Thanks for the advice.  

Would the purpose of the -.50 be to move the focus distance in a bit,
make it arms length or a bit less ... or .. is that a safety margin so
that i don't end up with my eye focusing from, say, 6 feet and out ?

Perhaps you could elaborate ?

I have no doubt I'll be real happy once I take the plunge, but I want to
be as informed as can be going in.  I'm actually lucky that I didn't do
this 2 years ago when I was first really considering it. At that time I
had my heart set on multifocals. Sure, they might have been fine, then
again maybe not.  

At this point I'm looking at normal IOL's, just need to decide if I want
to do something other than focus at distance, and the risks associated
with that.  

jim d

My first surgery was done in Canada on the left eye some time ago
maybe back in 2002 or so.  That one was performed by a
opththamologist at one of the local hospitals.  I had the usual n
food, drink, or oral medications after midnight of the previou
evening rule.  I remember the day of, the anaesthesiologist spoke t
me asking about previous sedatives I had used, and it's possibl
based on my responses and my retinologist's advice the anaes. chos
to use ativan as the general sedative for me.  I know he definitel
used ativan, but I'm not sure if that is just the sedative he woul
have used anyways, or if I was a special case.

Once the nurse started to prep me for surgery, one of the first thing
they did was put in an IV line to a bag of saline solution to hydrat
me.  I really don't remember too much else except that they put
sheet of special paper towel over my face with a little adhesive hol
to tape around the eye they operated on.  No idea how they kept tha
eye open, but it didn't hurt.  I was pretty much stone blind in tha
eye at the time so I didn't see much except the light in th
operating room.  After the surgery, they wheeled my gurney to
little curtain cubicle to lie down for a while and drink some juice.
Then they got me up and dressed, and I sat in a day-surgery recove
room full of la-z-boy recliners and all the other cataract surger
patients and ate a sandwich they brought.  :

My second surgery was a whole other ball of wax.  In addition to th
potential complications I faced in the first surgery, I also had
few senechia (sp??) which are points at which my iris had scarre
onto my lens.  My doctor explained that the cataract was encase
within a very fragile sac.  My iris was scarred onto that sac and i
was possible the sac might have torn open as the doctor cut th
senechia away.  The doc then cut a small slice in the sa
through which they extracted the cataract; this was another point i
the procedure where the sac could have torn open.  If that ha
happened, the cataract would have fallen into the eye, and I woul
have been referred to a retinologist to have a vitrectomy performe
to remove the loose cataract within the week.  This was al
information my doc told me in the pre-operation consultation one wee
before the surgery.  During the consultation, we also discussed how t
deal with other health issues (I have some unique immune issues tha
needed to be addressed), and I asked when my vision would stabilis
so I could get new glasses (~6 weeks) and what kinds of physica
constraints I had post-operation (no lifting, no exertion, no bendin
such that the head is below the waist for ten days after the surgery)

The procedure was performed by my ophthamologist (at Scott & Whit
in Texas) whom I know pretty well and have seen many times.  This wa
at a S&W clinic and not a full-on hospital like my first surgery
My husband and I waited together in the waiting room, then the nurs
called for me eventually and both me and my husband went back to
semi-private hospital room with a gurney, a couple of chairs, cabl
TV, and a shared bathroom.  I had to change into one of thos
tie-shut hospital gown things and remove all jewelry and clothin
from the waist up, and wear one of those elasticised paper hats t
keep my hair contained.  They let you keep your pants and socks o
and such, they just don't want you wearing anything near where the
will be operating.  The nurse gave me a big plastic bag to put m
things in that she would put in a locker.  Then she went through al
the consent paperwork with me,  I was very glad my husband was wit
me because I was not able to read very well, so he was able to mak
sure I understood what it was I was signing before I put my signatur
on the consent forms.  Then the nurse quadruple-checked that I hadn'
eaten or drunk anything, asked what kind of eyedrops I had put i
that eye that day, and got me to put an X with a grease pencil next
to the eye to be operated on.

After that, the same nurse got me set up on the gurney lying down,
inserted the IV, and put three different types of super-dilating
eyedrops in my right eye.  She applied topical anaesthetic to the
skin before inserting the IV and it was all pretty painless, but then
after maybe ten minutes it really started to ache so I let her know,
and she double-checked the needle and said it was most likely the
topical anaesthetic wearing off.  Before she gave me the dilating
drops, she gave me a freezing eyedrop first (because dilating drops
**sting**) and thank heavens that freezing didn't wear off before the
stinging effect of the other drops went away. :)  

Two members of the operating team came in to check on me, and the
anaesthesiologist asked about allergies, etc.  I found out from him
that he was going to use a barbituate to sedate me during the
surgery.  I personally don't like barbituates and asked him if he
would consider using ativan instead, but he said the barbituate was
the only option  because it sedates sufficiently for the surgery and
then wears off very quickly, whereas ativan hangs around for hours
and hours.  I personally don't mind so much being under the effects
of a gentle sedative for the hours following a minor surgery :), but
I can see how the clinic would prefer not to have to deal with a
bunch of patients sitting around recovering for that long.  

