Premium Cataract Surgery... Is It Worth It???

Thanks for watching! I'll be filming a cataract Q&A next week so leave your cataract-related questions down below, and I'll do my best to include it. See you in the next video ❤

It’s good information. I am using specs both for near and distant vision and recently diagnosed with cataract of both eyes. The doctor has advised mono focal lenses with use of specs for reading. I drive also and fiddle with phone and computer also.

And I have had cataract surgery in both eyes. Distance only correction and ended up with more astigmatism than before surgery

Hugh volume optical with 20 years experience

I’m an optician and my experience is there are some cases where it’s worth the money but the majority are coming back to me for glasses

Glaucoma /premium lenses

Thank you for the clear information.

You talked at one stage about some premium lenses not being an optimum in case of glaucoma .

April ‘25 I am scheduled for lens replacement
in order to create more space inside my eyes by implanting a flat lens in stead of the natural more ball shaped lenses ; and by doing so structurally lowering my eye pressure rather than taking medicines

Could you pls. indicate which type of premium lenses will likely be no option for me?
Thank you in advance !
Peter

I am 82 years old and have dry AMD and medium level astigmatism. Would premium Toric lenses be beneficial for me?

Hi Dr Lee, I love your videos. I had a Crystalens AO put into my left eye probably 10 years ago or more for a traumatic cataract. It was never right. Z syndrome, basically, I only use that eye to read. Beyond reading distance everything is blurry. I have mono vision. Right eye is for distance. Now I have an age-related cataract in my right eye, it is getting bad. I want the Crystalens removed and a new lens put in before I address my right eye. Do people get both eyes done at the same time? Is it dangerous to remove a Crystalens? I can't risk another bad result with my only good eye. Your thoughts would be amazing.

Hi Dr. Lee, are you familiar with the Juvene lenses? I know they have been used in a number of trials and give good vision at all ranges. Are they available to everyone yet? Could you do a video on them?

Not a fan of the underlying assumption that everyone wants or seeks “freedom from spectacle dependence.”
A recent study out of the UK reveals that majority of seniors have no problem with the idea of wearing glasses. Doctors should tube into this more rather than assume all patients think like them

As i am waiting for my doc and consult thanks for the info...

Have cataracts with only personal problem is starbursts from oncoming car lights at night. Have some central drusen and some map dot dystrophy causing opthamologist who does not do surgery to state cataract surgery may not provide as good a result as hoped for. I can read a computer screen now without corrective lenses and ophthalmologist said I could almost pass a driving test w/o lenses. Refraction: R sphere +0.75 Cyl -1.25 Axis 090. L Sphere +0.50 Cyl -1.25 Axis 080.
What is % of night vision halos with multifocal IOL? My research shows high and my thoughts are they are not an option. Any thoughts? Thank You for an excellent overview.

Can you address the issue of light sensitivity and glare and which lenses will be best to reduce this effect, don’t mind if I need to wear glasses afterward. Currently need 1 cataract fixed and wear bifocals.

Imagine if we had a president who could THINK this clearly ... let alone, speak this clearly,

30 years post-op RK surgery. No medical records available.
I currently wear contacts (vision returned to almost pre-RK status). What questions should I ask about different lenses? About the surgery? (8 RK incisions).

Very well explained, thanks. Is a progressive iol available? Is it different from multi focal lens? Do progressive lenses also lead to glares and night driving difficulties?

Great info

Hi Dr.Lee, I was reading about a new type of lens. I believe it is called a juvene lens and is under development. Could you explain what the advantages of this lens might be?

Hello Dr Lee, I had LAL surgery in both eyes in Jan 2024. I am scheduled for my 2nd adjustment in a couple of days. My goal is to never need glasses except for in extreme "up close" fine print situations. My understanding is that this is achieved thru monovision, (one is set for near to mid and the other is set for mid to far). What I was NOT told was that not everyone is well suited to monovision. I guess it all depends on how your brain processes the information sent by your eyes. Fortunately for me it has been successful and I am happy with the results. I would caution people that are considering a goal of monovision through lens replacement to make sure that they are good candidates for it. Your brain must be able to naturally choose the eye which is sending the clearest image. This is just my observation as a patient and I'd be happy to be educated further.

There should only be "premium" eye care. Thank Supply Side Economics and the Powell Memo for fucked medical care.

What happens if you don't have glaucoma when you're choosing your IOL, so you choose a glaucoma unfriendly premium lens, but you develop glaucoma years later?

