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mitch96

(14,652 posts)
Tue Apr 23, 2019, 01:58 PM Apr 2019

Medicare and cataracts...

Sorry if this has been asked before..
I have a growing cataract in my right eye. Doc wants to operate and gave me a bunch of options. Medicare pays for single vision lens with minimal out of pocket. Then he says for extra money ($1000-$3000) he can implant these super whizz bang lenses that do more things and are better.
Has anybody tried these upgraded lenses? How did it work out for you? Worth the extra $$$
Just curious... Need a second opinion..
Tnx
m

27 replies = new reply since forum marked as read
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Medicare and cataracts... (Original Post) mitch96 Apr 2019 OP
When I had cataract surgery 3 years ago they offered me the same thing. redstatebluegirl Apr 2019 #1
No, I got the cheapo lenses and they work well, elleng Apr 2019 #2
"I can see clearly now!" mitch96 Apr 2019 #3
I had the super duper lenses last year snowybirdie Apr 2019 #4
"We both need artificial years regularly" mitch96 Apr 2019 #5
I've had both eyes done leftieNanner Apr 2019 #6
Subject: Girlfriend's cataract surgery keithbvadu2 Apr 2019 #7
Thanks for the detailed description! csziggy Apr 2019 #24
I had cataracts for quite a few years but they were no big deal. Then, within a six month period, keithbvadu2 Apr 2019 #25
I guess I will just keep talking to my optometrist csziggy Apr 2019 #26
Cataract surgery several years later. keithbvadu2 Apr 2019 #8
Why wouldn't the doctor explains the pros and cons? soryang Apr 2019 #9
"and the physician never spoke to me again. " mitch96 Apr 2019 #19
they're jerks soryang Apr 2019 #20
I opted for the upgrade zeusdogmom Apr 2019 #10
I'm not sure but I don't think anything corrects astigmatisms. LakeArenal Apr 2019 #11
Aren't floaters part of the cateract? 3Hotdogs Apr 2019 #12
No Kitchari Apr 2019 #13
Let me rephrase. Does cat. surgery eliminate floaters along with the cateract? 3Hotdogs Apr 2019 #15
No and for some people, floaters develop as a reaction to cataract surgery wishstar Apr 2019 #16
I had cataract surgery on both eyes in 2008. A year later, I had a sinkingfeeling Apr 2019 #21
Good luck mountain grammy Apr 2019 #14
I just got the standard lenses that insurance paid for most of cost and am very happy wishstar Apr 2019 #17
I wasn't a good candidate for the auto focus lens, and got the single lens vision ones. Tess49 Apr 2019 #18
I elected not to get upgraded or bifocal lenses. I read that many folks sinkingfeeling Apr 2019 #22
I went for the upgraded lenses and am extremely happy with the results. PoindexterOglethorpe Apr 2019 #23
wow what do they do? x ray vision? all i know is when i had one eye done..I could... samnsara Apr 2019 #27

redstatebluegirl

(12,477 posts)
1. When I had cataract surgery 3 years ago they offered me the same thing.
Tue Apr 23, 2019, 02:01 PM
Apr 2019

Big push by the doctor for those lenses. After doing some research I found out that they are not as "super whizz bang" as advertised. If they try to tell you that you will not need readers or glasses ever they are not telling the truth. In fact some people who get these don't have a much better outcome than with the regular lenses. I have had a great outcome, I need readers, but heck those of $12.00 each, a lot cheaper than 3000 out of pocket.

