What was it like to have a Cataract operation in Thailand

[JetsetBkk]

One thing I found surprising was how much cataract there was in my eyes. The doctor said there was a lot and that the operation would take a lot of time to remove it all. But, after he had finished one eye, I looked down at the surgery floor through the new lens and it was pure white.

 

I then looked down through my eye with the cataract and the floor was yellow.

 

And at home, the same thing - the shower wall was white through the new lens and yellow through the old.

 

[doctormann]

3 hours ago, JetsetBkk said:

One thing I found surprising was how much cataract there was in my eyes. The doctor said there was a lot and that the operation would take a lot of time to remove it all. But, after he had finished one eye, I looked down at the surgery floor through the new lens and it was pure white.

 

I then looked down through my eye with the cataract and the floor was yellow.

 

And at home, the same thing - the shower wall was white through the new lens and yellow through the old.

 

Yes, remarkable isn't it!  I thought that my floor tiles were green but no, they are actually blue!

 

[lopburi3]

3 hours ago, JetsetBkk said:

One thing I found surprising was how much cataract there was in my eyes. The doctor said there was a lot and that the operation would take a lot of time to remove it all. But, after he had finished one eye, I looked down at the surgery floor through the new lens and it was pure white.

 

I then looked down through my eye with the cataract and the floor was yellow.

 

And at home, the same thing - the shower wall was white through the new lens and yellow through the old.

 

The operation is to remove the lens which has cataract so not sure why it would take more time for advanced cataract - the same size lens must be removed.  Perhaps the cloudy lens makes it harder to do safely?  

[doctormann]

2 minutes ago, lopburi3 said:

The operation is to remove the lens which has cataract so not sure why it would take more time for advanced cataract - the same size lens must be removed.  Perhaps the cloudy lens makes it harder to do safely?  

I was told by my surgeon that advanced cataracts tend to be denser and need more ultrasonic power and time to break them up.  This was certainly my experience - my left eye was worse than my right and the surgeon did take quite a long time to complete the removal of the cataract.  Right eye took maybe 15 minutes - left eye took 20 minutes or more.  Both eyes now good.

[JetsetBkk]

4 hours ago, doctormann said:

I was told by my surgeon that advanced cataracts tend to be denser and need more ultrasonic power and time to break them up.  This was certainly my experience - my left eye was worse than my right and the surgeon did take quite a long time to complete the removal of the cataract.  Right eye took maybe 15 minutes - left eye took 20 minutes or more.  Both eyes now good.

If I recall correctly, that was how it was explained to me, too - the thicker the cataract, the longer it takes to blast it away!  ???? 

 

I wonder where all the bits go?  ????  

 

[bert bloggs]

18 hours ago, doctormann said:

I was told by my surgeon that advanced cataracts tend to be denser and need more ultrasonic power and time to break them up.  This was certainly my experience - my left eye was worse than my right and the surgeon did take quite a long time to complete the removal of the cataract.  Right eye took maybe 15 minutes - left eye took 20 minutes or more.  Both eyes now good.

My main worry is ,i read that you cant sleep on the side you had done ,well i can only sleep on my rght sideand thats the one their doing

[sandyf]

19 hours ago, lopburi3 said:

The operation is to remove the lens which has cataract so not sure why it would take more time for advanced cataract - the same size lens must be removed.  Perhaps the cloudy lens makes it harder to do safely?  

I had the first one done Sept 2019, took 8 minutes, and when I saw the surgeon for the check up I said it felt like there was something in the corner of the eye. He explained that was the scar from where he cut the eye to remove the natural lens and insert the artificial lens. Said it wold fade over about a month and he was spot on.

I was a bit nervous so waited until I had done the first before booking the second, so had to wait about 9 weeks. In the meantime the hospital had created a new dedicated theatre with laser equipment. That op was a bit more uncomfortable but I didn't get the "foreign body" sensation. Post op I had 20/20 in both eyes and the astigmatism was greatly reduced. I don't wear glasses now, other than sunglasses, only problem is in the supermarkets reading some of the print on packaging.

Both operations came to 26K and I paid 10K for the ops to be carried out by the hospital CEO, with aftercare job lot was about 40K.

I was offered variofocal, about 20K more per eye, but dismissed that immediately. I wore variofocal glasses for decades and not without problems. You can change glasses much easier than the lens in the eye.