If you value your close-in vision...i.e. seeing your watch, doing DIY work, seeing instruments or people inside your car, seeing your phone (texts, etc.)? Please DO NOT opt for the Toric Lens. Since October 2023 my Toric Lens from Johnson & Johnson has left me CRIPPLED. Yes...I can read a license plate at 2-blocks, However, this morning I fell down 8 concrete stairs, head-first, because I no longer have depth perception OR balance. I was shamed into paying $1700 extra for the Toric Lens with the medical staff making me feel like a "cheapskate" for not choosing the so- called "premium lens." The worst medical decision of my life.

Thank you so much Dr. Lee. This information is really important to me.

Yes!

I have extreme astigmatism in my left eye. I had a toric lens put in and I improved 20/800 to 20/30. Worth every penny.

Hello I had refractive eye surgery for my astigmatism about 20 years ago. Then in my late 30s helped my vision and didn’t need to wear glasses. Now I’m in early 60s and have cataracts. Is there anything I need to worry about now?
Enjoy your informative video tutorials

Medicare and insurance companies do not cover cost of premium lenses.

someone has scars in the eyes can use premium lenses?

I got premium adjustable implants after I went blind in one eye. It cost $2000 extra per eye over my insurance and worth every penny. I now see better than ever with 20/15 vision and still read and do most close work without glasses. I can drive at night with no problems. Friends and relatives that didn’t or couldn’t spend the extra money are not that happy.

This video is disgusting you should be ashamed. You should be trying to give every patient the best outcome.

Having to pay extra so that you measure correctly is one of the most disturbing things I have ever heard.

You are sick this entire branch of medicine needs to be stomped back in line through legislation. Apparently ethics have left medicine.

I don’t have to pay more to get the proper contact lenses. This should not be any different.

You are not a good person nor is any surgeon who practices this way. You sound like a slimy used car salesman. Absolutely disgusting and you should be ashamed.

If you delete this I will make sure to post it on every video you make going forward.

Tks Dr for doing these videos. I wasn't clear for the LALs are they good for correcting an astigmatism of 1.5? If not can they still be used?

Yes, it worth it, I have restor multifocal toric iol in my right eye and panoptix multifocal toric iol in my left eye, my distance vision is about 20/20 (about 100%) and my near vision is J1+ (120%)

We don't know if it's worth it because the cost is like a mistery and nobody's will give you a straight answer. Oh but depends on how much correction you need! Like,whats the difference? A thousand millimeter in the lense?

Are there glasses you can wear that work well to counteract glare and halos while driving at night with multifocal lenses?

Upcoming cat surgery,enjoy you very informative videos,thanks for your dedication to help people!!

Very informative - one suggestion to make it even better than it already is: the video cutting/editing is causing the audio to overlap - recommend trying to leave a slightly bigger audio space so that audio from two different segments aren't "on top" of each other. otherwise - best I've seen to make this complex decision-making process - more understandable. Thanks - patient with several long-term eye problems - near-sighted/far-sighted, astigmatism, light sensitivity - and cataracts - - about to under go the procedure [and as a retired audio archivist, Library of Congress] I really need my eyes to continue my work.

Imgetting my surgery in november and wondering which is better monofocal or multifocal and does everybody get halos with multifocal also they are using baush laumb should i get their newest iol

I'd been wearing reading glasses over 15 years. Then about ten years ago I needed glasses for driving and intermediate vision. I'm now 58. So when I developed a cataract in my left eye, I chose to go with the premium multi-focal lens. I wanted to be independent of glasses so made the decision to also have the right eye done which did not have a cataract. It's now been one week since I had surgery on my right eye and two weeks for the left eye. I'm completely free of glasses. The one and only downside is the haze around lights which is more noticeable at night. For me it's an acceptable trade off. I'm an electrician and my work involves reading prints and performing detailed work plus loads of driving. I can't describe the freedom of being free of glasses. It was the best $7100 I'd ever spent.

Hi. I'm going to have cataract surgery in both eyes. I'm 50 years old and my cataracts is a result of prolonged steroid use (we believe). I'm on the fence about whether or not to get a premium lense, or if I should just do the standard lense. My vision is -1.75 and +2 for reading. It's a significant investment and I generally have good eyesight. My doctor says I have several years to reap the benefits but I also feel like the technology is pretty sophisticated and may be an overkill for me needs. Interested to hear any opinions. It would be about $6K for monofocal with astigmatism correction, for both eyes. Plus I'm unsure if my vision will change in the future. I know my vision is priceless and I'm happy to pay the money, but I also think there's no perfect solution and I generally don't have a problem with wearing glasses.

