Cataract Surgery Questions

[homeseeker]

Later this year I go for my annual eye test at a private hospital in Bangkok. I have cataracts in both eyes but so far the eye specialist has not recommended cataract surgery. When he does I would like to know:

i) which is the best cataract surgery?

ii) What is Lasik surgery?

iii) My insurance policy excludes eye disorders as well as excluding Lasik surgery but says "excepting a cataract surgery for implanting an intraocular lens..." 

what does this mean?

 

Many thanks for any input.

[Longwood50]

You do not want Lasik.  Lasik is for reshaping the cornea to improve vision.  A cataract is a clouding of the lens.  Reshaping the cornea will still leave you with a cloudy lens and poor vision. Plus Lasik makes selecting a lens replacement due to cataracts much more difficult.  

I had double cataract surgery earlier this year.  My vision was still not bad and every opthamologist I went to said I certainly could wait.  I am 73.  I said why should I wait until 80 to get better vision. 

I went to Jomtien Hospital saw Dr. Santa Methasari.  Excellent credentials, speaks wonderful English and is extremely pleasant.  He also is on staff at Bangkok Hospital Pattaya but the cost there is much higher.  

Cost for monofocal lens is 39,000 baht per eye.  Includes all the check ups, surgery, hospital costs, and follow up appointments.  I got a Johnson & Johnson lens so nothing "cheap" about what was used.  The cost would be more if you require a toric lens because of severe astigmatism.  Most opthamologists would tell you not to go with multi-focal which are the most expensive because they are difficult to accurately determine the correct power of lens replacement. 

I went with Mono Vision.  I have one eye slightly undercorrected and one fully corrected.  That allows me to read without glasses, and still have great vision for distance.  Your brain automatically selects which eye gives you the best up close or distance vision. 

My only complication is some slightly sticky feeling which the doctor said will diminish over time. 

 

[Jumbo1968]

2 hours ago, Longwood50 said:

You do not want Lasik.  Lasik is for reshaping the cornea to improve vision.  A cataract is a clouding of the lens.  Reshaping the cornea will still leave you with a cloudy lens and poor vision. Plus Lasik makes selecting a lens replacement due to cataracts much more difficult.  

I had double cataract surgery earlier this year.  My vision was still not bad and every opthamologist I went to said I certainly could wait.  I am 73.  I said why should I wait until 80 to get better vision. 

I went to Jomtien Hospital saw Dr. Santa Methasari.  Excellent credentials, speaks wonderful English and is extremely pleasant.  He also is on staff at Bangkok Hospital Pattaya but the cost there is much higher.  

Cost for monofocal lens is 39,000 baht per eye.  Includes all the check ups, surgery, hospital costs, and follow up appointments.  I got a Johnson & Johnson lens so nothing "cheap" about what was used.  The cost would be more if you require a toric lens because of severe astigmatism.  Most opthamologists would tell you not to go with multi-focal which are the most expensive because they are difficult to accurately determine the correct power of lens replacement. 

I went with Mono Vision.  I have one eye slightly undercorrected and one fully corrected.  That allows me to read without glasses, and still have great vision for distance.  Your brain automatically selects which eye gives you the best up close or distance vision. 

My only complication is some slightly sticky feeling which the doctor said will diminish over time. 

 

I thought Jo then Hospital was the same group as Bangkok Pattaya Hospital ?

[desdeash]

I had both eyes done at Ratchawithi Hospital near Victory Monument about 3 years ago. Everything was fantastic - the doctors, nurses, staff. I booked an appointment and was seen in a week, one week later the first eye was done, another week the second eye. In Canada it would have been free but I'd have had to wait over a year.

Before the surgery I could barely see the eye chart with my left eye, never mind the letters. After the surgery I could read the bottom line. 

I think I paid about 20,000 baht for each eye - I remember the total cost was  about $1,500 Canadian . 

[Purdey]

I had my cataracts taken out several years ago at Rutnin Eye Hospital in Asoke Montri road in Bangkok. Since a child I was short sighted. My eyes became cloudy and Rutnin operated. It was pretty straightforward and didn't take long. They only did one eye first to ensure there are no complications.

The second one two weeks later. 

For the first time, I was able to read and drive without glasses. 

Now my left eye is becoming cloudy so I will go back and see if they can operate again. A general practitioner told me 3 is the maximum number of operations. 

The last time it cost 50,000 baht per eye but I have company health insurance so not a problem.

[HarrySeaman]

I had Lasik to correct my vision, very near sighted (>9 dioptes in each eye), in 2002 at age 50 and have never regretted it, but it will make choosing a lens for cataract surgery by the  ophthalmologist much harder.