[doctormann]

1 hour ago, bert bloggs said:

My main worry is ,i read that you cant sleep on the side you had done ,well i can only sleep on my rght sideand thats the one their doing

You need to avoid putting any pressure on the operated eye for at least a few days so yes, you should not sleep on that side.  I was also told to wear an eye shield for a month - probably to avoid any inadvertent rubbing of the eye.

 

Sleeping on the opposite side to normal didn't come naturally but it had to be done.  The eye shield was a right PITA!

 

Can you not sleep on your back?  Anyway, no problem for you when you have your left eye done - presumably you are having both eyes done? - as you can then sleep on your right side, as normal.

[bert bloggs]

2 minutes ago, doctormann said:

You need to avoid putting any pressure on the operated eye for at least a few days so yes, you should not sleep on that side.  I was also told to wear an eye shield for a month - probably to avoid any inadvertent rubbing of the eye.

 

Sleeping on the opposite side to normal didn't come naturally but it had to be done.  The eye shield was a right PITA!

 

Can you not sleep on your back?  Anyway, no problem for you when you have your left eye done - presumably you are having both eyes done? - as you can then sleep on your right side, as normal.

No just the one eye as i do not have a cataract in the other eye

[JimmyJ]

On 3/9/2022 at 8:20 AM, CM Dad said:

I have had both eyes done here in Chiang Mai at the main government hospital in the city.  The doctor that many of my Thai friends consider to be the best in Chiang Mai did both surgeries a few years apart.  Both were out-patient procedures.  I went to the hospital in the morning and was back home by noon.  Total cost for each surgery was less than 50,000 baht.  Although I did have to get new glasses after each operation, my vision is now improved to the point that I could read without glasses if I wanted.  However, I rarely do that simply to avoid straining my eyes.  I have worn glasses most of my life, so it feels natural to wear them.  I had absolutely no complications with either of the surgeries.  Many of my Thai friends are doctors and all of them tell me to avoid the over-priced private hospitals,

Which hospital?

 

"The doctor that many of my Thai friends consider to be the best in Chiang Mai did both surgeries a few years apart."

 

And his name is...?

 

 

[crouchpeter]

On 3/10/2022 at 12:42 PM, Sheryl said:

 

There is always an injection to block nerves immediately before a cataract operation, unless it is done under general anesthesia (which is rare).

 

The injection is done in the OR itself so people may not think to mention it.

He said he had local in his cheek, so I'm wondering what block that was to anaesthetise the eye. That nerve, the sub-orbital, blocks the maxilla from 1 to 3 only.?

[orientalist]

Anyone had a cataract op at Chulabhorn or Ramathibhodi hospitals in Bangkok? The latter has good doctors but none of the admin or nursing staff speak English and can be unhelpful at times. I am looking for somewhere cheaper than Rutnin, which recently quoted me 80K+ for one eye.

[Sheryl]

2 hours ago, orientalist said:

Anyone had a cataract op at Chulabhorn or Ramathibhodi hospitals in Bangkok? The latter has good doctors but none of the admin or nursing staff speak English and can be unhelpful at times. I am looking for somewhere cheaper than Rutnin, which recently quoted me 80K+ for one eye.

Any government hospital can do this, at much lower price than private, but you will face the same inconveniences and language issues you mention at all of them

 

There is a government eye hospital in Nakhon pathom (about 1 hour drive from Bkk)  https://www.metta.go.th/

this would be the very best government facility to use for any eye issue, and TV members have reported favorably on it

They have a small branch in Sukhumvit, near Ekamai terminal in the Mediplex building I think.  I haven't heard any reports on it though. Tel 02 712 2066  email [email protected]

 

[orientalist]

I went to the Mediplex branch yesterday for a consultation. Very professional and friendly, though a bit slow as there seemed to be only one doctor there. After the usual vision tests, including a nasolacrimal duct flow test, and an examination of my retina, the doctor quoted 40,000 baht for one eye (monocular) and kind of recommended the blue-light blocking lens. Researching this a little, the jury seems to be out as to the benefits of BL blocking lenses. 

 

There is a queue of 3-4 weeks for the op so it'll end up being after New Year for me. Prior to surgery they want me to do what amounts to an annual checkup plus HIV and Hep B tests at a hospital. I suppose this is because they are a clinic rather than a hospital and they don't want any surprises.

