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Lasik or lenses replacement

MarkW

Well Known Member
Friend
While flying I need readers but have to wear them like bifocals.
For years I have been wearing readers but my distance sight has gotten worse.
Always figured I would get Lasik so I finally went to a local Lasik factory.
I was told Lasik was not for me but the best would be lens replacement.
I could do mono-focal or Multi-focal. Went for my last check before surgery next week and am having second thoughts.
The doctor said I would have halo's around lights at night and fine focus would not be good with the multi-focals.
Anyone with experience?
 
10 years ago I had 2 surgerys on my right eye. The 2nd to repair the first a year later. My eye is worse now then before the surgery. I was told that I healed too quick with a build up of scar tissue. So there is a risk. If you go with mono vision you will probably lose on your depth perception.

Tim
 
I’m sure you will get many different opinions here. One question is “how old are you”.
As a point of reference, I was always very nearsighted and wore glasses and contacts all my life. I had LASIK when I was about 40 and had 20/20 for many years. By the time I was about 45, I started needing readers.

Eventually, I got to where I needed distance correction also and started wearing bi-focal contacts. The last 2+ years I’ve been doing mono vision with my contacts. I had prescription glasses made especially for flying. I leave my contacts in while wearing my flying glasses. The glasses give me 20/20 in both eyes and I can still read my Glass instruments and iPad.

I know some people just can’t get use to wearing contacts but the new lenses are amazingly comfortable. I use Daily Wear now and they are incredibly thin.

I just turned 70 and will probably need cataract surgery eventually, but I will put it off as long as I don’t really need it.

I just saw Tim’s comment about mono vision. It has not effected my depth perception at all.
 
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I had new lenses installed (!) in both eyes last year. I didn't want the "iffy" results they said the "all-in-one" lenses came with so I chose single vision corrected for distance. That meant I need cheaters for close vision. All of my life I was near sighted so it took some getting used to but so far all is good.

-Marc
 
I've had cataract surgery and I opted for single vision (monofocal) intraocular lenses set for distant vision.

Note this if you decide on multifocal or accommodating intraocular lens implants (Ref: https://www.faa.gov/about/office_or...am/ame/guide/dec_cons/disease_prot/binocular/):

"Adaptation period before certification:

  • Surgical lens implantation - minimum of 3 months post-operative"


Here is the general FAA guidance:

 
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I had CrystaLens (Multifocal) in November of 2012. They have been fantastic! NO Halos!

I turned 70 3 months later.

I have to wear readers if print is very small or light is dim.
 
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I had new lenses installed (!) in both eyes last year. I didn't want the "iffy" results they said the "all-in-one" lenses came with so I chose single vision corrected for distance. That meant I need cheaters for close vision. All of my life I was near sighted so it took some getting used to but so far all is good.

-Marc

Same. It can be a problem when working in tight corners or trying to look up at something close, but much better than having cataracts!
 
I will share me 2 cents. Before I needed distance vision I had Mono vision, only one contact, it worked very well. Later in life I needed to have distance vision. So one eye is corrected for distance and the other eye is corrected for close up. It is amazing how the brain makes all that work. These are soft contact lenses. I am 79 now and all it good. I have not had Cataract surgery. It is coming, but I do not know when.
I am not now flying.
 
72 - cataract surgery in right eye 6 weeks ago. Formerly needed distance correction and 225+ for close work. I had a fuzzy zone from 18" to 48". Night vision in traffic challenges were becoming noticeable.

I got the fixed lens for distance, unaided I can read from arms length + i.e. panel to runway, but not closer. Colors are brighter, FOV is the same, no yellow tint anymore and 150 for the right reading lens. Depth perception improved with better clarity even in the one eye, with two I expect back t0 10 yrs ago (at least).

In a week, the left one will get the same treatment.

I have had no issues by removal of the right bifocal lens for flying and flying in daytime. Night could be different, but after the LS is done I will get new glasses to address that. I don't seem to have new issues and the sparklies from headlights is gone in the right eye.

It did take a week to recover from Versed for surgery. My brain lacked clarity for a week, vision was good in 3 days. The dilation lasted 36 hrs before fully back to normal. No pain, but some quite noticeable adjustments to the focus differences between eyes. I got a pair of readers for each eye then swapped the lens, and removed the right lens of my bifocals. I should have done it immediately. There are other post-op effects that were temporary - your Dr can share with you.

Your eye geometry will be measured and a specific lens made for you. There are focal lengths between "near" and "distant" vision, good discussion for you/Doc in terms of distances in focus.

I can not say anything bad about multifocal, but heard it from others and final straw was when the Dr said "halos".

Overall, I did not know how much improvement was possible. YMMV

There are some good books that cover this, internet sites are ~ok. I though I knew what was going to happen, and did generally, but the Doc was much more specific and very helpful.
 