 

I first went to Bumrungrad and was seen by the head of ophthalmology.  It was the worst and most rushed eye examination I have ever been given but he scheduled the surgery the next morning.  I was very shaken by the exam and his "bedside manner".  I walked down to the Nana Hotel, where I used to stay before renting a condominium, to sit and relax.  Some of the lobby guys I knew ask what was wrong and when I explained they told me to cancel the surgery and go to Rutnin Eye Hospital.

 

At the Rutnin Eye Hospital I received the best eye exam I had ever had, bar none, then the surgeon told me she wouldn't do the surgery for at least a month.  Even though I hadn't been wearing my contacts for 2 weeks in anticipation of the surgery my corneas were still swollen from wearing them for 30 years.  The surgeon took her time to answer all my questions before making an appointment for another exam A month later I had the surgery and the results were, and still are amazing.  My only regrets aren't asking for Valium in advance since I tensed up during the surgery, which made it harder for the surgeon, and not having anyone to escort me home and stay with me for a couple of days.

 

The lessons from my story:

1:  Trust your instincts about the ophthalmologist.  Unless you fell completely confident in the surgeon seek another opinion.

2:  If you are to remain awake during the surgery consider asking for something like Valium to keep you relaxed and have someone with you to make sure you get home safely.

[Longwood50]

25 minutes ago, Jumbo1968 said:

I thought Jo then Hospital was the same group as Bangkok Pattaya Hospital ?

Yes it is, however I "think" to promote the hospital it is running promotions and has lower pricing to get people to use the hospital.  Similar to a restaurant group that opens a new location under a different name.  They want to entice people to try it. 

One way or another, I got the same doctor I would have had at Bangkok Hospital and brand new first class facilities at Jomtien.  Very pleased. 

 

[allanos]

I had cataracts removed and monofocal intra-occular lenses implanted, ten years ago. I don't

know what my corrected vision is, but it's pretty good. I read, watch tv and drive without any

problem whatsoever, and the surgery has been absolutely trouble-free. I am 77 years old.

 

The ophthalmologist cautioned, before I went ahead with the procedure, that there is a

failure rate of around 7%. I thought it was a chance worth taking, and have been thankful

since, with the results.

 

Prior to the surgery, I had struggled with severe cloudy vision, so my only regret was that I

hadn't gone ahead with the cataract removal, earlier.

[luicks]

Has anyone had cataract surgery recently? I'm looking for an affordable hospital. I'm thinking about Srinagarind Hospital of Khon Kaen University but its rather difficult to get even a ballpark figure about the cost. Any recommendations?

[Longwood50]

14 minutes ago, luicks said:

'm looking for an affordable hospital. I'm thinking about Srinagarind Hospital of Khon Kaen University but its rather difficult to get even a ballpark figure about the cost. Any recommendations?

Excellent care first rate facilities, and includes all medicine,  pre-opt, and post op exams.  I am going for my 6 month exam next week.  There are two doctors only there on Thursday and the other on Friday.  Both speak English however I like Dr. Santa Methasari who did my surgery.  Very friendly great English.  The other doctor a little less so.  Jomtien Hospital Pattaya

 

Edited July 22, 2022 by Longwood50

[luicks]

Thank s a lot. That is very helpful.

 

[transam]

1 hour ago, Purdey said:

I had my cataracts taken out several years ago at Rutnin Eye Hospital in Asoke Montri road in Bangkok. Since a child I was short sighted. My eyes became cloudy and Rutnin operated. It was pretty straightforward and didn't take long. They only did one eye first to ensure there are no complications.

The second one two weeks later. 

For the first time, I was able to read and drive without glasses. 

Now my left eye is becoming cloudy so I will go back and see if they can operate again. A general practitioner told me 3 is the maximum number of operations. 

The last time it cost 50,000 baht per eye but I have company health insurance so not a problem.

How can a plastic lens go cloudy...?

[Jumbo1968]

1 hour ago, Longwood50 said:

Yes it is, however I "think" to promote the hospital it is running promotions and has lower pricing to get people to use the hospital.  Similar to a restaurant group that opens a new location under a different name.  They want to entice people to try it. 

One way or another, I got the same doctor I would have had at Bangkok Hospital and brand new first class facilities at Jomtien.  Very pleased. 

 

I was quoted a ‘special’ price at BPH of 68000 baht for 1 eye, what was the cost at Jomtien ?

[transam]

9 minutes ago, Jumbo1968 said:

I was quoted a ‘special’ price at BPH of 68000 baht for 1 eye, what was the cost at Jomtien ?

My special price to have both eyes done was 38,000bht, around 19,000bht each. Worth asking around....