I got wheeled into the operating room and my husband was sent off to
the public waiting room.  At this point I was pretty alert, and
everyone introduced themselves to me (anaesthesiologist plus
assistant, doctor plus two assistants).  Then the barbituates were
administered and they started the surgery.  I was knocked absolutely
out cold for about one minute (by design), tho not before I saw the
hazy image of my doctor leaning over my head with a scalpel coming
towards my eye.  :)  My doctor said he made about six incisions I
think, and my eyelashes were getting stuck in one of them so he
yanked out three or four at once to remove the ones that were poking
into the wound.  After being sedated a little while, my eyes started
to roll back into my head.  I wasn't aware of this, but I do remember
my doctor instructing me to keep looking at my toes several times.  

By the time they wheeled me out of the operating room, I was fairly
conscious again, enough where my doctor was making conversation with
me and getting semi-coherent responses.  I was wheeled into a little
curtained room and the same nurse came back and monitored my recovery
from the sedative and got me something to drink.  I had a hard plastic
eyepatch taped over my eye that I needed to keep on until the next
morning I think.  They also called my husband into the room, and he
helped me get dressed.  I had to be wheelchaired to our car, and
there was a kit of eyedrops, some medical tape, an instruction sheet,
and some sunglasses in a bag for me at the check-in desk.  I was
adviced I could take ibuprofen to deal with the ache, but if anything
like sharp pain in the eye or discharge started oozing from the eye, I
was to call the doctor ASAP.  I had to put four different types of
drops in four times a day for one week, with ~5 minutes between each
drop so they could be absorbed.  There was an antibacterial, an
antiinflammatory that targeted the retina, a prednisolone steroid
drop to treat inflammation in the front of the eye, and I can't for
the life of me remember what that fourth drop was for.  Then after
that I was done with the retinal antiinflammatory and for the
remaining three weeks I had to put in three different eyedrops four
times a day.  I asked my husband to administer the drops for me for
the rest of the day of my surgery because I was in such discomfort I
didn't want to do it myself.  I'm sure I could have in a pinch, but I
didn't want to.  For the rest of the day I didn't do too much.  I kept
the plastic patch on that whole day and that night, and wore the
eyepatch every night until ten days post-op.  It can be hard to
remember to put the patch on, so I got in the habit of putting it on
my pillow every morning so I would remember to put it on that night.

The next morning I had a follow-up appointment that my husband drove
me to, and then had another followup one week post-surgery, and a
final follow-up four weeks post-surgery where they tested my vision
and gave me a new glasses prescription.  

Now, my list of Things I Wish They Told Me Before My First Eye Surgery
and This Surgery:

1. You can't shower for 24 hours after the surgery.  I made sure I
showered just before going for surgery. :)

2.  We knew that I wouldn't be out of the clinic before 2 pm, so my
husband made sure I had a good sized snack at about 11:30 the night
before so I wouldn't be totally starving the next day.

3.  If you are a regular coffee drinker, you will get a caffiene
withdrawal headache during the fast and you will just have to live
with it.

4.  The appointment the following morning was casually mentioned to us
on our way out -- while I had taken the rest of the week off, my
husband had to make last-minute arrangements to get time off work to
drive me to that appointment.  So be aware you might need a driver
the next morning.

5.  While we had planned for the copay on the surgery, we hadn't
expected the antibacterial eyedrop to cost so danged much.  In the
kit, we got plenty of all of the eyedrops except for the
antibacterial one, for which we only received a week's supply.  We
had to get a refill on that eyedrop and it turns out that the best
antibacterial eyedrop on the market doesn't have a generic yet, and
there are no substitutions my doctor would accept, so we wound up
paying a $75 copay for it instead of $5 or $10.  

6.  Operating rooms tend to be on the cool side, so wear warm socks.

pair of good socks.

7.  You may need to talk yourself out of doing any and all lifting for
the first ten days.  I know I caught myself several times a day about
to move something quite manageable, and I had to ask for help doing
it which goes against my nature.  But, it is very important to follow
the doctor's directions regarding no lifting or bending.

And what's neat about this is that the readers from the 99-Cents-Only
store are very good and very cheap -- buy 'em by the dozen!

I once found on the web a movie of a "typical" cataract operation.  It
might or might not be good to watch such a thing, depending on how
squamish you are.