Cataract Q&A | Clear Vs Yellow-Tinted Lenses, Eye Drops As Treatment, Flomax And Eye Surgery???

[@MicheleLeeMD]

Thank you to everyone who submitted thoughtful and interesting questions for this Q&A! If you have any additional questions or if I did not get to your question, leave them in the comments down below. If there is enough interest, I'll make a part 2 with your questions ✌

[@saltwalk]

I am positively grateful that you would take the time to compile and respond to such an interesting mix of questions. I wish I didn't live on the opposite side of the world from you, otherwise I'd love to be your patient!

[@MicheleLeeMD]

I really appreciate your kind words ❤

[@harveyh3696]

Aloha from Hawaii. Ditto!

[@MicheleLeeMD]

@@harveyh3696 Thank you for your support :)

[@Keith492]

Thanks for the video.

[@dathyr1]

Thank you for all your information. Why would someone want to have yellow tinted lenses in their eyes? I could probably see the reasons why, but for me, I would just throw on yellow shaded glasses for certain viewing situations and keep the Cataract lenses Clear. I wear yellow tinted glasses (which I do not mind) right now to filter out UV or Blue light on computer screens. I am 75 years old and in the process to get both eyes fixed with new Cataract lenses - steering more for the Mono Focal lenses based on cost issues. Going through many You Tube videos so I can ask the right questions to the Doctor. Seems like every video I watch brings up newer information. Thanks and take care.

[@jayc3110]

Thank you for this wonderful Q&A session. Your videos are wonderful. Best wishes.

[@MicheleLeeMD]

You are so welcome! Thank you for your feedback and your support ❤

[@ridgelove6179]

HELLO DR LEE.. I HAD.CATATACT SURGERY ON BOTH EYES, (1 MTH APART) I DON'T REMEMBER THE EXACT NAME BUT IT COST ME (OUT OF POCKET) $2,700 PER EYE BECAUSE MY INSURANCE ONLY COVERED BASIC CATARACT SURGERY. MY LEFT EYE WAS FIRST AND I HAD A LOT OF SCAR TISSUE AFTER BUT MY VISION IMPROVED GREATLY AND I HAD TO STAY ON EYE ANTIBIOTICS (PURPLE TOP) A COUPLE WEEKS EXTRA, ITS BEEN 4 MTHS SINCE RIGHT EYE SURGERY, IT DOES BURN AND ACHE WHEN I'M ON COMPUTER FOR 30 MIN. ........ IT'S BEEN 3MTHS AFTER SURGERY ON LEFT EYE AND VISION WAS AMAZING BUT AFTER A MONTH VISION IS GOT A BLURRY, NOW I HAVE TO HAVE LASER SURGERY ON RIGHT EYE TO REMOVE A FILM THATS BEHIND MY CATARACT. .....I DO HAVE GLAUCOMA AND MY EYE PRESSURE IS BETTER. (DR STOPPED LATANOPROST) ......MY EYE'S ACHE AND BURN AFTER BEING ON COMPUTER MORE THAN 30/45 MIN. ......MY VISION IS VERY BLURRY N RIGHT EYE. .....I STILL HAVE HAVE SCAR TISSUE. .....EYE'S VERY SENSITIVE TO LIGHT. .....I USE PRESERVATIVE FREE DRY EYE DROPS SEVERAL TIMES A DAY. ......WAITING ON PRESCRIPTION FOR RESTASIS. ❓️DR LEE WILL MY VISION CONTINUE TO IMPROVE? ❓️WHY IS MY RECOVERY TAKING SO LONG? ❓️COULD MY MEDS (BP PILLS, CHOLESTEROL, BIPOLAR MED, GABAPENTIN) BE HINDERING MY RECOVERY? PLEASE GIVE ME YOUR OPINION AND ADVICE.