[Jumbo1968]

Just now, transam said:

My special price to have both eyes done was 38,000bht, around 19,000bht each. Worth asking around....

Is Jomtien Hospital near Big C South Pattaya ?

[transam]

2 minutes ago, Jumbo1968 said:

Is Jomtien Hospital near Big C South Pattaya ?

Dunno, I am a long way from there, I was talking about costs....????

[Regyai]

1 hour ago, transam said:

How can a plastic lens go cloudy...?

From my experience, it doesn't

What can and does happen (and happened to me) is that some time in after lens replacement the capsule its in deteriorates at the rear and requires an aperture to be made by a simple laser treatment.

See here: Posterior capsule opacification

[Jumbo1968]

37 minutes ago, transam said:

Dunno, I am a long way from there, I was talking about costs....????

Where was your at what hospital was the special price of 38000 ?

[dddave]

59 minutes ago, Jumbo1968 said:

Jomtien Hospital

Yes. Opposite side of Sukhumvit, a bit south of Big-C.

 

[scorecard]

3 hours ago, Jumbo1968 said:

I thought Jo then Hospital was the same group as Bangkok Pattaya Hospital ?

Apparently they both have the same owner but like in many industries it pays to have 2 level marketing for the same product. Capitalism at work.

 

E.g. a pair of mens shoes sold in a very high end shop with high end brand name for 10,000Baht. Same shoes available at low end mall, same production line but different brand name, price 1,500Baht.

 

A real twist, very expensive department store in Melbourne Australia has an internal boutique for Sxxxx shoes, all very expensive, perhaps equal to 10,000Baht. Shoes are made in Thailand, sold (using same brand name) at Mah Bhun Khong (spelling?) mall for 800Baht. Owner well aware of how to structure / strategize his/her business for best total revenues/margins. Capitalism at work.  

[Peterphuket]

18 minutes ago, scorecard said:

Apparently they both have the same owner but like in many industries it pays to have 2 level marketing for the same product. Capitalism at work.

 

E.g. a pair of mens shoes sold in a very high end shop with high end brand name for 10,000Baht. Same shoes available at low end mall, same production line but different brand name, price 1,500Baht.

 

A real twist, very expensive department store in Melbourne Australia has an internal boutique for Sxxxx shoes, all very expensive, perhaps equal to 10,000Baht. Shoes are made in Thailand, sold (using same brand name) at Mah Bhun Khong (spelling?) mall for 800Baht. Owner well aware of how to structure / strategize his/her business for best total revenues/margins. Capitalism at work.  

I agree with what you say but have to mention First class location have also a high price + other costs to pay.

[IAMHERE]

3 hours ago, Purdey said:

Now my left eye is becoming cloudy so I will go back and see if they can operate again.

posterior capsular opacification (PCO),  probably nothing to worry about and cheap to fix. google or youtube it to make yourself feel better. Not out of the ordinary.

[Longwood50]

2 hours ago, Jumbo1968 said:

I was quoted a ‘special’ price at BPH of 68000 baht for 1 eye, what was the cost at Jomtien ?

 

Same doctors, newer facility.  39,000 baht per eye 

I would ask for Dr. Santa Methasari.  He is there on Thursdays only.  No cost for the exam.  There is another Bangkok Hospital doctor on Friday's  I met him twice for post surgery follow up.  I went on Thursday for surgeries met with the other doctor the following day.  He was ok, however I was very pleased with Dr. Methasari.  I checked out his credentials. Graduated top school in Thailand, did internship at Queen Sirikit and he is on staff at Bangkok Hospital as well as Jomtien.  

The price is for single vision without Toric lens.  If you have bad astigmatism you "may" need a toric lens.  I had what I thought was bad astigmatism but the Zeiss machine they used to calculate the power of the lens needed for the cataract surgery indicated that the astigmatism would drop to a negligible level following surgery.  One way or another.  I had one eye slightly under corrected.  I can see distance fine with it but not 20/20 but better than before surgery.  More like 20/50.  My other eye is fully corrected.  Actually a touch better than 20/20 but only by .25 diopters.  Using both eyes, I have 20/20 distance vision and can read without reading glasses.  

I did the same thing with contacts years ago and had no problems.  Your brain will automatically transmit whatever is the clearest image.  So for distance it uses the one fully corrected, for reading it uses the one slightly undercorrected.  Both eyes assist but think of it as the correct eye is the one dominant the other as an assist. 

