Appointment before Cataract Surgery | Discussion about astigmatism, IOLs, Laser, Insurance, & more.

www.EyeOC.com
/ doctorkrad
In this video, join me and my patient during his pre-op appointment as we talk about his upcoming Cataract Surgery. We discuss Risks/Benefits of surgery, risks, lenses, astigmatism, insurance, advantages and disadvantages of IOL's such as the light adjustable lens (LAL), toric lens, multifocal, presbyopia reduction, and more.
Within a healthy eye is a clear lens. As we become older, that lens becomes cloudy. The cloudy lens is called a Cataract. In cataract surgery, the cloudy lens is removed and replaced with a clear artificial lens implant.
If you have any questions, feel free to leave them in the comment section below!

[@gail11117]

I went to two different Surgeons for an evaluation and neither one of them spent this time explaining all the options. I am going to a third and now I am more prepared!! Thank you so much!!

[@jonik.1931]

Boy, do I agree as well... To those considering the surgery educate yourselves and UT has such good info.

[@oldandstillhere]

I have been feeling guilty about a third surgery evaluation, so thank you for writing this!

[@judyledvina]

Wow! I wish you were my doctor! Did not get any explanation or education about what choices I had!! So helpful! Thank you

[@frankenfoamy]

Talked to 4 ophthalmologists in the last 2 months, All had mixed results with the light adjustable lens and would not suggest it, Perhap there are newer versions they were not aware. Appreciate this video

[@DoctorKrad]

It's not for everyone. And it's not perfect by any means. But my guess is that >95% of surgeons who would not suggest it don't own an LDD and therefore are unable to offer the LAL even if they wanted to. I have met some surgeons who despite owning the LDD get nervous implanting the LAL due to the way the lens shoots out of the injector. Understandably they're concerned about a surgical complication. Hopefully the next gen version improves on this. Also, the vast majority of Ophthalmology offices in the U.S. don't own an LDD and therefore don't have any personal experience offering the LAL. Would be great if the LDD cost was cheaper to lower the barrier to entry. The device costs about 150k, and that's a big financial risk for smaller offices. Best of luck to you!

[@taragibbons6616]

Good video! Very helpful to understand the exam and the results. Your patient is so sweet! What a nice patient. Personally, I hate the halos.

[@WanderNars]

Thank you so much for this video Doctor I learned a lot as a new scrub nurse in opthalmology , I know the reason what type of lenses the surgeon use

[@KMaddox]

If you are on Medicare, the removal of your cataracts is covered and the implantation of monofocal lenses is covered. All other lenses are considered "premium" and not covered by Medicare. The patient has to pay for the premium lenses.

[@Mark-rw3kw]

I believe that you also have to pay out of pocket for the use of a laser to do the implant, which is more likely to be needed for premium lenses (even when not talking about reshaping the eye with the laser).

[@KMaddox]

@@Mark-rw3kw I forgot about that, Mark. Yes, I believe that may be correct.

[@susan945]

Dr Krad, this video was so informative. I WISH my doctor had sat down with me & explained things with me, like you did with your patient in this video. It wouldn't even had to of been for the 30 minutes that you took with this gentleman, even just enough time to fully understand 1) the whole surgery procedure in full (before, during, after, what to expect fully) but, I think, more importantly 2) all my lens choices & exactly what they all did & were all about & made sure I understood fully my choices, like you did with this gentleman in this video, he's a lucky guy to have had that time with you & I'm sure whatever choice he made, you helped him to come to a confident & clear decision about it, just by your patience & willingness to make his options clear for him. My surgeon, she seems like a nice Doctor, I'm sure she's qualified to do the surgery fine, but, I'm still so scared about all the lens options. I feel that if she had just sat down with me & asked some of the key questions that you did, this choice, for me, would've been so much easier, now it's right around the corner for me & I'm terrified & not sure. But, I can't live with cataracts, so...I just want to say what a great Doc you seem to be & I feel your patients are very lucky to have you. I guess I'll figure it out.

[@DoctorKrad]

I’m so glad you liked the video! I appreciate your kind words ❤️ If you haven’t seen it yet, I also share this patient’s experience on surgery day! kzbin.info/www/bejne/jojRaZafoZqKqNksi=1DZ8_vj7P-LCUQpq

[@lamindarboe1713]

Doctor please where can I find you, which country are you. ​@DoctorKrad

[@lamindarboe1713]

Am still searching for a good doctor to help me out to cure my cataract please doctor anyway forward for my surgery please ​@@DoctorKrad

[@DoctorKrad]

@@lamindarboe1713 Orange County, California USA :)

[@lamindarboe1713]

@DoctorKrad am right in Italy and I really don't know how can I meet you sir.

[@kathyayun1473]

Thank you, doctor!

[@KMaddox]

Zenni Eyewear has lenses for nighttime driving. I believe they come in prescription and non-prescription.