Multi-Focal Contacts

I have been wearing multi-focal contacts for about 15 years and like them alot, I can see close and distant with both eyes without tilting my head and can wear regular sunglasses. When I started wearing them the FAA was not allowing monovision contacts so I tried the multifocal, had to have my eye doctor fill out a few FAA forms the first time. I am not sure if contacts are an option for you instead of surgery, but you might try them as a "preview" of what the surgery will do for you
 
cataract surgery

I had cataract surgery about 15 years ago ( both lens) and have never looked back. Awesome eye technology these days. I do need near vision correction for small print but far vision has been awesome. Check up on what the FAA will approve these days for lens but don't hesitate about this Sugery. It puts eye problems behind you as you age.
 
I had the uncommon cataract variety that appears at a younger age and had a lens replaced in the right eye. I went the traditional lens route after some research. It seemed the risk of not being happy with the multi were too high for me. I still need glasses for perfection, but that was ok for me, as I still have my natural left lens that needs correction.

I will say that the effort to design the lens is not pure science, but a good bit of art and experience. Choose your Dr wisely. A month after surgery, I was only a .25 diopter off of 20/20 with the new lens.

Larry
 
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I had new lenses installed (!) in both eyes last year. I didn't want the "iffy" results they said the "all-in-one" lenses came with so I chose single vision corrected for distance. That meant I need cheaters for close vision. All of my life I was near sighted so it took some getting used to but so far all is good.

-Marc

My wife just had the second eye done and she found the process to be No Big Deal. Biggest downside for her was the rather rigorous post-op eye drop schedule. She said that the improvement in vision has been rather astonishing. Not just acuity, but also brightness, contrast, and color rendition. After the first lens and before the second, she could clearly see the dinginess and yellowish discoloration that her cataracts had imposed, even though her visual acuity had been pretty good.

Insurance will typically pay for single-vision or mono-vision lenses. They typically label the multi-focal lenses as “cosmetic” and you’re on your own financially.

Be aware that not all brains can process mono-vision correction and it can be hard for some people to make sense of the disparate visual input. She did pretty well with the trial of mono-vision contact lenses but found that her vision was much, much better with the single-vision lenses, the only downside being the need for cheap readers to optimize near vision.

I’m told that I’m about a year or two from cataract surgery/lens replacement and I’m looking forward to it. Pretty sure I’ll go single-vision too. My Class III medical doesn’t require glasses for distant vision but does require corrective lenses in the plane for near vision.
 
If you have cataracts that deserve surgery you will probably be amazed at how much better you can see afterwards. More light gets through the lens, and it's not yellowed, so colors will be brighter. The surgeons I know rarely place the multivision lenses; mostly for people who absolutely insist on not wearing glasses. He said with the current technology they just won't be as sharp an image as a standard lens. With a fixed focal length you need to decide if you want to see up close without glasses or far away without glasses, or somewhere in-between.
 
Cataract Lens Replacement

I had both eyes done recently with multifocal lenses. I have worn glasses for more than 70 years and bifocals for more than 45 years. Now no glasses and I can see far and near. I can see the panel clearly and see detail on my EFISs with no issues. I do need sunglasses but night vision is fine, slight halo but nothing special. So great to not have to clean glasses and have my nose hurt and the interesting thing is that unlike bifocals, where it you look forward or up you cannot see close, with multifocals you can see left, right, up down, without moving your head. It is amazing what your brain can do.
Ed
 
All very good info. Thank you very much.
I am 62 this weekend. I was told a few years back that I had the start of cataracts. I guess we all have some clouding at this age. This doctor searched hard for cataracts so the insurance would pay a portion but said no.

Glad to hear no one has had halos so bad they gave up night flying.
Still seems mono may be a safer route.

Hmm.
 
Don't have time to look it up right now, but...what are the rules re: BasicMed and the various options discussed here?

It would suck to end up with a denied medical, forever precluding BasicMed as an option, for something like cataract surgery/lens replacement. (I'm already on BasicMed, so not a problem for me, just thinking that folks with a Class III and no BasicMed might want to consider it).
 
Don't have time to look it up right now, but...what are the rules re: BasicMed and the various options discussed here?

It would suck to end up with a denied medical, forever precluding BasicMed as an option, for something like cataract surgery/lens replacement. (I'm already on BasicMed, so not a problem for me, just thinking that folks with a Class III and no BasicMed might want to consider it).

I've had cataract surgery and I opted for single vision (monofocal) intraocular lenses set for distant vision. No problem getting an FAA Medical Class III or BasicMed renewed if one has a good outcome after the procedure. I have both simultaneously, issued by my AME. Having cataract surgery would need to be disclosed on the BasicMed's CMEC form, just like on the FAA medical application form.

