A Patient’s Account of Trifocal Lens Replacement

This testimonial has been posted in its original form without any corrections.

George (61 years old) – Netherlands.

I wanted to give a different kind of review for Praga Medica, which hopefully will help others considering lens replacement and what to expect, from my experience, of having trifocal lens replacement.

I have no association with Praga Medica and have not agreed/will not agree to any fee or service for this review.

This might be a long read but I wish I had this information fully beforehand and hopefully this will help you decide about surgery and using Praga Medica.

I am sure not everyone has the same experience of lens replacement and the trifocal option, I believe, is slightly different in design to the other types of lens replacement options.

So, this is an account of my own experience but not necessarily what you could or would have.

Praga Medica will advise and I found them very professional from initial contact to completion.

Would I recommend them…. absolutely!

My Personal Eye History

At the age of 41, I found myself needing reading glasses. I started at +75 for reading, then over the next 5 years my close reading went to +2.0. I found also that my distance also required +75 then +1.25. This was not an extreme prescription, so I used reading glasses but the constant difference of when and not when to use glasses gave me bloodshot eyes, and my eyes ached. I tried varifocal glasses, but they made me feel sick and I didn’t like constantly moving my head to get the right focal point. I tried contact lenses for 7 days but I found them very uncomfortable and strangely because I have a strong blink reflex, I couldn’t put them in or take them out by myself.

So, at 46 (2004), I decided to try LASIK eye surgery in the UK (Boots). Because of my eyesight, they did something called monovision. Right eye long distance and left eye for reading.

So, this worked great, although it took a little while for my brain to get used to using the one image and ignoring the out-of-focus one. I still needed +1.25 for close work but that was OK.

This worked until I was 56 (2014) when due to presbyopia, I started wearing reading glasses more, as my right eye was blurred most of the time. I got some varifocal glasses for long drives, as my eyes got so tired. I still didn’t like using them all the time and probably like most people with presbyopia, you live in a world of long distance with strained or fuzzy close vision, as you don’t want to keep putting your glasses on every two minutes.

My last eye test before have lens replacement was:

R +1.50 C -0.50 as 120.0 Nab add 2.50

L  +0.50 C -0.50 as 55.0 Nab add 2.50

Why Lens Replacement?

I saw my brother nearly two years ago, after he had a lens replacement due to a cataract. He had been very short-sighted all his life, with a – 6.

He had one eye done and then another some months later. He said that he had the halo effect initially, that Praga Medica also tell you about but other than that, his eyesight was great. So, I thought this is something I quite liked – the idea of being glasses-free.

Why Praga Medica?

I did a lot of reading about the lens replacement procedure and watched the videos of the operations on YouTube (if you are squeamish, don’t watch this video of trifocal lens replacement surgery: https://www.youtube.com/watch?v=eydzDIB9-Mc).

I was looking at websites that offered this service in the Netherlands, Germany, Belgium to see what the cost difference would be.

This review from Kurt I found very good and helpful to understand some of the things you might expect from your trifocal lens replacement experience https://www.youtube.com/watch?v=QYrGewQXYJM.

Although these operations are carried out in most countries, they are not done in the vast numbers carried out in Prague. I saw Praga Medica and looked at their website. As a lot of people have already mentioned, the communication was very good. No hard sell, just facts and details as requested.

As an engineer, I also felt that if someone is carrying out thousands of operations over many years, their skill level and experience of doing so many different eyes would be much better than someone who has done less…. I wasn’t wrong!

So, I contacted Praga Medica, who after submitting my prescription and personal history details, suggested I have trifocal lens replacement. They sent all the information and arranged everything.

The Prague Experience

I had never been to Prague, so I booked a Mon to Sat flight together with my wife, as she had never been to Prague either. After confirming the surgery dates with Praga Medica, paid my deposit and opted for the extra €90 Praga Medica Service Package. If you want a hassle-free drive to and from the airport, someone (multilingual) to assist you in attending the eye clinic, then the hospital; pay the extra for this!

John (Jan) the Praga Medica driver was great!

I asked Praga Medica to book the hotel (Hotel Ankora). This was the same price as Booking.com but included breakfast.  Try and ask for the higher floors for a better view. 7th or above.

For those who (us English) like a tea or coffee in your room, take a travel kettle, as the hotel doesn’t have these in the rooms.

The Ankora also has some apartments, should you wish to rent one. Their restaurant is used for breakfasts in the morning, then becomes an Indian restaurant in the afternoon/evening. The food was very good. We got to see a lot of Prague before and after the surgery and the old city/ castle were very nice.

The preparation and the surgery. (Make sure you take with you some sunglasses and buy a cheap pair of polarised night driving glasses €10, as these are great at filtering out some of the daylight and lights at night after the surgery).

  • Day 1@ 08:00 I was met in the hotel reception and was escorted to the clinic across the road. I spent around three hours having eye checks and was asked about which option I wanted (laser incision or have the surgeon do this) – I chose the surgeon. They explained because I have larger eyes, the Alcon trifocal lens would be a better fit for me. Then after this, off out on the town for the rest of the day. Paid the outstanding amount for the operation.
  • Day 2@ 08:00. I was met in the hotel reception again and taken to the hospital for my first eye operation. You are asked to take a clean/comfortable set of clothes and socks. At the hospital I changed into my t-shirt/ tracksuit bottoms and socks. They give you some slip-on shoes.

Next they sit you down in a small waiting area (there always seemed to be two or three people in this waiting area).

You are asked if you want to have a pill to relax you.. Please take one! You might not feel anxious at the time but you could later (my blood pressure was up!). This does not dull your senses, or make you lightheaded and does not have any other effect but really does make you feel relaxed.

