Anyone facing cataract surgery read this first ...

[LoneRanger]

Don't get one of the IOL's (Intra-Ocular Lens implant) that filters certain wavelength of blue light. They have a yellow tint to them set-in at the molecular level. There are two schools of thought about them in Ophthamology.

One side says they are good and should be used because the spectrum of blue light they filter may, over time, be harmful to the retina.

(Think of the retina as a radar dish at the end of the optic nerve but sitting inside the eye attached to the interior surface the back of your eyeball. The image coming through your pupil is projected onto the retina and sent to the brain by the optic nerve.)

The other side says they are unnecessary and the protective claim is not solidly proven and so they're unnecessary and in fact can cause a loss of contrast in low light conditions and also color perception may be reduced in some patients as well in the eye with the yellow tinted IOL.

I had cataract surgery in August and they put in the yellow tinted blue light filtering type. The only thing explained to me during consult was option for either a monovision lens for clear distance vision or a multi-focal "premium" lens that works like a tri-focal for closer in vision to be sharp too. They recommended the monovision type and since that is all my insurance would cover (premium lens a substantial increase in out of pocket cost to me...) I opted for that. But I was never told about whether it would be a clear one (referred to as UV filtering in the med pubs) or the tinted type that filter that certain wavelength range of blue light.

Now, my "review" of this yellow tinted lens (Alcon AcrySof IQ) is I guess pre-mature since I am looking through a fill of silicone oil in that eye because of a recent surgery for detached retina (vitrectomy-- they suck out all the natural gel and put in silicone oil). But I am noticing the exact things that the med journals have cited about some patients being able to detect a subtle reduction in low light contrast and ever so slight change to color perception vs the other eye's sight. I am not mad at my cataract surgeon, I like him. Just would have appreciated knowing about the yellow tinted type vs clear beforehand.

It's not like looking through yellow shooting glasses, not at all. It is very very subtle but I can tell. I think it's because of being a BITOG'er. Only a BITOG'er would probably notice. Perfectionists us . . .

Some references on the controversy:

https://www.aao.org/eyenet/article/back-forth-controversy-on-blue-filtering-iols

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843900/

https://www.ncbi.nlm.nih.gov/pubmed/26742866

https://www.ncbi.nlm.nih.gov/pubmed/22412976

 

[Warstud]

My Mom had the surgery and complains of Glare. Have you experienced Glare after the surgery?

 

[2cool]

Thanks for the heads-up! I hope your therapy is successful.

 

[CT8]

Could the detached Retina be the cause of the low light loss?

 

[CT8]

Originally Posted By: Warstud
My Mom had the surgery and complains of Glare. Have you experienced Glare after the surgery?
Could the glare be because there is more light entering the back of the eye?

 

[Cujet]

http://www.komar.org/faq/colorado-cataract-surgery-crystalens/ultra-violet-color-glow/

Many of us would assume the additional UV transmissivity would be damaging. To me, that would also require the assumption that we were properly "made" in the first place. Something that cannot be true as the cornea has already failed!

I'd choose the additional UV transmissivity, and mitigate any risk by wearing sunglasses.

FYI, I am one of those people who can naturally see a bit more into the UV than average. I wear water-clear contacts and they absolutely reduce the brilliance of certain things that have UV light.

 

[Donald]

Find an opthalmologist you like and trust and listen to what he/she says.

 

[TomYoung]

Originally Posted By: Donald
Find an opthalmologist you like and trust and listen to what he/she says.


Really!!! could there be a worse place to read/post medical informaton and advice?

 

[LoneRanger]

Just sharing a story, not trying to reach the world here.

 

[Cujet]

Originally Posted By: TomYoung
Originally Posted By: Donald
Find an opthalmologist you like and trust and listen to what he/she says.


Really!!! could there be a worse place to read/post medical information and advice?


Incorrect, and short sighted. Information is power, finding it here might just be what someone needs. Many people facing medical decisions might not realize they have a choice, often a wide range of choices. Intelligent people can often make better choices for themselves than their doctor.

Would I let my surgeon choose a common knee replacement (probably made in China, for more profit) ? Or, as an avid bicyclist, might I be better served with a replacement knee designed and proven for sports activities, specifically long distance cycling? As a pilot, I'd never, ever let the doc install certain IOL's.

Knowledge matters.

Does the car dealership choose the best oil for your uses? Or simply use what they have on hand, ordered by the supply lady in office 309?

 

[LoneRanger]

Here's my eye saga just for background. Glasses by 4th grade, nearsighted (myopia). Due to the lens power required my glasses were fairly thick at the edges by college, maybe just shy of 1/4". Started wearing contact lens then, soft, and toric for the left. After about 20 yrs of wearing contacts and glasses, finally welcomed LASIK in 2003. What a feeling. It got me to 20/20 each eye and you want to talk about being thrilled. At that time, age 40 the LASIK ophthalmologist told me after the pre-LASIK screening exam that I had the "seeds" of cataracts on each eye, but nothing developed enough yet to mar vision or preclude going forward with the LASIK, but I could expect to need cataract removal earlier in life than others. By about 2011 the 20/20 had faded slightly enough that I got a weak pair of glasses to sharpen up night vision for driving. Nothing major, about like the difference between television in 480p vs 1080. However left eye was getting a shadow image effect similar to back in the day when you'd try to tune an old school tv to a UHF channel and there would be that slightly ghosted or shadowed image. The "seed" had blossomed into a cataract, and ophthalmologist advised glasses or contacts can't solve the imaging issue when a cataract is causing it. Hence the surgery in August and the IOL.

Long story short, myopia (and I had a lot of it) means elongated eyeballs and a higher risk for retinal detachment. Cataract surgery and IOL implantation is another risk factor because the IOL'stake up less space in the front (anterior) chamber of the eye than the natural crystalline lens that they remove (they use ultrasound to break it up), so it may give an already liquifying (naturally due to aging process) vitreous humor more room to move around and this can cause the vitreous humor to detach off the backside of the eye i.e. the retina. If the vitreous comes off clean then you're fine but if it has areas it sticks to the retina it will tug on it and the retina can tear. Fluid can then get behind the retina and cause it to detach. So the vitreous being the culprit they in some cases go in and remove it altogether (vitrectomy) and laser-repair the tears, aspirate any sub retinal fluid, and then put in either a special gas or silicone oil as a tamponade to help hold the retina in place while the laser treatment scars up (turns into a "weld") and the retina neurosensory [outer] layer otherwise heals back on to vascular layer of the back of the eye (reunites with it's blood supply). I got the silicone oil by choice over the gas ball because the gas ball requires 7-10 days of specific no-cheat head positioning, face down for 50 minutes out of every waking hour and sleep 100% face down the entire time in bed. I knew I could not abide that as a fit and active 53 yr old with a relatively impatient nature who likes to stay busy.

The silicone oil is just as transparent and clear/colorless as water so visual clarity/transparency is on par with natural vision, but acuity is skewed to about 20/50 in that eye because silicone oil refracts light differently than the natural vitreous did. Thus the left eye needing a +3 diopter lens after the surgery.

A 2nd operation hopefully next month goes in and removes the oil and puts in a fluid equivalent to the aqueous fluid that resides in the front chamber of the eye, which they say works just fine. Right now i see to drive and to work just fine with a +3 lens in the left side of glasses and the -1.25 lens from 2011 in the right side. But the disparity in diopters plus vs. minus still causes a bit of a headache by mid day some days.