[@aliciagriggs8531]

I am at risk for narrow angle closure and I was advised to have cataract surgery to prevent such a thing. I did have an iridotomy in my left eye and several months lo ater had cataract surgery in that left eye. I am not happy with the results. I can live with my vision clarity, but I have side effects such as negative and positive dysphotopia, halos, starbursts, a shaking or strobe effect on the left side of my field of vision, I can see the edge of the lens, swollen lower lid and drooping eye lid on top and sides. My eye surgeon told me that the Vivity IOL would not produce any Starburst or halos. Which was not true. Also the doctor never mentioned that I would see green tints on people's faces and hair while watching TV. Otherwise I am happy with the colors and clarity. I will need glasses for close up and distance. I Can See Clearly around arms length. Is there any special precautions or something I should do because my right eye has a mature cataract? It took me several weeks to be able to see out of my left eye after cataract surgery. Additionally, in the Outpatient Center which happened to be doctors owned, there were people working there attending to me that were obviously either mentally or developmentally challenged. After the surgery, one of those people were rubbing my eye pretty hard to clean it. I don't know if that had anything to do with the bad outcome. Or maybe it was due to the fact that the Dr's office failed to give me the necessary eye drops I was supposed to begin taking prior to the surgery. It was necessary for me to have the YAG laser afterwards to be able to see clearly. However, the YAG laser treatment also gave me more interference around lights at night . When I'm looking out of my left eye it looks like I have a bunch of mucous on the left side of my eye and I feel like gouging out my eye. I don't want to have to deal with that on my dominant right eye also. Any recommendations to prevent the same side effects when I have cataract surgery on my right eye. Should I have an iridotomy first? In your experience, which IOL produces the least amount of Starbursts and halos? Thank you.

[@MicheleLeeMD]

I'm so sorry to hear about your experiences! If you have narrow but not closed angles on the right eye, you can either get the laser to buy you time or do the surgery, which will help open up the angle. The side effects you mention - droopy eyelid, dysphotopsias, dry eyes, PCO - are all common and all the exact side effects I mention in my video about side effects: kzbin.info/www/bejne/b4CmeKxmbdCej8k Vivity has less glare/halos than multifocal lenses but there can definitely still be some. If this is bothering you, you may want to consider a monofocal lens. Talk to your surgeon about your options for the second eye when the time comes. Best of luck - I hope your symptoms and quality of vision improve over time ❤

[@christineribone9351]

That was good!! I now have 40 plus questions, I'll be sending you the best. Please do another video.

[@zynthos9]

Thanks Dr. Lee for commenting on Lasik/Refractive procedures relative to cataracts. One additional question. Does having a laser procedure like Lasik predispose you to getting cataracts earlier than you otherwise would have? Specifically in the context of PRK where Bowman’s Layer is removed which may allow more UV light to reach the lens which could lead to cataracts earlier

[@generic_official]

How soon after cataract surgery can you drive?

[@MicheleLeeMD]

Great question! Most of the time you cannot drive the day of surgery because of the sedation received, but you can start driving the day after surgery. There are a few caveats - I'll be sure to explain this in the next Q&A if there is enough interest :)

[@56phil020244]

Great video, Dr, Lee. I have a lazy eye how will this effect cataract surgery? Thank you.

[@MicheleLeeMD]

Thanks for your question! I'll include this in questions to delve into for the next Q&A :) The short answer is that if you have lazy eye and have a weaker eye as a result, you may not benefit from a multifocal lens - especially in the weak eye. The cataract surgery itself should not be affected by the fact you have had a lazy eye - regardless if you've had surgery to correct this or not. Hope that helps!

[@56phil020244]

@@MicheleLeeMD Perfect. Thanks, Doc.

[@perceivingacting]

What colour of IOC do you use in your surgery? Yellow or clear? Why? Pros/cons?

[@snowwhite0712]

patients who has high myopia, like -10, can they have cataract surgery? I like ur videos, i find them very informative

[@MicheleLeeMD]

Yes of course! There is a slightly higher risk of a retinal issue like a tear or detachment so make sure you talk to your eye doctor about your risk profile.

