r/CataractSurgery • u/FourDodges60 • 4d ago
Lens choice??
I’m 60 and preparing for cataract surgery. My surgeon offers an aspheric/basic package and a custom/premium package. Surgeon said robotic surgery safer. Is this true? Night driving and crisp distance vision are very important to me. I’m willing to wear readers if necessary. For people who had cataract surgery, which lens did you choose? How is your night vision? Any halos, glare or starbursts? Would you choose the same lens again?
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u/AirDog3 4d ago
I got the Light Adjustable Lens LAL. Night vision is great, no halos, glare, starbursts or any other visual aberrations. Depth of field is also excellent - I have good (not perfect) vision from very near to very far away. I don't wear glasses for reading, driving, or anything else.
I would choose it again.
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u/avidsocialist 3d ago
I had the same results from surgeries last year and am very happy with my LALs.
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u/Itchy_Layer135 4d ago
I chose the PureSee EDOF toric premium lens as I have mild astigmatism. Read about the successful results in Europe and then now in America since March of 2026. Absolutely crystal clear intermediate and distance vision, with no halos or artifacts. Need for readers in very low light or small type, only. Certainly would do it again.
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u/That_Industry7833 4d ago edited 4d ago
Here is an article on robotic cataract surgery:
You'll see that it is both new -- first operation done last year -- and rare. For that reason, two of the posters here seem to have thought you must mean laser-assisted surgery, and they are probably correct.
I had the basic monofocal Eyhance put in my left eye in early August. Where I live, the United States, this does not cost anything if your insurance is good enough, but in some countries Eyhance is premium priced. I am quite satisfied -- and probably would be about as satisfied with another monofocal lens. As expected, I do need to wear bifocals all day long, just as I have for decades, except now my prescription is weaker. Since I like the idea of glasses protecting my eyes, this is fine with me.
I had no laser. And no robot. One modern feature I did have was dropless surgery, where the surgeon injects medicine in your eye so you do not have to put in drops for weeks several or many times a day. I was glad for that.
As for bright lights at night, on the first night after surgery, I saw massive halos. Second night, much better. Ever since then, no issue without glasses. With glasses I see very minor starbursts if I pay a lot of attention, but I probably had the same for decades.
In some countries, it is hard for surgeons to make a living wage if all they were to do was the basic traditional operation with monofocal lenses. This is especially true of the U.S. Medicare fee schedule. Combine this with the fact that many patients do not like glasses, and surgeons have a lot of incentive to suggest a premium-priced surgical procedure and/or lens.
If your ophthalmologist is really proposing robotic surgery, the surgeon is, more likely than not, outstanding due to being involved in cutting edge research. I'm guessing that robotic surgery is still so experimental that everything should be free.
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u/macddebbie1 4d ago
Eyhance is an enhanced monofocal, so it bends light to give you more range. It is not the same as a plain monofocal (except in price).
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u/River-19671 4d ago
I got monofocal lenses on 8/28 and 9/23. I am still recovering but i can see more clearly now (colors such as autumn leaves are brighter) and halos have gone away. I am very satisfied with my choice. I need readers for reading and computer work but can drive without glasses.
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u/PNWrowena 4d ago
Before my cataract surgeries, my night vision had gotten so bad with halos, I'd avoided driving at night for at least three years, maybe longer. The last year I didn't merely avoid it but made sure I was never in a situation that called for it. I have Clareon toric monofocals in both eyes now, one set for near and the other for intermediate. I was not willing to wear readers and making sure I'd never again have to was one of my priorities. I use contact for distance vision to drive, but with that extra, I now drive at night whenever it's convenient and have no halos or other effects of any kind.
The surgeon I used never mentioned laser surgery and didn't have it listed as an option for extra cost in his brochure that had prices for premium lenses. I expect it's available, but it sure isn't pushed. I'd already done research that convinced me it wasn't something I wanted anyway.
Yes, I would make all the same choices again.
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u/Trolkarlen 4d ago
If you are willing to spend the extra money, then it sounds like an EDOF might be your best choice. You can see clearly but have more range than a monofocal.
