in a particular app that I use. I would say that my near and mid vision is "perfect". My distance vision is great in full light but I wish it was better at night. The surgeon says that will improve over the next few months.

I've had poor vision my whole life. I'm not using any kind of corrective lenses now. Two days after surgery I was driving without glasses for the first time in my life because I can see better than I could when I was 15.

The tri-focal implants were expensive because the insurance didn't cover any of it.
Do you have Medicare or Senior Advantage?

Since you are in Hawaii, did you have it done at Kaiser Permanente?
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Old 12-17-2020, 09:03 PM
 
Location: Puna, Hawaii
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"Do you have Medicare or Senior Advantage?"

No.

"Since you are in Hawaii, did you have it done at Kaiser Permanente?"

No. There are only a few surgeons in the state that do this surgery. I don't know if any of them are Kaiser doctors. I had mine done here: https://www.hawaiivisionspecialists.com/

I did exhaustive research on these implants before I got them and one of the takeaways was that the skill of the surgeon was the biggest factor in measuring outcomes, especially for astigmatism.

It was expensive. You get what you pay for. If the surgeon has a laser-equipped office for cataract surgery, somebody with medicare may not get laser if medicare only pays for scalpel surgery. It's not because the scalpel costs the surgeon less, it's because the liability insurance for the laser machine isn't going to cover the surgeon for a scalpel-only medicare procedure. And on top of the procedure, there is the cost of the multi-focal implant that medicare isn't going to cover. That is 100% out of pocket regardless of insurance or lack thereof. To clarify, I didn't get LASIK. There is a separate type of laser-assist surgery for cataracts that is specific to that disease that "comes with" the purchase of a premium inter-ocular lens implant. It speeds accuracy (increases outcomes) and drastically reduces healing time compared to using knives. I don't know if having the laser equipment is a requirement for these implants, but I wouldn't use a surgeon that didn't have the laser machine.

So part of the success of the procedure is the implant, and some is the surgeon, some of it is the laser, and the insurance is none of it. I haven't received all my bills yet, but I'm guessing at the end (and I have "good" private insurance) is that insurance pays about 10%. Of course a lot of that is just having the procedure done in Hawaii where medical bills aren't exempted from sales tax. The implants were $3,200 each ($6,400) but over $6,700 after sales tax. That is just for the materials implanted into the eyes, not procedures and other costs.

After insurance paid, my out of pocket to get vision restored is over $7,000 but I think it will clock out just under $8k. To put into perspective, that is more money than I have spent on anything else in my life other than child's education or real estate (I've never owned a new car) and caused me to readjust my retirement plans. In other words, it was one of the biggest investments I've ever made, it's not something that can be put into a spreadsheet to determine if medicare this or insurance that. One either accepts poor restoration of their vision at little cost, or they spend a fortune and see great again. It SUCKS. But that's life right now.

Is it worth it? It seems like it now but only time will tell. I know people who had medicare-funded cataract surgery and they are all still wearing glasses and I can see better than any of them, and I'm not wearing glasses or anything. Also, I've had to tell everybody in my family their only Christmas present this year is knowing I can see well again. It all comes down to priorities.
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Old 11-17-2021, 12:47 PM
 
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I had the PanOptix trifocal toric lens implants after cataract surgery, the first eye six weeks ago, second eye four weeks ago. My near/close vision is very good. I don’t need glasses to read, or see the dashboard gauges in my car. But my mid-range and distance vision is still very problematic. Not at all sharp, and rather blurry. I have avoided driving anywhere that isn’t familiar. I can’t read road signs while driving until they are very close, I have a problem judging how far away approaching cars are (when making a left turn with oncoming traffic for example) and I can’t read the menus on my TV clearly from 10 feet away. I am an amateur photographer, and looking through the lens of my camera I can’t tell if things at any distance are in focus. My surgeon was and still is perplexed, because the lenses are right where he put them, they haven’t rotated or moved, and the toric measurements were within the small margin of error. We are monitoring the situation, treating for possible dry eye issues that maybe weren’t evident before, but I am so far pretty unhappy with my results.

I’m wondering if anyone else has had this issue with blurry distance vision and if it resolved over time. Since my vision is still adjusting he didn’t want to give me a prescription for glasses yet, so I’m kind of stuck with this blurry distance vision for now. It sure what to expect, if this issue will resolve over time, or if I will need to have the lenses replaced. $5,000 for the surgery and lenses.
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