JimH123 Loc: Morgan Hill, CA

There is a 2nd type of multifocal lens called Vivity. This type does not have the circles and does not generate halos. It is also a toric lens and can correct astigmatism. I had these lenses inserted this past March and April.

Prior to the cataract surgery, I was very near sighted with a diopter of about -6 and it was getting worse each time I went in for an eye exam. Plus the cataracts were getting bad enough that driving at night was horrible the way lights looked like big blobs of light. And in fact I had stopped driving at night.

In actuality, the common multifocal lenses with the circles do give a wider range of correction than do the Vivity. But the cost is the halos that I did not want to have. And this has been the case. I have no halos whatsoever now that surgery is over.

The option I chose was this. For Vivigy lenses, think of dividing your vision into 4 regions -- distance, not as far distance, reasonably close and up close. When specifying what you want for each eye, you get 3 of the 4 regions. You can make both eyes the same, or offset on one eye, and this is what I did. My dominant eye is my left eye, so I went for distance, not as far distance, and reasonably close. And for the right eye, I chose not as far distance, reasonably close and up close.

What I find is that I do have presbyopia. We all encounter this problem as we age. Even though my right eye is supposed to allow me to see up close, it is a weak up close. Sitting at my computer, my right eye can read my two screens without a problem while the left eye is not as clear. But when I go outside, my eyes stop down and I can't tell any difference in the two eyes. Everything is clear. And I no longer need corrective lenses for driving. And driving at night is easy. Headlights and taillights are not blobs any longer and there are NO halos.

I did buy a new pair of glasses and I can see far and near with them. For far, they clean up a small amount of residual astigmatism. And for closeup, I can easily read my cell phone. But some things need extra help and I keep the drugstore cheepies around with 3.5x just in case I need to see something really small.

Additionally, I went to COSTCO with my prescription and had them provide me a pair that is for arm's length and up close, and these I really like using while at the computer. In fact, they are perfectly clear to about 5 or 6 feet, and for reading, the whole page is clear without tilting my head up or down for best focus as I do with the full range glasses.

When my first eye was done, I found my distance vision was not as sharp as it should be, and the surgeon did some calculations that determined that the lens needed to be turned a degree or two. This was done while the 2nd eye was operated on. He told me for rotation, he only needed to make a very tiny hole and to insert a tool to reach in and nudge the rotation the needed amount. The result was incredible. Close to 20:15 in that eye. Just a touch of astigmatism remaining, but not so much that it impacts the vision very much. The 2nd eye did not need that extra rotation.

My insurance + medicare covered the cost of a standard cataract surgery and I was resposible for the cost of the upgrade.

Very, very pleased with my vision now. I started wearing glasses at age 13 and now, 60 years later, I can enjoy life without glasses when I want to. And no problem using the camera without glasses. Everything is clear. Could have never done this before the surgery.

lnl Loc: SWFL

My ophthalmologist said I was not a good candidate for multi-focal lenses so I got the ones that focus on distance. It was quite a change, after being near-sighted for about 60 years or more. However, I am very happy with my choice. I get readers at Dollar Tree in the 2.0 to 2.5 range and leave them all around the house—kitchen, living room, bedroom, computer, my purse. I have fairly good up close vision with these lens implants which also corrected for extreme astigmatism. I can easily see the bedroom clock. If I have trouble seeing the back screen on my camera, I look through the viewfinder and can see all my settings there easily. It’s like looking at them in the distance where I have 20/20 vision. I am thrilled not to have to wear glasses any more. No more rain, no steam from cooking, no spots on glasses. I feel it’s a small price to pay to wear readers when I am reading.

Bill_de Loc: US

The first time I went for an eye exam the doctor said that for my age I'm doing OK. In 2005 I retired and started using the VA. My doctor said it won't be long before I will need the surgery. I was told that twice a year until ...!

Whenever I see a new doctor they ask to see my glasses. When I tell them I had gotten a mild pair around 2010 and used them for a couple of years. I keep them in a kitchen drawer because because once in a while the print on some labels are just too small.

My last visit after the exam, the doctor said all was good, and I would pass the exam when I go to DMV for license renewal. I laughed, and she laughed, when I told her I renew my license on line. The were suppose to use something to age the look every so often. The license picture in my wallet now looks just like the one from six or seven years ago. I do use regular and some kind of prescription eye drops every day.
I will continue to watch this thread to hear of anything coming around the bend.

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At 73 I know my time is coming, but for now I feel very lucky!

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jpgto Loc: North East Tennessee

I had my left eye done 2 weeks ago so I am still in the process of healing. My doctor, after numerous tests felt a clear lenses would be best with no corrections. However I do wear progressive lense glasses which now seem to be blurry in that left eye. To complicate the situation I had a vitrectomy to the same eye making the healing process a bit more complicated. Personal suggestion follow what your doctor tells you! "All the best with your operation. I couldn't believe how simple it was. Absolutely no pain, I couldn't even feel what he was doing. He warned me I would hear a little vacuum sucking out the old lens and I heard him asking a nurse to hand him the new lens. That was it."
Good luck
PS no surgery for the right eye any time in the near future!!!

jimkolt Loc: Sun City, AZ

I was nearsighted. Had cataract surgery a year ago. I play the organ and opted for lenses that would provide clear vision at about arm's length. Have single vision glasses I use for driving and golf. To my surprise vision is about 20/30 and I spend a lot of time without glasses.