Just my take on this having had the surgery in both eyes with regular lenses.

mitch96

(14,652 posts)
3. "I can see clearly now!"
Tue Apr 23, 2019, 02:14 PM
Apr 2019

That's all I'm looking for. As of recent it's just transient out of focus problem in the right eye.
If I rub the eye sometimes I can clear it up. I guess the cataract is small at this point.
I will still need glasses as my left eye needs correction and I just want to see clear how ever I get it..
tnx
m

snowybirdie

(5,627 posts)
4. I had the super duper lenses last year
Tue Apr 23, 2019, 02:15 PM
Apr 2019

Hubby had the older kind right years ago. We both see fine but need reading glasses. None for driving however. I really don't see a difference. We both need artificial years regularly. Kinda wish I had saved that six grand!

mitch96

(14,652 posts)
5. "We both need artificial years regularly"
Tue Apr 23, 2019, 02:28 PM
Apr 2019

I had artificial years in my mid 60's. That was when I though I could do things but my body said NO!
Artificial Tears, right?
m

leftieNanner

(15,689 posts)
6. I've had both eyes done
Tue Apr 23, 2019, 02:34 PM
Apr 2019

Two years apart. Did not spring for the fancy schmancy lenses for either eye. I have worn glasses since I was two years old, so for the first time in my life, I don't need glasses! Except for reading, of course. And Costco sells readers - 3 pairs for $20.

The surgery itself is a snap. I can give you more details about what happens if you are curious.

keithbvadu2

(40,097 posts)
7. Subject: Girlfriend's cataract surgery
Tue Apr 23, 2019, 03:14 PM
Apr 2019

Subject: Girlfriend's cataract surgery


I watched Girlfriend's right eye cataract surgery on 17 Dec.
(I had both of mine done earlier this year.) They had a small viewing room slightly above the operating room and a window to look in. Couldn't see a thing; too many people around the table. Instead, they had it on a flat screen tv. A giant eyeball with some clamps holding the eyelids open. It had to be the same view the doctor was seeing.
They cut two tiny slits at the bottom and left side of the eye. The LPN said about point two millimeters (maybe it was two mm). Then they put a metal probe in there (sometimes two) with a rounded tip.
Then they smooshed around the organic lens and broke it up into pieces. It had covered the whole eye. They inserted a small (everything is small) hollow tip in there and vacuumed out the pieces of lens until the eye was clear of debris.
Then they inserted a flat, wide probe that had the new synthetic lens. It looked like a vacuum cleaner wand that's wide and thin.
The synthetic lens was folded over like a tortilla shell folded into the center from both left and right.
As soon as it was pushed out of the wand, it started to unfold into a circle.
The doctor used the rounded tip probe to guide it into place and help it unfold.
It does not cover the entire eye like like the organic lens did.
He said the pressure of the eye holds it in place.
When I had mine done, the doctor said he put one in that had a focal point of about an arm's reach.
It doesn't take long at all. Some say eight to fifteen minutes.
My first one didn't take long but the second one seemed to drag and I was impatient/anxious for it to be over with. Don't know what made me feel that way.
They numb your eye with some drops and liquids.
One of them burns. You're not too keen on that one.
My anesthesiologist said that they gave me about two beers worth of anesthetic but I couldn't even notice it.
The patient cannot see diddly.
You cannot feel what they are doing and all you see are some bright lights looking down at you.
The place Girlfriend went to did about 33 or 35 cataract surgeries that day. Big bucks for the partners that day.
Plus she had a laser procedure to help fix/lessen astigmatism. That did not take very long either.
She said it gave a little burn feeling in the eye.
It also gave a $1,400 burn feeling in the wallet.
The 'even better' laser procedure would have cost $3,900.
The laser was optional so Medicare does not cover it, of course.
She can tell that her vision is better and the astigmatism is better for the right eye.
Might or might not have the left eye done in six months or so.
.
We get touchy and protective about someone fiddling with our eyes.
.
Just plain FANTASTIC, AWESOME, INCREDIBLE that they can do such things and it's now routine.