 

The consultation and tests cost 1200 baht.

[orientalist]

In the end I had the op at the Nakhon Pathom facility - Metta Pracharak Hospital. You need to speak Thai, but very good service. It cost me 30,400 baht, 8000 of which was the "out of normal hours" surcharge. 

[superal]

16 hours ago, orientalist said:

In the end I had the op at the Nakhon Pathom facility - Metta Pracharak Hospital. You need to speak Thai, but very good service. It cost me 30,400 baht, 8000 of which was the "out of normal hours" surcharge. 

Thanks for the info and update

Having read some reviews on the above hospital , I understand why you chose out of normal hours . One reviewer said he had an appointment time but waited another 4 hours . Many people waiting to see the doctor . How long were you in the hospital from start to finish ? I assume all is well with your sight , post-op ? BTW , how did you pay them , cash or card ? Also did you have a pre-op consultation by appointment or have to wait in the queue and was the operation date given then ?

[orientalist]

3 hours ago, superal said:

Thanks for the info and update

Having read some reviews on the above hospital , I understand why you chose out of normal hours . One reviewer said he had an appointment time but waited another 4 hours . Many people waiting to see the doctor . How long were you in the hospital from start to finish ? I assume all is well with your sight , post-op ? BTW , how did you pay them , cash or card ? Also did you have a pre-op consultation by appointment or have to wait in the queue and was the operation date given then ?

I had the op 2 days ago. My eye feels the same as before but it's like the vision has gone from 720p to 4K and colours are vivid. I paid by credit card. They can handle foreign cards but you should inform them in advance.

The first time I went to the hospital all the doctors were at a conference so they gave me a 2pm appointment the following week. On that day I did all the different tests and measurements for a cataract op and then saw the doc around 4pm. Another test and then saw the doc again to finalise things. I wanted a simple monocular lens set for distance, so nothing complicated. I didn't ask about toric lenses to correct astigmatism. The doc asked what time I wanted the op and I said afternoon, so I got a 1pm appointment a month later with the op scheduled after 4pm. This is what the receipt describes as "outside government office hours."

On the day of the op there is a fair bit of waiting as you prepare for surgery. They dilate your eye for an hour, give you paracetamol and Valium (2mg), and wheel you down to the operating rooms. Then another wait of maybe 20 mins before you go in. The op takes about 15 mins after they put numbing drops in your eye. No pain, just some pulling sensations and slurping noises from a machine, plus three briight lights. You are allowed to blink except at the end. They put a patch on your eye and wheel you back to your bed. Then later a nurse comes annd shows you how to clean the eye and tapes a guard over it. She tells you how to prevent infections and gives you a leaflet. Then a long wait for the doc to come and check the incision. I got out about 7.30pm. 

[orientalist]

I recommend anyone thinking of having the op join the FB Cataract Op group, read as much as you can and ask all the questions you have before seeng the doc. You can have the lens set for close-up instead of distance, you can have multifocul lenses or you can get toric lenses for astigmatism, the latter more expensive. You can also choose a blue-light-blocking lens, which seems to be standard these days except in the UK NHS.

I believe they knocked 4500 baht off my bill because I had already had a full health chexk at another hospital and given them the report.

The nurse told me about a foreign teacher who went for the op but was so terrified they had to give him an injection to numb half his face. I guess that's an option but it isn't necessary. The doctors know what they are doing!

[Tropicalevo]

19 minutes ago, orientalist said:

The doctors know what they are doing!

That is my experience as well.

Just under 3 weeks ago I had lenses in both eyes replaced with trifocal lenses. Cataracts in both eyes.

The operation was almost 'fun'. Almost like I imagine taking LSD back in the '60s but without any after affects.

I went for Bright View.

https://www.brightviewcenter.com/products_services_detail

Expensive but absolutely brilliant.

I do a lot of work on computers and I needed two different pairs of glasses for different distances. Reading and large computer screen about 1 meter away. My long distance vision was starting to suffer as well.

After the first op (right eye) I was reading emails on my laptop within 4 hours. Same with the op on my other eye.

When I got home , I threw away 5 pairs of glasses. Definitely need sunnies though. (They should call it exceptional Bright View.

Everything is just amazing.

[superal]

38 minutes ago, orientalist said:

I had the op 2 days ago. My eye feels the same as before but it's like the vision has gone from 720p to 4K and colours are vivid. I paid by credit card. They can handle foreign cards but you should inform them in advance.