[@redstone51]

Dr. Lee I have what they called advanced cataract in my right eye and partial cataract in my left eye. I have been okayed for surgery in 2 weeks on my right eye after having been cleared by a doctor using ultrasound to see past the bad lens. They also said it may take more than 1 surgery to clear it. Do I go home and wait for a repeat with nothing in my eye and how long will it take to do another attempt???😮🙏

[@prasunchoudhury8711]

Thanking you again for all your help, creating these educational videos and answering all our questions. I am following up with one more query. As far as choosing lenses (monofocal, toric or multifocal) for cataract surgery, is there any correlation between the type of lens and post cataract complications incl posterior capsule opacification (PCO)? PCO is probably not uncommon and can be relatively easily treated with YAG laser capsulotomy, right?

[@MicheleLeeMD]

There is some thought thtat the design of the IOL may play into PCO. Yag laser capsulotomy is quite quick and painless, as wel as very effective!

[@Nick-bp7jf]

Hi. Thank you for the video. I will pose a question if i may. After Cataract surgery i find my night vision is worse. Car tail lights and street lights now have a halo effect along with spikes of light. Daytime vision is fine. The lens that was used was to correct my distance vision. Any explanation you could offer for this would be great. Thank you.

[@searchthescriptures2214]

Did get halos in the night with a monofical lense ?

[@prasunchoudhury8711]

One question regarding cataracts and floaters: based on what I have heard, new floaters can appear after cataract because vitreous detachment (PVD) can very likely happen after cataract surgery. If someone already had PVD in his/her eyes prior to cataract surgery, then will chances of onset of new floaters after cataract surgery be somewhat diminished as there won’t be floaters caused by PVD? Thanks very much for any feedback on this!

[@MicheleLeeMD]

Thank you for your question. Yes, if you've already had a PVD it is less likely you will develop new floaters. You can still get floaters though due to inflammation inside the eye while healing as well as debris from the surgery. This usually goes away over time! Hope that helps ❤

[@constancetammons2043]

I love your videos soooo informative. Thank u!!❤❤

[@timpotter6332]

Thank you for your incites, it is very helpfull.

[@AznJsn82091]

Great video! Since it's Halloween season, could you make a video of the scariest patient encounters you've had?

[@MicheleLeeMD]

Oh goodness - there have been quite a few 😅 I'm on trauma call this week and there have been quite a few gnarly corneas. I can certainly make a video about it sometime!

[@AznJsn82091]

@@MicheleLeeMD I would love to hear about them!!

[@harveyh3696]

@@MicheleLeeMD It would be a public service presentation in that it might make us consider taking precautions to protect our eyes when doing things. I had cataract surgery in one eye recently so will be wearing glasses for some time until my other eye lens degrades. I'm thinking that if I had both eyes corrected, I might be less cautious protecting my eyes whereas my previous glasses did so passively. I'm thinking that when I have both eyes 'fixed', I just might order a pair of clear/uncorrected glasses, UV protected of course. Been wearing glasses for decades. Tried contacts on and off for the same time. Maybe I'm nuts but I go back and use contacts even though I know I'm going stop after hating the maintenance. When you put on glasses, you're good to go. Wish there was a permanent anti fog solution available. Luv your video presentations!

[@MicheleLeeMD]

@@harveyh3696 I appreciate you sharing and your feedback!

[@chasa4347]

Very nice Q&A. I'm one of the lucky ones that has 2 complications for cataract surgery. I had RK surgery back in 1992, and was started on Flomax in 2021. My RK was 4 cuts per eye, which I think is less risky. I've read differing opinions on Flomax, some say doing something different for BPH and being off Flomax for quite a while is better, others say that one dose affects your iris. My cataracts are just starting to form, so it will be some time before I need surgery. (Not affecting my lifestyle at all at present.) Any thoughts?

[@kamakshiraman3286]

I love all your excellent presentations. How to separate Cataract & PVD Symptoms ? I am diagnosed with both . My concern is whether my Cataract surgery will worsen my PVD symptoms ( floaters , flickering lights , shadows & dry eyes ) . Please explain . I would appreciate it . Thanks .

[@comprehensive_official]

Will cataract surgery restore the optimal vision from your youth? Mine was better than 20/20, can that be achieved again?