===========================================
===========================================
===========================================

Girlfriend's second cataract surgery

done on thursday may 08.

came out fine, maybe even better than the first.

she noticed a tremendous improvement the next day.

i watched this one also.
the doctor had to work a little harder on this one.
the cataract was a bit more developed and tougher to break up than the first.

i learned a new tidbit of knowledge about the operation.
the doctor is barefoot.
he sits on a special stool which does not look so special,,, after all, a stool is just something to sit on, right?

the stool has foot pedals. At least two pedals for water and suction and probably a third pedal to push the new, synthetic lens out of the wand into the eye.

he has to use his hands/fingers to control/position the various probes into and around the eye under the outer layer.
if he had to use his thumb or other fingers to control water and suction, the action of the finger movement would also cause the probe to wander.
NOT a place you want a lot of uncontrolled movement!

she says it still came out great and is now only wearing glasses for up-close reading.
she was seeing 20/20 out of the left eye the day after surgery.

this time, she did not have the laser surgery for the astigmatism.
that would have been out of pocket, just like last time.

when she declined the extra laser surgery, the heavy guns sales pressure kicked in.
not quite called foolish but leaning towards it and 'you really should have it done'.

will get an eye exam in about a month for a real prescription but doesn't look like it will be very strong.

coming out great so far!
.
(added later) ---- it seems that the second eye was a little bit tougher because she did not
have the laser treatment done.

csziggy

(34,189 posts)
24. Thanks for the detailed description!
Wed Apr 24, 2019, 07:47 PM
Apr 2019

How bad was your girlfriend's astigmatism? Mine is very bad in my right eye - so bad glasses really do not correct it effectively. I tried contacts weighted for astigmatism years ago and they were better than glasses, but with my seasonal allergies I couldn't wear them consistently.

While I only have the very beginnings of cataracts I'm thinking about exploring getting surgery in a few years to improve the vision in that eye. I checked into LASIX surgery about twenty years ago and at the time was told they could not fix the vision in my right eye. They recommended that I wait until my cataracts get bad enough and have the lens replaced then.

My Dad didn't have cataract surgery until he was 86. Mom never had it before she died at 97. I'd really like to have better vision in that eye sooner than those ages!

keithbvadu2

(40,097 posts)
25. I had cataracts for quite a few years but they were no big deal. Then, within a six month period,
Wed Apr 24, 2019, 08:11 PM
Apr 2019

I had cataracts for quite a few years but they were no big deal.

Then, within a six month period, they became a big deal.

I don't think her astigmatism was very bad.

csziggy

(34,189 posts)
26. I guess I will just keep talking to my optometrist
Wed Apr 24, 2019, 08:16 PM
Apr 2019

Every year when I get checked.

The problem is that I was always far sighted and as I age I get more far sighted. But I do fine needlework and need more and more magnification to see the work.

Last year's checkup was the first time any sign of cataracts was mentioned - I had just turned 66.

Frankly I would be happy to pay to improve the vision in my right eye. Even if I still have to wear glasses for reading and needlework, it would be a wonderful improvement since now I really do not have binocular vision - that is how bad the right eye is.

keithbvadu2

(40,097 posts)
8. Cataract surgery several years later.
Tue Apr 23, 2019, 03:16 PM
Apr 2019

Cataract surgery several years later.

Sometimes the artificial lens will develop a haze over it after several years.
It does not happen to everyone.
You can see but not focus.
My right eye had that happen about 5 years afterwards.
The left eye seemed fine. Key word; seemed.
The optometrist could see the haze and after a while it got bad enough that she recommended laser treatment.
The laser treatment is done by a doctor specially trained in the laser.
They dilate your eyes and really, really examine them.
They put a lens about ¾ of an inch deep on your eyeball with some sticky goop.
They hold your head very still and you look into the laser machine.
You see four quadrants of red.
Then she zaps your eye a multitude of times and she keeps zapping until she feels it is done.
She is looking at your eyeball all the while.
Sometimes you feel the zap and sometimes not.
It feels a little bit like a static electric shock when you grab the doorknob.
Not painful but noticeable.
My right eye took 39 zaps. I did not feel any of them. 14 March '19
The left eye took 50 zaps and I felt most of them. 26 March '19
Driving home each time, the eyesight was worthless in that eye.
You might see some floaters for a while.

The left eye seemed fine. Or so I thought.
The optometrist and the laser doctor both were amazed that I was claiming how well the left eye worked. It was not fine. It was just much less bad. It focused fair but was deteriorating at a slower rate.
It took about 8 to 10 hours for the right eye to work ok and I could easily tell the improvement.
The right eye was so much better that I could then tell that the left was not up to snuff.