This is where they begin a series of eye drops and the nurse keeps coming back and dropping more in your eye. I counted 7 times before I was then moved to another prep area. Here I was given a surgical gown, some more eye drops, asked some questions about my procedure, which eye (they chose to do my non-dominant eye first – no idea why and I didn’t ask). I was given shoe covers, a hairnet with my name across the forehead and the eye they would be doing. They gave me hand sanitiser and rubbed my hands.

Next the door opened and I walked into the theatre. I was greeted by the surgeon, who asked me to sit down and gave me a cuddly/stress pillow……I was already relaxed.

Next, the seat went back, a nurse used some antiseptic wipe around my eyes and asked that I not touch my face after this.

They then put a paper cover over my face (with an eyelet). The surgeon positioned this, then, yet more drops.

The surgeon asked me to look at the lights and concentrate on this. The whole procedure took around 10 minutes. There is no pain at all, or any discomfort. I suppose the anxiety comes from not knowing or having an expectation. The strange thing I wasn’t expecting- upon completion of my procedure, they put on an eye patch on me and I stood up. One of the nurses took a photo of me and the surgeon, which they then gave me a copy of! They gave me the details of the lens they fitted and eye drops + instructions on how to use them. I walked back to the hotel and was done for the day by 10:00.

  • Day 3. Woke up excited to see what would be the result. I took the patch off and could see perfectly up close, I could read the small print on the eye drops. There were no marks on my eye from the operation, in fact it looked perfectly normal (when I had laser eye surgery previously, my eyes were bloodshot afterwards). I walked outside with my driving glasses and noticed how the green and blue colours in particular were so much richer in colour. I moved my glasses to see if it was these, but the surgery had and continues to enrich some colours which was not there before the surgery.

08:00 – I walked over to the clinic and did a number of eye tests. Up close was great, I could see everything on the card. The lady then asked me to read the wall eye chart. I could not even see the top line clearly. I was assured this was normal.

From the clinic, I walked back over the road to the hospital at around 09:00 for the second procedure @ 10:00. This was exactly the same as day two. I took the pill, but because I knew what to expect,  I was totally relaxed again.

I asked the surgeon one question after he finished and that was that I was getting a flicker in the bottom left corner of my eye. Again, he said that was normal at this stage. There was no second photo, so make sure you smile on the first one!

  • Day 4.Repeat of the start of day 3. This time the light generally was more intense.

09:00 – Walked across the road to the clinic for another check-up and pressure test on my eyes. They told me how to use the eye drops. Not swimming for 4 weeks, no heavy lifting or bending forward either for 4 weeks. Some information on what to expect during the coming 4 weeks. I was advised to have an eye test and pressure test after a week or so, then another after 4 weeks. And that was it. Spent the rest of the day and the following day walking around Prague.

So how are my eyes now four weeks on from the operation?

  • For the first few weeks my sight close up was excellent. In strong daylight or LED lights it can be dazzling. Wear the night driving glasses!
  • Again for the first few weeks my sight from a distance of 3 metres was blurry. It‘s a bit like when you have your eyes open underwater. You can see but the further you look the less you can see.
  • I got back to Eindhoven airport at night and we drove very slowly back home (45 minutes). Looking at the headlights, brake lights and street lamps it looks like they have a series of rings around them, or spider webs.
  • My eyes ached for the first few weeks. Not sure if this was the light or your brain saying your eye lensmuscles are tired, when in fact after the implants, the lens muscles are no longer used. After a few weeks the aching went away. I also found when in the shower and you close your eyes a bit tighter, my eyes ached like there was a contact lens in my eye. This went away after a few weeks.
  • Being in the house in the evening, I would forget I had had eye surgery until I took my dog for a walk late in the evening. The LED lights and the bicycle lights had large spider webs around them. I did notice this became much less but after 4 weeks it is still noticeable but doesn’t put me off driving. In fact, even with this slightly blurred vision, I can read car number plates at a distance that I couldn’t read without glasses previously. So I know my eyes are improving all the time.
  • So four weeks to the day after my second operation, I finished using the eye drops. They give you other eye drops, in case your eyes get dry ( they test you for eye dryness at the 1st appointment).

Summary

I think if you are expecting an instant change in your life and perfect vision straight after the surgery, you will be disappointed. You should read as much as possible about it and watch Kurt V’s videos. Expect this to be a gradual or slow process. I do see much better now than I did before with glasses and my close-up vision is superb. I use a laptop at work and I can see perfectly even as close as 15 cm away from the screen.

There are a few things which are noticeable and just a force of habit. For example:When I wake up and go to look at my phone, I am blindly searching for my glasses, then realise I can open my eyes and see for myself. The aching eyes have gone and there is no evidence or sensation of having anything in my eyes.

My wife says my eyes look more sparkly, certainly, they don’t look as bloodshot. I am still very sensitive to light and wear the driving glasses sometimes in the office, when the sun shines through. I can now see the projector from the back of the room, whereas I had to sit on the front seat immediately after my op.

I need to get my second pressure and eye test done but  will wait a week or so. The pressure was normal at the last check.

I think my eyes will take months to be as I expect them to be.

This is only week 4 of ‘glasses- and cataract-free’ vision. I am very pleased with the results and look forward to my sight improving in time.

I hope this helps you with your decision!

Bonus: If you like a steak, we went here to this pub/restaurant and both had an Angus steak. It was the best steak I have tried outside of the USA. It is within walking distance of the Ankora and excellent value for money. Mlsnej Kocour, Belgická 116/42, 120 00 Praha 2 – Vinohrady, Czech Republic

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