[@MicheleLeeMD]

The short answer is that you won't be able to get your "young" eyes back again, but we can get pretty close. If everything is normal with your eyes then you should be able to achieve 20/20 or better vision after surgery. I'll include this question in the next Q&A to expand on this answer. Thanks for your question!

[@qeadwsws]

Hello Dr.Lee, After my right eye cataract surgery, everything is slanted, and vertical edges appear wavey. It was not this before the surgery, could this be fixed? Thank You George

[@MsEller316]

I had no idea that high IOP after surgery was caused by the retention of the fluid they put in during the surgery to prevent collapse. The day after surgery I had to have fluid removed...in fact the second surgery I had an awful headache the next morning. As soon as the fluid was removed the headache subsided and the pressure went down. I have had a lot of dry issues before and after surgery. Have you had patients with allergic conjunctivitis due to certain eye drops..eg the preservatives?

[@MicheleLeeMD]

Thank you for sharing your experience. Yes, preservative allergies are actually pretty common! Is this something that you have experienced?

[@MsEller316]

@@MicheleLeeMD Yes Indeed

[@MicheleLeeMD]

@@MsEller316 Oh no, it sounds like you've gone through a lot from your surgery between the high eye pressures and preservative allergy! I hope everything is OK now ♥

[@MsEller316]

@@MicheleLeeMD not quite but getting there

[@gtrguyinaz]

❤❤I wish 10 years ago I had the opportunity to have you as my surgeon for cataract replacement…

[@MicheleLeeMD]

Thanks for your kind words :)

[@joy6097]

Very good and informative video Doctor gave me choice between Tecnis 1, or Tecnis Eyhance, acrysof single piece or multiple piece or Bosh Lomb monofocal lens. Please let me know are all lens have bluish tint after surgery or any one give normal white tint? Which lens give less bluish tint between above? Why blue tint after catract operation? Any monofocal lens have normal white tint ? Please answer. I have emergency surgery.

[@emem4176]

How do u keep your eye still? Im convinced i wont be able to. "Your eye will be clamped open" "Youll be on drugs" "Your eye will be numb" ok but i could still move during surgery and im terrified i will...

[@jimclarksenior2180]

Is there any specific clinical concerns for a patient who has an Autoimmune disease, such as Ankylosing Spondylitis (AS), when having cataract surgery? I realize that Iritis is a common condition experienced by patients with AS. Thank you.

[@MicheleLeeMD]

Thanks for your question! I was actually going to answer it on the last Q&A and filmed an answer but it got cut because the video was way too long. The short answer is that if you've had a history of iritis/uveitis associated with your autoimmune disease, then you need to talk to your doctor about starting oral steroids (or strong steroid eye drops) before your surgery to prevent a flare-up. If you have not, then we usually just monitor closely. If I end up filming another Q&A I will definitely include this question!

[@jimd7241]

Hello How long should I wait after surgery to start using my Xiidra Dry Eye Drops again... Thanks

[@tkmokk9325]

Hi...Dr. Michele Lee, 🎄🧑‍🎄Will the DAILY : watching the TV, viewing the computer/laptop screen while working, and viewing the handphone screen(like when playing video games, sms, etc..) slowly contribute to the development of CATARACTS in our eyes in the long run?

[@MicheleLeeMD]

Short answer is probably no. The long answer is that we still don’t fully understand the long-term effect on blue light and electronics on cataract formation. Hopefully we will have more of a consensus on this soon!

[@patricialo8561]

Hi Dr LEE, I am thinking to get the monofocal toric lens for the cataract surgery. As I wear contact lens in last 40 years and I hate to wear glasses. After the cataract surgery, can I wear the contact lens to improve the mid and near distance vision?

[@sidewinder3434]

Dr Lee Are you using the The ORA System to give better lens calculations for patients who have had LASIK surgery ? If so , what is the extra cost ? I just read about this while looking at an outpatient surgery center which my Dr uses I have had LASIK surgery done 20 years ago

[@MicheleLeeMD]

Ora is a great tool to confirm the lens power. I actually made a video explaining ORA if it could be helpful: kzbin.info/www/bejne/l5-XgXWKpamNn7s

[@sidewinder3434]

@@MicheleLeeMD Ah, yes ! I forgot about this in your video ! Thanks I'm learning a lot about cataract surgery before I have mine done.