lmTrying Loc: WV Northern Panhandle

My other hobby is building plastic models.When I lost focus in the left eye, I found it difficult to place small parts and mark small measurements using only one eye. I need both eyes for the depth perception to focus together near and far. So I got both lenses to focus at a far distance. Having wore glasses for 50 years, continuing would be no problem. After surgery I got examined for tri-focals as before. I don't have the 20/20 vision with glasses as I did 5 years ago, but I'm getting used to it.

jjanovy Loc: Lincoln, Nebraska

I opted for the distance only lenses, mainly because I’ve worn glasses for 80 years and just don’t feel right without them. I also have trifocals, and have had for many years. I’m very happy with the cataract surgery; clearly the correct thing to do. I also use several cameras, including Nikon Z7-2 and D850, and adjusting the viewfinder focus helps. But I’m also a very patient person (inherited from my father?), with a variety of photographic subjects, but mainly landscapes, local birds, and macro. The cataract lenses are a very minor problem compared to the uncooperativeness of some of my photographic subjects!

bobmcculloch Loc: NYC, NY

My wife just had her eyes done, multi focal were available but NOT recommended by the surgeon, BTW Top guy in the area, she got the 2' to infinity choice, no problems , loves them on the last day for the drops today, another BTW see if the 1 drop option is available, we had the choice of 3 drop routine or a 1 drop routine. Start out drops 4 times a day , either 3 drops spaced 5 min apart or 1 drop for each session, Bob.

MadMikeOne Loc: So. NJ Shore - a bit west of Atlantic City

Below is the link to the topic I started when I asked for experiences from our members prior to my own cataract surgery in October of 2020. Lots of great info that helped me make the right decision for myself.

https://www.uglyhedgehog.com/t-663648-1.html

starlifter Loc: Towson, MD

I've had both eyes done several years apart with single vision lens's. I can read 99 perccent of the time and distance and photogaphy are no problem

Celtis87

Had the surgery five years ago. Got the multifocal lenses. Best decision ever. Used to be tethered to my reading glasses. No more. Downside? Need strong light for reading. Dim light won’t work well. I’ve seen no impact on my photography efforts, other than losing the need for glasses to read the screen and no longer needing diopter correction on the viewfinder. And I’ve been told the technology has improved over the five year period, so today’s lenses would be even better. Hope that helps.

sodapop Loc: Bel Air, MD

That is very true. Medicare paid for the lower-priced one but nothing for the multi-focus. I got the lower one and now need glasses to see up close which I did not have to before. Reading glasses are a pain

johonew

I had both eyes done during Covid lockdown in 2020, and have had the same experience...multifocal, and they work great for me. And as above, decent lighting is a must to read, but is rarely an issue and I have multiple pairs of cheap reading glasses around the house if and when I need them. The halo effect was a little bothersome at first, but now I rarely even notice it. The multifocal lenses have enhanced my ability to enjoy photography and stamp collecting and made my quality of life much, much better. I also had to have vitrectomies in both eyes due to floaters, and with both surgeries, I am a very happy camper!

Retina Loc: Near Charleston,SC

I am looking into this as well. The single focus lenses and procedures are completely covered by Medicare (for us older folks) and by a supplemental carrier. With any of the multi-focal lenses, they don't pay a dime even though the bulk of the cost is not due to the lens itself. Partly this is because many surgeons prefer using a more expensive (and non-covered) laser technique when installing multi-focal lenses.

My impression is that Medicare is doing some back door means-testing. "If you can afford to upgrade the lens component, then you have the money for all of it." I asked my surgeon about this yesterday. He says simply that there are a lot of things in the world that aren't right. Not much help but true. So I rationalize the extra cost because my eyes are worth the price of decent cameras and lenses.

On the question of lens choice, single focus lenses, covered by most insurance, give the clearest optical results but with a greater need for corrective glasses depending on the situation. Traditional multi-focal lenses offer decent vision with less need for glasses except for close work. But as already mentioned, they do produce halos and glare with bright lights with a dark background. Oncoming headlights is the classic example. Night sky viewing will likely never be the same. There is also less contrast in dark scenes. The new non-refractive multi-focal lenses, e.g. Vivity, are nearly, but not completely free of artifacts. I am very torn about the choice between the clear mono-focal lens and the expensive Vivity option for the convenience of needing glasses less often for reading at a moderate distance. No way would I select the traditional multi-focal refractive lens because of night driving, photography, and whatever little astronomy I enjoy. Even the low artifact Vivity might leave me wishing I saved $6-7K and got the clear, mono-focal lenses, but I am going to take that chance and spend the bucks for the Vivity lens. The Z9 will have to wait. I say Vivity, but there may be other brand names for the same technology, so I am not necessarily tied to one. it's just what my surgeon uses. The biggest problem so far has been getting time with the ophthalmologist about lens choices. They should provide references to unbiased articles early in the process. Too often they will give you 10 minutes about what can be an expensive and impactful decision when you start out knowing nothing. Patients who have options should read up before getting those expensive 10 minutes and at least have more informed questions.

This is just me, but if my only hobbies were photography and astronomy, I would definitely go with mono-focal lenses. As a musician who needs to see small print music and occasionally glance at the conductor, I am going with the lower artifact multi-focal lenses.

Most of the links reviewing the lenses are published by manufacturers. Here are a couple examples of less biased articles with the first I thought was the most informative:

https://www.reviewofophthalmology.com/article/which-lens-for-which-patient
https://www.reviewofophthalmology.com/article/iol-review-2021-newcomers
https://www.reviewofoptometry.com/article/realworld-performance-of-newer-intraocular-lenses

My surgery is two seeks away so I welcome any comments about what I have found so far.

Bultaco Loc: Aiken, SC

My wife and I choose to correct for distance, we both have glasses to read. It's been over 20 years with no regreats.