Absolutely worth it to me. Low level astigmatism (below CYL 1.0) may not need a toric lens. Just got my 2nd multifocal PanOptix 4 days ago and I can see how I'll make my money back before long just due to my own increased productivity.

Hi. Can one use multi-focal lense if one also has astigmatism?

Dear @MicheleLeeMD , please would you be kind to please would you be kind to tell me what does mean model of IOL : Phaco + multifocal TORIC IOL / Synergy TORIC/; MODEL DFW100 ? I cannot find it anywhere 😔

Excellent information. Wondering if you made a video on secondary cataracts. In other words after the initial cataract surgery the new implanted lense starts to cloud or a new cataract forms.

Great topic. Speaking specifically on the latest trifocal premium IOL's, the first rule is that they should not even be considered in any other preexisting ocular disease where there is potential for added aberrations which will be compounded after implantation and near impossible to resolve thereafter without explanting them. Post premium IOL LASIK theoretically sounds good, but practically it is a thumb suck and should not be discussed as rescue except in extreme cases.

Trifocals do indeed achieve very specific quantitative visual targets very well but it comes at the sacrifice of qualitative visual traits that we may take for granted in our daily lives. Contrast, brightness, saturation, sharpness, motion blur etc important only for flat screen TVs and photographic recapturing of the moment now become tested in reality and all of a sudden the patient becomes shocked on its importance which is tested to the maximum.

It must be understood that trifocal lenses are actually a compromise in overall visual functioning reserved only for those who are the business of being correction free. This must be explained fully from the start with the "How badly do you want it" tone.

Ophthalmologists must not fall into the marketing hype of the brand which promises vision beyond the patients dreams and saddles the ophthalmologist with the burden of broken promises.

Just as you can have cataracts which impair your sight but you do not notice it because you have lived with it for so long, so too do the manufacturers of these lenses rely on you getting used to poor eyesight after 9 months for a poor performing lens. They then attribute your surrender to the lens to "Neuroadaptation" which is akin to using touch and sound to get around - you may navigate better but it does mean you have better vision. The reality is that they work spectacularly well for a very small percentage of cataract patients which if applied correctly would not be feasible to manufacture the lenses.

It is also unfortunate that in the USA lens selection is limited by the FDA and the generation of premium trifocals available to you are outdated and not really used in other countries.

If you are serious about your sight, consider researching lenses like the Hoya Gemetric and if it sounds good consider a medical holiday to get the sight you deserve.

@MicheleLeeMD
Do you know if some lenses let in more light than other lenses?
I have the panoptic multifocal and after 4 months of having surgery the brightness is still significant.

So how does one see after having the first eye done before the second is done. I poked a lens out my glasses but did not get the results I expected. Seem like my original trifocals still gave the best results, both lenses.
Putting in the eyedrops seems easy but not if you have not done it before, and its about $.75 a drop when you miss. Does not sound like much but when you have to buy another bottle for $125 for the other eye since you ran out on your second eye cuz you missed a few times.

Hello Dr. Michelle, I just have my cataract surgery with trifocal premium lens. It's almost two months now but my left eye is experiencing a little bit cloudy. Why is that?

I've had monovision naturally most of my life. My distance eye is much worse now & both eyes have cateracts. I'd like to find a dr skilled in blended vision but so far Im hearing light-adjustable is the only way they'll do that. It's hard when these lenses are $5,000 each.

Blind in one eye for 50 years (trauma), diabetic, and cataract presently forming in the other eye, with astigmatism. I INSIST on glasses for their protective shielding from foreign objects! Additionally, having enjoyed 20/12 correction for all these many years, I am loathe to surrender or risk a bit of it. Vision is more than precious to me. Though I will never see it and can only visualize it in part, my wife and I enjoy stereo (3D) photography, and we have no problem spending whatever it takes to obtain a sharper image. We are partners in this, as she is experiencing macular degeneration. 
Vision is a miracle, a gift beyond price. I tell my avuncular family members it is worth more than their lives to me. Yes.

Are there any special considerations or complication associated with patients that have DRS in the eye? Doses the constant movement of the eye cause issues? Thank you.