The first time I went to the hospital all the doctors were at a conference so they gave me a 2pm appointment the following week. On that day I did all the different tests and measurements for a cataract op and then saw the doc around 4pm. Another test and then saw the doc again to finalise things. I wanted a simple monocular lens set for distance, so nothing complicated. I didn't ask about toric lenses to correct astigmatism. The doc asked what time I wanted the op and I said afternoon, so I got a 1pm appointment a month later with the op scheduled after 4pm. This is what the receipt describes as "outside government office hours."

On the day of the op there is a fair bit of waiting as you prepare for surgery. They dilate your eye for an hour, give you paracetamol and Valium (2mg), and wheel you down to the operating rooms. Then another wait of maybe 20 mins before you go in. The op takes about 15 mins after they put numbing drops in your eye. No pain, just some pulling sensations and slurping noises from a machine, plus three briight lights. You are allowed to blink except at the end. They put a patch on your eye and wheel you back to your bed. Then later a nurse comes annd shows you how to clean the eye and tapes a guard over it. She tells you how to prevent infections and gives you a leaflet. Then a long wait for the doc to come and check the incision. I got out about 7.30pm. 

Once again , thanks for the detailed info . The procedure sounds very much the same as the op I had in the UK on my left eye . Was pleased to hear that they did not give an injection into your eye , as some hospitals do in Thailand  ( according to Sheryl , if my memory serves me right ) .           Forgive me if you have mentioned before but have you had both eyes operated on for cataracts ?

[superal]

3 minutes ago, Tropicalevo said:

That is my experience as well.

Just under 3 weeks ago I had lenses in both eyes replaced with trifocal lenses. Cataracts in both eyes.

The operation was almost 'fun'. Almost like I imagine taking LSD back in the '60s but without any after affects.

I went for Bright View.

https://www.brightviewcenter.com/products_services_detail

Expensive but absolutely brilliant.

I do a lot of work on computers and I needed two different pairs of glasses for different distances. Reading and large computer screen about 1 meter away. My long distance vision was starting to suffer as well.

After the first op (right eye) I was reading emails on my laptop within 4 hours. Same with the op on my other eye.

When I got home , I threw away 5 pairs of glasses. Definitely need sunnies though. (They should call it exceptional Bright View.

Everything is just amazing.

Did you have both eyes operated on at the same time ?

[orientalist]

12 minutes ago, superal said:

Once again , thanks for the detailed info . The procedure sounds very much the same as the op I had in the UK on my left eye . Was pleased to hear that they did not give an injection into your eye , as some hospitals do in Thailand  ( according to Sheryl , if my memory serves me right ) .           Forgive me if you have mentioned before but have you had both eyes operated on for cataracts ?

No, this was my first. I was putting it off for financial reasons but uveitis and steroid drops last year made the cataracts much worse. Like Tropicalevo I have used multiple pairs of glasses and now varifocals but at my age couldn't justify the expense of varifocal IOLs and they have some disadvantages. 

[Sheryl]

5 hours ago, superal said:

Was pleased to hear that they did not give an injection into your eye , as some hospitals do in Thailand  ( according to Sheryl , if my memory serves me right ) .           

 

Not into the eye. Injection of a nerve block  is commonly done below the eye (upper check area). 

[Tiber]

At going on 77could haw sworn by now cataracts, but no, but am going for lense correction, laser soon

[orientalist]

An update on Metta Pracharak eye hospital:

 

First, my bill was not reduced because of my having a health check elsewhere. When the bloods are done there the cost is added to the bill. It seems they just tell everyone the cost will be plus or minus 35k and then it depends on what they have to do. 

 

Impressed with the service we took the gf's mother there as she was blind in one eye (almost blind in the other) due to a very dark cataract. They insisted on an overnight stay at the hospital as the op would be more difficult. They must have expected it to hurt because they gave her an injection under the eye. The op went ok and we chose the private room at 1800 baht. In the morning the occular pressure was so high they asked us to stay another night. 

She was discharged the following day but really couldn't see much other than light. The total cost was 27k including the 8k after-hours fee and 3600 baht for the room. They had reduced the basic op fee from 22k to 11k without any explanation. My guess is a trainee surgeon did the op under supervision. They had us install their app to do a video call consultation for the first 3 days. So far so good. 

