catarac treatment and options

[notrub]

It seem as though I have a catarac problem.  All the lens options on the test glasses were not satisfactory.  The doctor (a real one) asked me to look through a pinhole in a disc held in front of my eye and suddenly my vision cleared.  I tried this again at an opticians and she confirmed that I have cataracs.  The doctor offered to remove my cloudy lens and put in a clear one.  The problem with that is fixed focus and, while I understand the concept it is not clear to me how that would affect my daily life.  Also, is that the only option?  I have read that lazier treatment has been effective and I would assume this sort of treatment would not affect being able to focus on different distances.

 

I am 70 years old and have had perfect eyesight all my life.  Now night driving has the starburst lighting effect and so I avoid driving then.

 

Any comments or help please?  Thanks in advance.

[Sheryl]

Whether done with a laser or the conventional  phacoemulsification, cataract surgery consists of removing the lens of the eye after which an artificial lens is placed.

 

There are different types of artificial lenses:

 

Fixed-focus monofocal. This is what you refer to and most people will need reading glasses with this type of lens - unless you opt for monovision whereby different strength lenses go in each eye, leaving one eye 20/20 and the other a bit near - for reading. The brain adjusts and "sees" out of the appropriate eye. Works well for some people others have trouble with the adjustment.

 

Accommodating-focus monofocal. These lenses  are very new, I'm not sure if available in Thailand. They  respond to eye muscle movements to shift focus from far to close up. I do not know how well they work.

 

Multifocal. These lenses work like bifocal glasses - there are different strengths on different parts of the lens to allow for near and far vision. I have heard mixed reports about them.

 

Anyway with cataracts there is no choice but surgery (though timing of the surgery depends on how much your vision is affected - no need to rush it if you are still getting around OK).  Phacoemulsification is much more widely used in Thailand than laser and laser approach does not give better result. Whether you will need reading glasses afterwards will depend not on the surgical technique but on the type and strength of lens implanted afterwards.

 

Best to see a specialist in this and discuss the pros and cons on different types. If you are in or near Bangkok, Rutnin hospital is reocmmended. Dr. Roy there speaks fluent English and has been well recommended by other TV members. http://www.rutnin.com/en/doctor/#2

 

 

 

[ubonjoe]

27 minutes ago, notrub said:

The problem with that is fixed focus and, while I understand the concept it is not clear to me how that would affect my daily life.

I had it done and it did not affect my life at all other than improved vision in that eye. Before it was done my vision was blurry in that eye and it was a dramatic improvement after the surgery. 

[lopburi3]

As said this is a relatively normal condition in our 70's and once it becomes an issue it is best to take care of it.  You will be amazed at how colorful the world looks once it is done (although your brain will tone it down in time).  With the single vision lens your distance sight should be fine and all normal activities without glasses.  But for reading (shopping labels) and such you will probably want to have off the shelf type reading glasses.  You may also want a weak (1.5 type) for computer use - although I do not use when watching video on computer.   

[Thanyaburi Mac]

I've had cataracts in both eyes done at Rutnin, fixed focus replacements, all OK.

 

Mac 

[notrub]

Thank you very very much for comments re eye cataracts.  I saw a Dr. Nithidol here in Buriram who runs his private practice weekends and is the eye specialist at the main hospital here.  He has asked for 20,000 THB for the operation and this seems OK to me.  Are there different types of fixed focus lenses or just the one?  Thanks again. 

[lopburi3]

There are different makers but believe all about same cost and do not believe other offered as an option; and the size/shape of the lens is important - you should have a special check made to measure and not sure all clinics would have that equipment.  

[notrub]

Further to cataract treatment here is a link to regeneration of the lens using stem cells.  http://www.bbc.com/news/health-35762713  pretty neat.

[Sheryl]

This is still considered experimental. It has been done on only 12 patients, all of them children. There has been no experience yet on aging eyes.

 

There has also not been much time following them up yet. One of the big concerns with stem cell treatments is the risk of tumor formation due ot uncontrolled cell growth, which could occur years after the fact.

 

It is a promising line of research but a long way from being available as treatment.

[wealthychef]

On 3/6/2018 at 7:44 PM, Sheryl said:

There has also not been much time following them up yet. One of the big concerns with stem cell treatments is the risk of tumor formation due ot uncontrolled cell growth, which could occur years after the fact.

Yes, but this is not true for all stem cell treatments.  There is definitely disagreement about stem cells, but nowadays mesenchymal cell treatments seem to be the preferred treatment precisely because they avoid the tumor problem: "(in) embryonic stem cells, many experimental studies have observed tumor formation.   This is also a concern for what are called induced pluripotent stem cells (iPSCs).... Our main cells of interest, however, also found in bone marrow and really any tissue that has blood vessels in it, are mesenchymal stem cells (MSCs), which are the ones primarily used for regenerative treatments.”  Excerpt From: Jason Marchetti MD. “A Buyer's Guide to Stem Cell Therapies: Safely Choose the Right Regenerative Treatment for You.”  I recommend getting this book to become more educated about the treatments and risks involved.  Basically just make sure they are using mesenchymal cells. Here's an article that I think you'll find authoritative that I believe shows mesenchymal cells are a real deal, if not yet FDA approved.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444610/

 

Edited March 8, 2018 by wealthychef
Added NIH article