[@tkmokk9325]

Hi..Dr. Michele Lee, What is the VISION like with a - 2 (minus 2) IOL MONOVISION lens implant pls?

[@MicheleLeeMD]

It would be blurry for distance but hopefully clear for reading. Not sure if that answers your question, my advice is to talk to your eye doctor about the best options for you

[@dancooper41]

Dr. Lee, thanks for the great videos! My question is, would you ever recommend choosing different IOLs for each eye? For example, a Vivity in one eye, to minimize halos when driving at night, and a Panoptix in the other eye, for better vision close-up than the Vivity provides. Thanks!

[@MicheleLeeMD]

Yes, absolutely. We can mix and match lenses all the time, depending on your needs. Hope that answers your question!

[@LisaBBoardwine]

Thank you very much for your informative videos! Have you ever had a patient whose toric lens rotated after cataract surgery? Can this be corrected?

[@MicheleLeeMD]

Yes, that can certainly happen especially right after surgery. When that does, we usually go back in and rotate the lens within a few weeks. If it's been a while after surgery, you can ask your doctor about options like refractive surgery to correct your astigmatism. Hope that helps!

[@LisaBBoardwine]

@@MicheleLeeMD Thanks so much Dr. Lee. My first cataract removal with having a toric lens put in and this has happened not once- but twice. I am now seeing a specialist for a third try at making the toric lens stay in place and not rotate. Very frustrating and scary.

[@Rita50]

Would you be able to wear glasses on multifocal IOLs? I heard that eyes cannot adjust to glasses if you have multifocals.

[@tonisiegel4249]

I have been wearing soft contact lenses for long time and when I do cataract surgery, do I need to wear contact lenses anymore?

[@carolyngallimoretocunit]

HOW SAFE IS CATARACT SURGERY AND CAN CATARACTS BE TREATED❓ THANK YOU SO KINDLY,

[@MicheleLeeMD]

Cataract surgery is an extremely safe and effective treatment for cataracts. There are some risks and side effects to surgery so it is best to discuss this with your eye surgeon to make sure it is the right time. Best of luck ❤

[@carolyngallimoretocunit]

@@MicheleLeeMD THANK YOU SO KINDLY DOC, I APPRECIATE ❣️💞♥️

[@michaelbruner3555]

I do have a scheduled visit next year to see if I qualify for surgery. My optometrist said he can no longer adjust prescription for astigmatism (in both eyes). I do have some cloudiness and he said I have the beginnings of Dry Glaucoma (comes and goes every couple of years). With the above being said what can and cannot be repaired during cataract surgery? Thank You!

[@MicheleLeeMD]

It is hard to say without examining your eyes. The cataract (cloudy lens) can for sure be repaired, and if you have early glaucoma your surgeon may offer a minimally invasive glaucoma procedure to perform at the same time. The astigmatism may or may not be corrected (your choice) with a toric lens or LRI (cuts on the cornea that reshape the cornea). Hope that somewhat answers your questions!

[@jayblue5310]

Hello, Dr.Lee, I will be having another cataract exam this month my 1st exam had a slight epiretinal membrane in my left eye because of my lifestyle I have selected the vivity lens because I want sharp clear crisp vision as much as possible and would like astigmatism correction I'm ok with readers I have not discussed this yet with my surgeon but have done research about various lens and selected vivity premium lens would the slight pucker be a problem with vivity thank you

[@MicheleLeeMD]

You should be OK with an EDOF lens like Vivity if you have an epiretinal membrane. I would make sure you discuss your options and outcomes with your surgeon to make sure there are no other considerations. Best of luck!

[@emanalsiniy5844]

Hi doctor, I have wet macular degeneration and am taking Eylia inaction every 3 months, and I have cataract bilateral. My doctor said that the panoptic lens is not suitable to my wet macular degeneration, and it is better to have mono lense

[@emanalsiniy5844]

Why can you explain

[@delenechang316]

What can I do to stop my right eye from tearing?? It's tearing constantly

[@frostar701]

What would loss of variable focus mean after surgery? And how would I perceive this? No video I have seen has addressed this.

