Multifocal lens replacement surgery

[utterflapdoodle]

I've posted about this recently in another thread and got the impression more people might want to know about my experience.

I had lens replacement surgery three weeks ago and would be happy to answer questions about it if anyone is interested in having the procedure themselves.

This was not for cataract but simply to improve my vision. I'm 54 and had the normal degree of presbyopia on top of astigmatism and deteriorating focus at all distances. I was using monofocal contact lenses and four different pairs of glasses.

I was thinking about it for years and eventually the annoyance and inconvenience of not being able to see well at any distance was greater than the fear of the surgery.

I'll caveat this by saying I don't live in the UK. I live in Germany and had the procedure done there.

I'd be interested in hearing more about your experience!

I'm in my mid-40s and have severe myopia (-10/11) and mild astigmatism, for which I wear single-vision glasses and contact lenses. No long sight yet at all! I'm not a candidate for laser surgery because my short sight is too severe, but the optician suggested I investigate lens replacement surgery instead, but also that I wait a few years until I have developed presbyopia (and it's settled down).

@mackerella Yes you'll probably have to wait a few years until the presbyopia kicks in properly. This started for me at about 45 and took a few years to fully develop. My vision at 54 was markedly worse than at 45.

If you can see an eye doctor rather than an optician they should be able to assess if you are suitable yet for the surgery. The clinic I went to did the assessment for free.

There was a young lady, in her 20s, in my group for the surgery and she was having additional lenses implanted in front of her natural lens. She was also too short sighted for laser treatment.

Is there anything in particular you want to know about the procedure or the result?

Hi - thank you for sharing your experience. Are there any risks specific to this surgery and is it 'permament'? I have considered lasering but am put off by the risks and by people saying the effect doesn't always last.

@Antarcticant I had laser surgery myself about seventeen years ago. I was happy with the result but eventually started to need glasses again when the presbyopia kicked in at about 45 which is normal and what you would expect to happen.

The laser surgery was to correct my distance vision and eventually, in the last couple of years, even that got worse so I suppose it was not permanent in my case. I'm glad I did it though as I got many years of near perfect vision out of it.

The result of the lens replacement should be permanent. My vision should stay stable now for the rest of my life assuming I don't develop any eye disease.

From everything I've read and been told by the doctors the risks of both laser surgery and lens replacement are very low. Especially if your general health is good.

Lens replacement is the same as cataract surgery which is done on millions of people round the world every year. There is very little the medics don't know about it.

Of course balancing the risk against the benefit is a decision you'll have to make yourself. Personally I decided the small risk was worth the big benefit.

Thanks, @utterflapdoodle! I suppose, it would be useful to know about the recovery time for the op - was there any "downtime" afterwards, and was your vision corrected straight away or was there a settling down period?

Also, were they able to correct your vision fully, or do you still need glasses?

@mackerella There are a few days after the operation where your vision is a bit weird and wobbly for want of better words to describe it. The brain has to get used to a new way of seeing.

I had my right eye done on a Tuesday and the left on the following day. I booked the rest of that week off work. In the event I did not need to take any more time off than that.

You wear a little patch over the eye until the next morning after the operation. As soon as the patch came off I could see pretty well. Well enough to work at the computer if I wanted.

I don't need glasses now for anything. I choose to wear them when I'm doing my manicure just to magnify and see really close up but that is a choice rather than a necessity.

The doctors tell you not to expect perfection as this operation can't give you absolutely perfect vision at every distance. For me reading small or low contrast print is still a bit difficult. I can read it but it is not completely sharp. That could still improve over the next few months.

One thing I did not expect was how much brighter colours look now. I did not have cataract but as you age your natural lenses become less clear. It was really obvious when only one eye was treated. It was like the untreated eye had a sepia tint!

Thanks @utterflapdoodle . I'm in my late 40s and while my myopia has settled down from its rapid deterioration in my 30s, I have a feeling my presbyopia has a way to go (only started with varifocals last year) so it might make sense for me to wait a few years, as you did.

@Antarcticant You're probably right. The lens replacement is normally recommended for older people who have fully developed presbyopia. Though a consultation with an ophthalmologist would answer that question for you.

One major advantage of having this operation now is that I will never get cataract. I'll have an extra twenty years or so of good vision rather than finally having the cataract operation because my vision has deteriorated so much that I absolutely have to.

I'll ask the optician how my presbyopia is progressing the next time I go - but just judging from my vision I think I may need a new reading prescription soon.

Just a thought that struck me - I don't suppose you happen to know if a family history of glaucoma is a contra-indication for this procedure? Unfortunately I have a history on both my mum and dad's side.

