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Lens Replacement Theory: Part Two

Posted on Tuesday, June 4th, 2024

Dave!I'm talking about my cataract surgeries this week! If you missed Part One from yesterday, you can find that here.

The first step in addressing your cataracts is to have a consultation with an expert. There are choices you'll need to make and, while you can read about this stuff on the internet, you really need to talk things over with somebody who can guide you to the best options FOR YOU... not for some random social media influencer or YouTuber or (most definitely) me.

CHOICE #1: Which lens is right for you? During the discussion with my doctor, I was given four options...

  1. Monofocal Distance. You can see things far away, but near-to-mid-range vision will require glasses.
  2. Monofocal Near. You can see things close-up, but mid-to-far-range vision will require glasses.
  3. Multifocal 2-Zone. You can see things from about 24 inches away to far away, but near vision will require reading glasses. Some halos and glare possible. Diminished contrast possible.
  4. Multifocal 3-Zone You can see near to far without glasses. Halos and glare more probable. Diminished contrast more probable.

Thanks to the shitty state of "health care" in America, the cost of the lenses will likely factor into your decision depending on your insurance. My insurance would only cover monofocal lenses (outside of whatever deductible I had left, of course). Any other lenses would be 100% my responsibility to pay for (though the surgery itself is still covered). If I wanted multifocal lenses, they are $2,900 each... $5,800 for the pair!

Now, my first instinct was to skip right to the Multifocal 3-Zone lens. No more glasses at any distance? Sweet! But I work as a graphic designer and love photography. The idea of losing any contrast in my vision scared the shit out of me. Would I even be able to do my job any more if I lost contrast? This is mostly a factor in low-light conditions, but it can creep into any situation because the light entering your eye is split between three focal zones. Most people in most situations would be fine with that. But after telling the doctor my concerns, she agreed that I'd be "safer" with the 2-Zone lens because the light is only split between two focal zones. This gives me the best compromise between not wanting to wear glasses and preserving the most contrast in my vision. Since these lenses are going inside your eye, it's not like I could replace the three-zone lenses easily or cheaply, so better safe than sorry.

Pacific Cataract and Laser prefers Alcon brand lenses, and their 2-Zone lens is called AcrySof IQ Vivity. I, of course, read reviews and experiences online from people who had this lens implanted, and no red flags were raised. Yes, there were a few people unhappy with them, but those were outlier opinions that didn't match what the vast majority of people were saying.

CHOICE #2: Which anesthesia is right for you? Which, to me, wasn't a choice at all, but I'm not everybody. I was given two options...

  1. Paralyzing Injection. Let's just cut to the chase... they stick a syringe full of paralyzing solution via a small needle under and behind your eyeball to paralyze the muscles which allow you to move your eye (which also removes your ability to blink). I heard this and was like "SIGN ME UP!" Because it seems as though NOT HAVING YOUR EYE MOVING AROUND WHILE SOMEBODY IS CUTTING INTO IT IS A NO-BRAINER. Spoiler Alert: You feel a small pinch. That's it. The paralysis wears off about 3-1/2 to 4 hours after surgery. The only residual pain is from your top eyelid being taped over your bottom eyelid so your eye doesn't dry out while you're unable to blink. I also felt where they poked me a little bit for a few hours after the paralysis wore off. No regrets. Highest possible recommendation. Safer for you. Easier for your surgeon. 17 out of 5 stars.
  2. Topical Anesthetizing. I asked the guy injecting the paralyzing solution into my eye muscles why in the heck anybody would choose to not have it. His answer? Fear of needles. For people with that fear, they offer a topical anesthesia which makes it so you can't feel any pain while they're operating on you, and no needles are involved. I cannot fathom going this route. They offer an oral anti-anxiety drug for people to not freak out during surgery, but they give it to you before your eye is either paralyzed or anesthetized, so that may help you with the whole needle thing. I've done all this before, so I didn't need the drugs... but you should ask the doctor about it if you think you might need them.

And thats the end of Part Two. Tomorrow we operate!

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