[@MicheleLeeMD]

Great question. With a standard or monofocal lens that is replaced after cataract surgery, the lens is the same power throughout so you can usually just focus at one focal point (such as distance, but not reading). I'm not sure if this answers your question completely so let me know how I can clarify!

[@Swenser]

Damn. If I had my time over again, I'd be a cat surgeon. In Australia they are allowed to rip a massive amount from people's wallets. In most industries the concept of competition keeps prices relatively , well, competitive. But some niche industries like this and dentistry, the heads seem to conspire well to keep prices enormous. Unless of course it can be explained to me why a thirty minute procedure involving a scalpel a microscope and a lense costs 5,000 US dollars?

[@prasunchoudhury8711]

I have learned so much from your videos. I am 50, am slowly developing early cataracts and will likely need cataract surgery some years down the line. I just saw that your practice is in AZ now. You were previously in Seattle, right? Would have loved to have you as my Opthalmologist/eye surgeon.

[@MicheleLeeMD]

I appreciate your kind words :) Yes, I currently practice in Scottsdale, AZ but before that I was at UW in Seattle.

[@tom95521]

The Clareon Vivity lens literature says it filters UV and Blue Light. Does that mean I will notice a yellow tint? I will have a couple of weeks between eye surgeries.

[@MicheleLeeMD]

The vivity is the yellow-tinted lens. There may be just the slightest difference in color perception, if any, and it will be better than having a significant cataract. Hope that answers your question.

[@tom95521]

@@MicheleLeeMD Cool. I was hoping it had a slight yellow tint. I might notice a difference while waiting for my second lens implant but that's okay. Thanks!

[@ma.cristinabercacio5531]

Does a cataract need an eye operation immediately?

[@TRICK-OR-TREAT236]

DO TINTED LENSES REDUCE OR ELIMINATE NIGHT TIME HALOS ?

[@TinaICXCNIKA]

FINALLY! @5:53 you explained and better yet, SHOWED what I've been trying to explain to others! Thank you so much, #MicheleLeeMD

[@MicheleLeeMD]

Aw, you are so welcome!

[@quietsignal]

Execute a written contract for outcomes, since this is elective surgery.

[@kavaleao1528]

HOW MUCH IS THE COSTS OF A PREMIER LENESS? MUCH ALOHA'S

[@peterlim3189]

How do you know if your Dr have enough expirenced on cataract surgery? Cause if you ask them, they might lied.

[@juliebryant3968]

I asked the nurse before I went ahead ...

[@anthonykeller5120]

Can i wear contacts afterwards?

[@MicheleLeeMD]

You can, but your glasses and contact prescription with change after surgery!

[@christineribone9351]

Excuse me Miss Lee, I don't understand what you are saying at 14:04 " . . . the cataract is blocking the ??? ?? System of the eye . . ." The output system? The optical system? Or the.outboard system?? Thank you.

[@maryskelton8033]

Do you do stem cell for cataracts ?

[@MicheleLeeMD]

Thanks for your question! We don't use stem cell for cataracts yet, but maybe one day we will have use for stem cell technology.

[@maryskelton8033]

Thanks-- I noticed thay have been done on children. If for children, why not for us older people?

[@MicheleLeeMD]

@@maryskelton8033 Thank you for your comment. I haven't heard of stem cell therapy being common place in children with cataracts yet. We perform stem cell treatments for conditions like limbal cell deficiency on the cornea, and there are experimental treatments for the use of stem cells for other eye conditions like glaucoma and corneal dystrophies. One day there will be something less invasive in place of cataract surgery.

[@petercrossley1069]

Just avoid UV by wearing photochromic lenses.

[@nedcrouch3202]

Dr wong said I had a cataract. I said, NO! I have a toyota.

[@ismayilarifoglu6226]

Please, marry me.

[@jamesshay815]

Please don't do this surgery