Two weeks later, she did the left eye.
There is no set number of zaps.
It is her judgement call as she is doing it.
They thought the left eye would take less hits because it was not as bad as the right.
Actually it took more hits than the right and it did not take as long afterwards to clear up the vision. Two days later – left eye good but not as good as the right yet.

Girlfriend’s first eye hazed over in fewer years than mine. It took 55 hits with the laser.
Her other eye is not as bad so it might be six months or more before they do laser on it.

Supposedly it does not happen again.

It is so gradual that it gets pretty bad before you really notice it.













soryang

(3,306 posts)
9. Why wouldn't the doctor explains the pros and cons?
Tue Apr 23, 2019, 03:26 PM
Apr 2019

I found out after the fact that I would have probably had a better outcome with better lenses. The best surprise is no surprise. Ask a specialist.

After the surgery when I told the surgeon I wasn't having a good outcome, he told me it was my imagination. Then I pulled out an article from the journal of opthamology with a 73 page article written by a board certified doctor with a phd in physics as well, which described exactly what was wrong with the eyes of certain patients post surgically in cases like mine and the physician never spoke to me again.

So the moral of the story is that the risks and benefits of alternative options need to be discussed with the professional provider beforehand.

mitch96

(14,652 posts)
19. "and the physician never spoke to me again. "
Tue Apr 23, 2019, 08:03 PM
Apr 2019

Had that situation many moons ago..
I had Radial Keratotomy surg on both eyes about 35 years ago. RK was the precursor of Laser corrective surg and uses a scalpel blade. Long story short was a nurse dropped a stainless tray on a tile floor in the O.R. and the doctor jumped on the last cut. He ripped the nurse a new one. After the local anesthesia wore off my eye hurt like hell.. Fast forward two weeks. I go in for the post op check and I'm sitting in the exam room with my chart. Being a nosy medical type I take a look see. I'm reading his post op notes and the SOB said I moved on the last cut!! When the MD who did the surgery came in with all his residents I called him on the notes and his "jumping" on the last cut. His eyes got as big as saucers, he spun around and left never to be seen again. About 10 min later the head of the Ophthalmology department came in and apologized profusly. I got no charge treatment for that eye if there was any problems. There were none.
MD stands for M assive D enial.
m

zeusdogmom

(1,047 posts)
10. I opted for the upgrade
Tue Apr 23, 2019, 03:37 PM
Apr 2019

Full disclosure : I am naturally near sighted in my right eye, far sighted in my left eye. Astigmatism in both eyes. Upgraded lenses took care of the astigmatism. And since my eyes were already set up to handle near and far naturally, I don't need glasses of any kind. For the first time since I was 5 years old, no glasses hanging on my face. It is wonderful!!!!!!!

The only kicker is near distance which was set up for reading. It didn't dawn on me to check the music stand distance which is a little too far for the near vision eye and a little too close for the far vision eye to see the music notes clearly. I have adjusted - sit forward on the chair a little and bring the stand a bit closer when I play clarinet in band. For handbells, I whined and complained enough to get my own stand which I can position any way I want. 😆

LakeArenal

(29,797 posts)
11. I'm not sure but I don't think anything corrects astigmatisms.
Tue Apr 23, 2019, 04:12 PM
Apr 2019

Or floaters. So I might ask about that.

wishstar

(5,486 posts)
16. No and for some people, floaters develop as a reaction to cataract surgery
Tue Apr 23, 2019, 06:29 PM
Apr 2019

I had several large floaters suddenly appear about 2 months after my cataract surgery. Even after 9 years later, I still have the same large floaters but my doctor was correct in predicting that the appearance of the floaters was probably just a one-time side effect and i would get used to them. My doc says nothing can be done for my floaters. I only had some tiny ones pre-surgery.

sinkingfeeling

(52,989 posts)
21. I had cataract surgery on both eyes in 2008. A year later, I had a
Tue Apr 23, 2019, 11:35 PM
Apr 2019

laser procedure that removed the floaters I had as a result of the surgery. Been great ever since.

wishstar

(5,486 posts)
17. I just got the standard lenses that insurance paid for most of cost and am very happy
Tue Apr 23, 2019, 06:35 PM
Apr 2019

You have a choice of getting standard lenses that will give you clearer near vision, or standard lenses that will give you clearer distance vision. I was extremely nearsighted all my life and decided on getting lenses to give me clearer distance where I could do everything except read small print without glasses. So I am now nearly 20-20 for distance, can drive, watch TV and read everything on TV and get around fine for most activities without glasses and only need reading glasses for close-up work, reading and computer.