I have a replacement lens for another reason but just wanted to say that you do need to be aware that while you won't develop a cataract you do have a risk of developing posterior capsule opacification which is a film that develops on the back of a replacement lens.

It's a simple fix with a short laser surgery but the risk is there. I know 3 people who have had lens replacement for various reasons, myself being one of them and 2 of us developed POC about 2 years after the lens replacement and needed a YAG procedure to fix it.

@HalfShrunkMoreToGo Yes I am aware of the risk of posterior capsule opacification but as you pointed out the solution is a relatively quick and easy laser treatment. As risks go it's not too frightening.

I have a colleague who had lens replacement then suffered a retinal detachment one year later which is far more alarming and dangerous. The general medical consensus these days is that it is not actually connected to or caused by the lens replacement. I certainly hope so.

I’m 40 and had it done last year for a congenital cataract which had started getting worse. Not sure if mine is called a multi focal lens or a tri focal one? I know it’s got 3 concentric circles for near, mid and long distance and my brain adjusted quickly. It’s fab to have had the cataract surgery and not need glasses. The technology is fairly new here and I would not have got the special lens on the nhs. And I even had to ‘top up’ the private health insurance for it. But am glad I did.
It’s also my very dominant eye so was quite nerve wracking.
I’d had the other (non dominant) eye done about 20 yrs ago as the cataract on that side was much worse. But just had it replaced with a normal lens fixed at mid distance. But that was my lazy eye anyway (probably because of the worse cataract from birth I guess) and it never evened out.
overall I’m really happy with mine and would recommend my surgeon (South East)

@Antarcticant Honestly I have no idea about the glaucoma being a contra-indication or not. A quick internet search tells me it may depend how advanced the glaucoma is.

I have no medical qualification so best to ask an optician or ophthalmologist.

@utterflapdoodle Strangely I was the opposite of your friend, had a retina detachment first which needed a full Vitrectomy surgery so had a lens replacement as part of that then ended up with the POC.

I needed the laser thing about 6 months after and it was no issue. It was put to me as almost a certainty that I’d need it.

id had it after the first cataract removal 20 yrs ago too.

I had both mine done under general anaesthetic. I think but aren’t sure that maybe congenital cataracts can be a bit ‘deeper’ than ones that develop in old age? But also I’m beer squeamish about anyone touching my eyes

Will do - just asked on the off chance in case it had applied to you. This is a really interesting and useful thread.

I have always been Long sighted and has glasses from a very young age, although I could manage to see quite well without them until my late thirties. I'm now 48 and have to wear them all the time which I hate. Everything is blurry without them, can't recognise faces etc. I was considering laser eye surgery, but it's a bit more complicated for long sight so I'm now maybe thinking of going down the replacement lens route.
I assume you had it done privately ( my mum had it done on Nhs for cataract but they would not cover multfocal on nhs) where did you have it done please? Also, did or do you have dry eyes at all as I can be prone to this.
Thanks

Sorry, just seen you are in Germany, but please could you answer the dry eye question, thanks.

Reegee my DH recently had his done in the Uk at the private arm of Moorfields in London. Cost £9,400 for both eyes, tri focal lenses, previously +9 with an astigamatism if I remember correctly. Had them done two weeks apart, all has been fine.

Thanks, that's really helpful. I'll definitely investigate Moorfields. Glad to hear all went well for your DH.

@reegee I already had dry eyes before the lens replacement. I wore hard contact lenses for years which can cause dry eyes then had laser surgery which made the dryness worse.

I don’t notice the dryness during the day. I use moisturising eye gel before going to bed and if I wake up in the night. Otherwise it’s fine.

To answer your question there has been no change at all to the dryness after the lens replacement. The doctor told me the operation would not make the dryness worse and thankfully she was right.

I had the operation done privately at a clinic called EuroEyes. The cost here in Germany is 7000 euro (about 6000 pounds) but the health insurance provided by my employer covered it.

I’m told in the UK that only monofocal lenses are offered for the NHS cataract surgery. If you want multifocal lenses you have to go private.

Hi
just read this thread,very interesting.no mention of ghosting,halos,star bursts,problems with car headlights at night?
I have worn glasses since small,can’t see anything clear at any distance without glasses.iam 62,no cataract yet.
I have been to optical express and they recommend the Eyhancemono lens (£8000),which is less prone to the above issues.I would still need reading glasses of the shelf they say.
most of the reviews I have been reading about lens replacement have mentioned the above issues and basically put me off.

I had that in the beginning but my brain soon adjusted. Christmas fairy lights looked amazing with the halo 🤣
I don’t love driving at night in the winter but it’s so much better than it was and worth it for me not to have glasses at all.