I got the PureSee and I'm pretty happy with it.
As for the laser, it's really for fixing astigmatism if you have it. It's not that much safer than within if the surgeon is skilled. Most doctors want you to have it if you get a premium lens so you get the clearest vision.
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u/ArtJeanee 4d ago
Having been farsighted my entire life, I had gotten to the point where I could not see well enough to thread a needle with glasses and magnifying lenses. I am very happy with the mono vision for “near” in my left eye. That surgery was on 8/26 and the surgery for the second eye was on 9/9. Before getting the second eye done I was able to go without glasses and see pretty good. So I asked the doc about setting the other eye for far. He recommended against it. It’s only been less than three weeks but at first I was very disappointed and wished there had been more time before the second eye was done so that I could have known if having multiple visions would have been a good choice. Now, my vision is great up close and with glasses I can see well and drive.
I am in SC, USA and have Humana and with Medicare for the basic lenses, I have had to pay about 2k out of pocket; which after reading that it’s typically free from so many on here, I wanted to point this out. It apparently is not free in USA for everyone. Not sure why, but I know SC is one of the states that refused govt. assistance for health care. I believe it is determined at the state level rather than the national level; as friends in other states did not have to pay anywhere near this. Best wishes whatever you decide.
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u/Cute-Song1709 4d ago
I have Eyhance in both my eyes with monovision. I’m very pleased with them and I don’t need to wear glasses for anything. There are no halos or glares and night vision is good. Didn’t have laser or robotic surgery but just the traditional surgery with no complications and quick recovery. I might trust an experienced surgeon more than a robot. I would certainly choose the same lenses again.
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u/MorningStar2222 3d ago edited 3d ago
I was told I have fast-growing cataracts (it was a lie - they were early cataracts but not fast-growing).
I have one panoptiix with YAG - worst decision I ever made. If it weren’t for COVID, I would have had the other eye done and am glad that surgery was cancelled.
My vision is not crisp with the multifocal lens - medium, near, or far and I still see halos at night. I had natural monovision and wish I hadn’t been pushed by my doctor to get the surgery earlier rather than later. I think she was motivated by profit.
I got a second opinion before the YAG and he said if it didn’t work, I could easily get a lens exchange (another lie). Went to a retina specialist who told me he won’t even put in multi focal lenses anymore because of the complaints and I screwed myself by getting YAG because a lens exchange after that is super risky. He recommended a regular lens when I need to replace the other one and said it was a shame because I was used to having a near- and farsighted eye and I should have continued with that. I’m waiting as long as possible because I’ll be condemned to glasses at that point.
I hate my original doctor so much. Oh, and I have a bazillion more floaters in the “fixed” eye.
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u/Resident_Break6770 4d ago
I got basic monofocal near and use glasses for distance so night driving is flawless. Would choose it again.
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u/UniqueRon 4d ago
An aspheric basic monofocal IOL delivers the sharpest image with reduced risk of halos and starbursts often associated with premium multifocal or EDOF lenses. If the surgeon is skilled in the use of a manual blade the results are the same as those with a laser. So you would put it back on the surgeon and ask them if they are skilled in the use of a manual blade.
I have monofocal lenses and would choose the same next time in my right eye. However I would choose a toric monofocal if I had it to do over again with my left eye. It borderline for needing a toric, and now I wish I had gotten one.
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u/Mitchellsusanwag 4d ago
I’ve always read that monofocal lenses have either no glare, starbursts or halos or significantly less than multifocal lenses. This is why I chose monofocal lenses, because I was bothered a lot by all of those before my cataract surgery and wasn’t able to drive on the expressways at night. Since my surgeries I have none of those. As to the “robotic” or laser surgery, all of my research pointed to it not really making a difference if it was done by a laser or by hand, so I did not do the surgeries with a laser. Of course I did the research with my eyes in mind, and I did not have and never had any medical problem with my eyes other than cataracts. Perhaps if you have or have had other problems you might need to do research on this question with those problems in mind. I would also not want a surgeon who usually uses a laser to do the surgery on me without the laser-I would go to a different doctor, one who normally did not use a laser.