[orientalist]

On 7/10/2023 at 12:46 PM, orientalist said:

They had reduced the basic op fee from 22k to 11k without any explanation. My guess is a trainee surgeon did the op under supervision. 

Oops. Scrub the above comment. When I checked both bills it seems the lens cost for the m-i-l was just 700 baht whereas mine was 6,500. Not sure why. Possibly because I had asked for blue-light-blocking IOLs and they may have been a foreign import. I didn't discuss the cost of the lens with the doc. Anyway, had my other eye done yesterday and all went well. Total cost 30,600 baht. 

[orientalist]

A bit of extra information about the IOLs:

It turns out the m-i-l, because of her dense, hard cataract, needed a procedure called extracapular cataract extraction (ECCE) which allows for a bog-standard rigid IOL made of PMMA. It was manufactured by Neo Eye in Indonesia.

I got the ultrasound surgery using a popular American IOL made by Alcon. It's foldable acrylic and comes with its own inserttion device - supposedly more accurate and quicker to use. So that's why my op was more expensive. Unless you have a dense cataract I think ultrasound is probably the default procedure.

[LatPhrao]

Have recently been searching for cataract surgery options in Thailand.  This thread came up but information was out of date. But was a start.                                                                                                          I can now vouch for and would like to update that a quality option at Hospital Sirivej Lamphun aka Princ Lamphun Hospital, at the small town of Lamphun (not far from Chiang Mai), is available.  In the past they ran a promotion targeted at foreigners for 18,000 thb.  As of this month - May 2024 that price is now 26,700 thb.                                                                                                                                                            Cataract Surgery with Standard Lens: 27,600 THB  (*best price found in Thailand - May 2024)
Cataract Surgery with Specialized Lens: 40,800 THB      

Hospital is available on Line for consulting and working out appointments.                                                                                         I have just completed the surgery - can recommend the caring staff, the nurses and aides, the hospital - Princ Lamphun Hospital, the facility, the surgeon. Hospital is in a rustic setting. The hospital is modern, clean, well maintained  They do have a few English speakers. I had the fortune of a Thai friend, English speaker, who accompanied me.  Highly recommend doing the same to ease all aspects of travel, lodging and dealing with hospital and staff.

[jas007]

Cataract surgery with only local anesthesia?  I never knew that was possible.  
 

In the USA, I was under general anesthesia.  Whatever they did during the operations was a mystery to me.  I went in and the next thing I knew the operation was over. I think I’d rather have it that way than to try to lie still during an operation. That would probably drive me nuts.

 

Anyway, I now have another problem. One of my IOLs is dislocated, so I’m going to have to schedule surgery to have that fixed.  Supposedly, it’s a more difficult, longer operation, so I guess I’ll be finding out how they do it in Thailand. General anesthesia will probably make it more expensive, if that’s how they do it.

[Sheryl]

18 hours ago, jas007 said:

Cataract surgery with only local anesthesia?  I never knew that was possible.  
 

In the USA, I was under general anesthesia.  Whatever they did during the operations was a mystery to me.  I went in and the next thing I knew the operation was over. I think I’d rather have it that way than to try to lie still during an operation. That would probably drive me nuts.

 

Anyway, I now have another problem. One of my IOLs is dislocated, so I’m going to have to schedule surgery to have that fixed.  Supposedly, it’s a more difficult, longer operation, so I guess I’ll be finding out how they do it in Thailand. General anesthesia will probably make it more expensive, if that’s how they do it.

 

Do not delay on this, it is considered an ocular emergency as there is a risk of the dislocated lens damaging the eye.

 

Both repair of a dislocated IOL and cataract surgery are usually done under local anesthesia in Thailand. It used to be the same in the US and still often is, but with the advent of very effective and comparatively safe   short-acting IV sedation (e.g. propofol), that is often also provided in US. This is not actually general anesthesia, rather what is termed "conscious sedation", the patient is deeply sedated but rousable to strong stimuli. However  there is no memory of the procedure afterwards.  (propofol can also be used in combination with anesthetic gases for true general anesthesia but that would not  have been done for a cataract surgery).

 

If you feel strongly about it, you can request IV sedation for the repair, but it will add to the cost. The procedure without it won't hurt, but of course can be anxiety-provoking to go through. Up to you -- but as mentioned, do not delay.