 

 

 

[Jumbo1968]

1 minute ago, Longwood50 said:

 

Same doctors, newer facility.  39,000 baht per eye 

I would ask for Dr. Santa Methasari.  He is there on Thursdays only.  No cost for the exam.  There is another Bangkok Hospital doctor on Friday's  I met him twice for post surgery follow up.  I went on Thursday for surgeries met with the other doctor the following day.  He was ok, however I was very pleased with Dr. Methasari.  I checked out his credentials. Graduated top school in Thailand, did internship at Queen Sirikit and he is on staff at Bangkok Hospital as well as Jomtien.  

The price is for single vision without Toric lens.  If you have bad astigmatism you "may" need a toric lens.  I had what I thought was bad astigmatism but the Zeiss machine they used to calculate the power of the lens needed for the cataract surgery indicated that the astigmatism would drop to a negligible level following surgery.  One way or another.  I had one eye slightly under corrected.  I can see distance fine with it but not 20/20 but better than before surgery.  More like 20/50.  My other eye is fully corrected.  Actually a touch better than 20/20 but only by .25 diopters.  Using both eyes, I have 20/20 distance vision and can read without reading glasses.  

I did the same thing with contacts years ago and had no problems.  Your brain will automatically transmit whatever is the clearest image.  So for distance it uses the one fully corrected, for reading it uses the one slightly undercorrected.  Both eyes assist but think of it as the correct eye is the one dominant the other as an assist. 

 

 

 

I have glaucoma as well as cataracts, the consultant admitted having the cataracts done probably won’t make my vision much better maybe just clearer. It makes me reluctant to spend money when there could be little or no difference to my vision.

[ClaySmc]

4 hours ago, Purdey said:

My eyes became cloudy

Several months after my cataract surgery, my lens started to become cloudy and the doctor used a laser to “burn off” the particles that had collected on the surface of the lens, so you might not need another new surgery. My vision became as sharp as after the surgery. Now, it's been over ten years and my vision is not as sharp as before, so I was recently wondering if I could do the surgery again; it's good to know that we can have them replaced up to 3 times.

Edited July 22, 2022 by ClaySmc

[lopburi3]

55 minutes ago, Jumbo1968 said:

I have glaucoma as well as cataracts, the consultant admitted having the cataracts done probably won’t make my vision much better maybe just clearer. It makes me reluctant to spend money when there could be little or no difference to my vision.

That might be if glaucoma is very advanced (little side vision) but making what you can see clearer might well be worthwhile.  I have both glaucoma and IOL (but glaucoma is minor and under control).  As for cost you will pay many times the price for a stent (and most do not question that - even when it might well be questionable).  But it is our call what we want to do.

Edited July 22, 2022 by lopburi3

[Jumbo1968]

2 minutes ago, lopburi3 said:

That might be if glaucoma is very advanced (little side vision) but making what you can see clearer might well be worthwhile.  I have both glaucoma and IOL (but glaucoma is minor and under control).  As for cost you will pay many times the price for a stent (and most do not question that - even when it might well be questionable).  But it is our call what we want to do.

I am a bit dubious about the diagnosis for my glaucoma, I had deteriorating eyesight, I had all the test done in the U.K.,no glaucoma was detected. the NHS couldn’t find a reason why. 18 months later BPH diagnosed glaucoma ? 

[lopburi3]

1 minute ago, Jumbo1968 said:

I am a bit dubious about the diagnosis for my glaucoma, I had deteriorating eyesight, I had all the test done in the U.K.,no glaucoma was detected. the NHS couldn’t find a reason why. 18 months later BPH diagnosed glaucoma ? 

Am no expert but if that severe would have expected UK to have found it - they did do the flashing dots on wall or computer to check your field of vision?  I would go to another facility to double check and get another opinion as IOL can really help a lot of people if you do have cataracts.  A trip to Rutnin might be worthwhile even if you decide to have another facility so any procedure.

[scorecard]

2 hours ago, Peterphuket said:

I agree with what you say but have to mention First class location have also a high price + other costs to pay.

Good point, but the case i'm referring to doesn't have a costing difference per one pair of shoes amounting to thousands of Baht, that doesn't compute.  

[Jumbo1968]

They did exactly the same test in the U.K. as BPH, flashing dots, photos, etc I had a head scan in the U.K. as well which was clea. The  eye specialist in the U.K. a Muslim lady appeared harassed, I came away from the hospital none the wiser. I received a letter a few days later to say come back in a year for another check up in. This time. It was during Covid and I had made all the arrangements via the Thai embassy in London to come back here with my wife, she was on 6 month visa but I managed to extend it a few times over a 15 month period. In hindsight I should have asked for a second opinion but in the U.K. getting appointments isn’t straight forward as a GP has put forward a request for a consultation, at the time there was a huge backlog so I could have been waiting for months.

I think I will go Jomtien this time, the eye consultant at BPH emailed the other with an appointment but I cancelled it.