Two of my friends opted for the near-vision standard lenses because they wanted to see clearer for close-up, but I prefer never having to wear glasses except for detail close activities. One friend got the expensive deluxe lenses but she is not happy, says she still needs glasses and has a lot of glare and problems with her night vision.

Tess49

(1,598 posts)
18. I wasn't a good candidate for the auto focus lens, and got the single lens vision ones.
Tue Apr 23, 2019, 06:56 PM
Apr 2019

I went from wearing coke-bottle glasses to 20/20 vision in one eye, and about 20/40 in the other. It took me a long time to not reach for my glasses the second I woke up in the morning. I can read the fine print of boxes, etc. without readers. I do wear a cheap pair of readers if I'm reading a lot. Keeps my eyes from getting tired. Both eyes together cost about $800. Most of that cost was for the eye drops you have to use after the surgery.

sinkingfeeling

(52,989 posts)
22. I elected not to get upgraded or bifocal lenses. I read that many folks
Tue Apr 23, 2019, 11:38 PM
Apr 2019

could not adjust to them and were disappointed in the cataract surgery. So, I buy reading glasses for $1.50 at the grocery store. I have a pair in every room and in my purse.

PoindexterOglethorpe

(26,727 posts)
23. I went for the upgraded lenses and am extremely happy with the results.
Wed Apr 24, 2019, 03:47 PM
Apr 2019

I have been nearsighted my entire life. I recall not being able to see the blackboard in first grade. I wore glasses until age 16 when I got hard contacts, eventually got soft ones some years later. In my early 40s, as is common, I started needing reading glasses with the contacts, and my regular glasses became bifocals.

However, the last pair of glasses I got, sometime in the late '90s, were unusable because the eye doctor forgot to specify a "slab off" for the left lens, needed because of the extreme difference between the magnification for distance viewing, and the reading part. I paid $400 which was ludicrous. I should have tried to get the eye doctor to pay for the replacement, but I didn't. I just lived without regular glasses.

I started growing cataracts at a relatively early age, but they barely progressed for a couple of decades. Then suddenly there were noticeable changes in my vision and my current eye doctor said it was time for the surgery. I had some choices about lenses, one of which would have been what's called monovision, meaning one eye corrected for distance, the other corrected for reading. I'd tried that once with contact lenses and simply couldn't adjust. But a lot of lens wearers like that kind of correction. Perhaps for me part of the problem was that one eye was essentially twice as bad as the other, which probably made the monovision thing trickier.

So now, some seven years after the cataract surgery, while I still need reading glasses for reading or other close work, my distance vision is phenomenal. I feel as if I can read small signs on distant mountains. Apparently I had even better results than many people.

You might want to discuss with your doctor specifically what benefit you'd get from paying the more money. You have certainly heard both opinions here, but rather than go with whichever of the different stories seems more plausible, try to get exactly what your eye situation is and what would be improved for the more money.

Keep in mind that this is pretty much a one shot deal. There's really not an option to go back and replace lenses that aren't quite what you'd hoped.

I often say that cataracts were the very best thing that ever happened to my eyes. Just being able to open my eyes in the morning and see is astonishing and wonderful.

samnsara

(18,282 posts)
27. wow what do they do? x ray vision? all i know is when i had one eye done..I could...
Wed Apr 24, 2019, 08:39 PM
Apr 2019

..see WHITE! and the other eye was still seeing cream. So I had the other done asap. Not sure what more they could have done short of giving me 20/20 vision.

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