Here is the general FAA guidance:



You will have to have your Optometrist or Ophthalmologist fill out FAA Form 8500-7, "REPORT OF EYE EVALUATION", to take to your AME afterward for an FAA Medical.



Note this if you decide on multifocal or accommodating intraocular lens implants (Ref: https://www.faa.gov/about/office_or...am/ame/guide/dec_cons/disease_prot/binocular/):

"Adaptation period before certification:

  • Surgical lens implantation - minimum of 3 months post-operative"


For all of the eye examination info, see pages 60 - 71 of "GUIDE FOR AVIATION MEDICAL EXAMINERS (Updated 05/25/2022)":

 
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With the last post here about 18 months ago, I’m interested to know if anyone else that has had lens replacements would share their experiences.
 
Me, too.

This is all good to know. I'm at a stage now (67) where my LASIK from about 15 years ago to correct a lifetime of myopia is not holding true. My dollar-store reading correction has gone from 1.25's to 2.00 at present, and there's a considerable zone of blur at intermediate distances that is there with and without readers. Although I got LASIK in the hopes of shedding glasses/contacts and only having to wear readers while reading, I find myself nowadays wearing them the entire time I'm awake. I tried progressive bifocals before the LASIK and hated them. In the last few months I've been noticing that my uncorrected distant acuity is no longer near the 20/20 (originally 20/15 post-op) that I've enjoyed since the procedure. Today, my distant vision is the same whether I am looking through my readers or not. This tells me I've become "over-minus'd" about one diopter. I imagine if I could take a diopter off of my current LASIK correction I would have much sharper distance and intermediate vision and could probably go back to weaker reading glasses.

I plan to discuss this with my ophthalmologist soon. I don't know if I have cataracts brewing (likely at my age) but if replacement intra-ocular lenses are in my near-term future, that will certainly influence what I decide to do in the interim. A second round of LASIK would make no sense if intra-ocular lens implants are just around the corner. The capabilities of the new implant lenses sound very attractive.
 
With the last post here about 18 months ago, I’m interested to know if anyone else that has had lens replacements would share their experiences.
My wife had cataracts, suspected when her vision became more difficult to correct to 20/20, confirmed by her ophthalmologist. She had the lenses extracted and replaced. Multi-focal lenses were one option, but not covered by insurance. Monovision was a possibility and she knew she could tolerate that since she had used monovision contact lenses. She finally opted for mono-focal lenses and resigning herself to buying drug-store readers. She has negligible astigmatism so toric lenses didn't need to be considered.

The operation, one eye at a time, was nothing. Local anesthesia, about 15 minutes. Zero pain. Only significant inconvenience was a rather elaborate regimen of eyedrops for awhile. She had no starburst, did have minor issues with floaters for about 2-3 weeks and then disappeared. Vision in both eyes now is 20/20 and she has a fleet of +1.5 diopter readers ($15 for three pairs at Walgreens). Interestingly...she noted that her vision got brighter. She hadn't realized that things were looking dingier and yellower and was astonished by the difference after the first one was done. She had been using increasing amounts of bleach in the wash as she couldn't figure out why the towels weren't getting whiter :)
.

I had radial keratotomy decades ago, pre-LASIK. Did great until I got old. Now, I'm waiting for the point where my vision can't be corrected to 20/20. And so far, our towels still look white to me. Our ophthalmologist is a colleague of mine. He examined me the other day and said he could likely make a case for cataract surgery that my insurance company would go for, but my vision is still correctable to 20/20 so I'm holding off for now.
 
Had both eyes replaced with new lenes due to cataracts at age 60. Made a world of a difference. Very straight forward procedure with little post-procedure effects (other than the intended one). Chose mono-lenses that improved my overall natural vision and made the world clear again. Still need glasses for close-up work, but far vision just fine.

No haloes or starbursts,

As a side note: Showed me the benefit of wearing sun-glasses to protect eyes from cataracts!!!
 
I had cataract lens replacement surgery on both eyes a little more than a year ago. I had extreme nearsight and astigmatism as well as cataracts. I paid the extra and used the Alcon Vivity lenses. These are extended depth of field lenses and are also available as toric lenses to correct astigmatism. My distance vision now is excellent - better than it's ever been with glasses or contacts - and I can focus on detail into about 14". I'm seeing traffic that I could never spot before. I can see the panel just fine without readers. I only use those for finer print like the newspaper or magazines. I have bifocal safety glasses for the shop. Great for seeing detail work. Wish I'd done it years before.

By the way, I fly under basic med. I emailed AOPA and they said that it was up to me to self certify and that nothing else was required but that to return to fly. No notification or paperwork necessary.


Ed
 
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