[@kathyrobertson4493]

Amazing information. This has been the most informative video I have seen about the cataract surgery and the entire process. Thank you for sharing. On my way to clearer vision.😊

[@charlieb6514]

Superb video! Thank you!

[@mikeske9777]

I just went through having my cataracts in both eyes taken care of in March 2024 and since I wore heavy thick glasses for extreme far hyperpia with a +6.00 in the right eye and a +6.25 in the left eye and being 66 I also had bifocals with a +3.00 in both eyes. I also have a very slight astigmatism. I did not mind the idea of needing to wear glasses post operative the doctor stated that since I did not have mush of a issue with the astigmatism I would not be a good candidate for LAL lens and I do not really need the toric lens if I would continue to use glasses. The third thing is I still wanted and do drive at night I wanted to reduced glare from head lights that the cataract caused. I ended up with the basic lens and even these are so life changing and the primary reason is the hyperpia is almost completely taking care of with the IOL that was implanted. I now have had a good recovery and in fact remarkable recovery for me. No more heavy clunky glasses and the expense that entailed. I have awesome mid to distance vision with the corrections is none for the right eye and a +0.25 for the left and the bifocal corrective vision is at a +2.25. I can drive easily and one thing I noticed almost immediately after the surgery in driving is my depth perception is back as I had problems for years as the cataracts developed. This was a complete success and a great life changer for me. Kudos go to my doctor that explained the reasoning and logic for what was ultimately selected and not trying to upsell me to something that might or might not work. Since every patient is different and what they want is different but for me I am so happy with what was selected

[@agusticuria3331]

glad to know it worked well for you :-) Would you have it done before having cataracts after exepriencing the outcome?

[@mikeske9777]

@@agusticuria3331 That would be a yes

[@naturegirlfromny]

I was just diagnosed with cataracts and have had symptoms for a couple years. I am looking forward to seeing again!

[@Mark-rw3kw]

I currently wear progressive lenses with +5.00 and +2.50 add. I have found that with glasses, I need a lens with a high abbe value, such as Hoya 1.60 plastic with abbe value of 42. Polycarb (abbe value 30) and some 1.67 lenses (abbe value 36 or so) don't work for me with glasses, and cause noticeable color fringing in my reading area. I noticed that for IOL monofocal lenses and toric lenses (I do have some astigmatism) that different brands of IOL lenses have different abbe values, and was wondering if a high abbe value lens is likely to also be important for me if I have cataract surgery.

[@derekspeck8346]

Excellent explanation. I’m in process to get cateract surgery and this info is very helpful. Thank you!

[@Mark-rw3kw]

Does using a laser during cataract surgery (to install the lens, not to use the laser to reshape the eye) with a toric lens reduce the chance that the lens might need to be readjusted after surgery (due to inaccurate placement, or unwanted rotation afterwards, etc)?

[@gussoidarg3956]

Thank you for the information doctor, quick question, in one of your last videos you've mention an edov lal lense, I've noticed you haven't mentioned that to him, could that lense offer reading glasses too?

[@taragibbons6616]

I was waiting for that too. At around 10:30 on the video counter he goes into the light adjustable lens (LAL) lens. I am due to have surgery for my own LAL surgery next week (I hope this is a great lens for me, and for this patient).

[@AngelaNorvaisas]

I have cataract surgery on Monday I have a pre op on Friday I'm glad I research so I know I can ask questions if I need to

[@markmw123]

Great information, LAL for me but, would hope to still be able to read my phone without readers…..

[@jotocs3]

Thanks doc that was great info. I had a retinal detachment repaired and was told I would probably need a cataract surgery soon. My question is how do I know the 3d and depth perception problem I am experiencing is not due to retinal or a cataract impact on my vision?

[@Swenser]

Considering everything, im choosing basic lense with close up vision. I prefer to reduce risk of side affects as much as possible. I do t consider having to wear glasses a side affect. But odd vision and light affects would bother me more.

[@lucabrasi5070]

Excellent video. Very informative and clearly explained. Thanks

[@peterzing7483]

Absolutely 100% well done. thanks from Australia.👍🏼🙏🏻

[@bchollis1451]

How about the Vivety lens with Toric correction included? How would that rank?

[@spirit9877]

Hello Dr. Krad. I had RK surgery in the early 1980's for myopic astigmatism. I placed my hand over one eye to check my eyesight of the other eye. Right eye far vision is better than left eye. Right eye near vision is worse than left eye. Should Apthera IC8 lens be used for right eye since near vision is worse than left eye, and LAL for left eye since far vision is worse? Or, is LAL best for dominant right eye and Apthera IC8 lens for left eye? Please explain pros and cons. Thank you!

[@karbear910]

Very interested in this answer.

[@venuslatte1522]

What is your procedure for insulin dependent diabetics pre-surgery? I was told fasting AND no insulin for 8 hours prior.