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53 yo seeking guidance.

Posted , 12 users are following.

RichBR
RichBR

Hi. I'm 53 and recently diagnosed with a cataract in my right eye. The left lens is clear. I just stumbled into this forum which is a wealth of knowledge. I've got a follow-up appointment in a couple days, so I'm trying to quickly get up to speed on a few things. Current prescription: OD sph -3, cyl -1.25, axis 135. OS -3, -0.25, 150. I'm trying to think through the best options. I currently wear glasses; contacts years back gave me some dry eye issues, but I haven't tried them in many years. I'd like to reduce dependence on glasses as much as I can. But since I'm only having one eye done, it sounds like that's not too likely. I work with computers every day, so good vision in that range is important. I already deal with some halos at night.

Can someone give me some starting points in what I should be considering for a lens option? Has anyone combined cataract surgery in one eye with Lasik in the other?

Thanks in advance for your thoughts on my scenario.

RichB

0 likes, 23 replies

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  • Night-Hawk
    Night-Hawk RichBR

    Posted

    Since your left eye uncorrected should give you excellent near (reading) vision, and  you mentioned computer distance vision (intermediate range) is important you might consider targeting your right eye with a monofocal toric IOL for around -1.50D or so.  That should achieve good intermediate focus in the right eye, and the difference between the right eye should not be to much to get used to.  You would need glasses only for distance like driving with this combo.  You might test it first with a contact lens simulating this in one eye.
    • RichBR
      RichBR Night-Hawk

      Posted

      Agree. This is something I should look into more.
    • Guest
      Guest Night-Hawk

      Posted

      Night-Hawk pretty much said verbatim what I would recommend (assuming your left eye is good for reading right now), including the part about testing various outcomes using contact lenses (We must think alike -- for what it's worth, we've both been through single-sided cataract surgery).  I found the newer contacts are so much more comfortable that previous ones, and it would be wise to test a few combinations out before the cataract progresses too much.  I would guess that a -1.5D in that eye would give you great computer vision, and that the combination would be good for covering most intermediate/near.  If the asymmetry proves to be too much, you could always pop in a contact lens in the left eye to bring it closer to the right, then just use glasses for driving. Or, you could at any time use a contact lens for distance in the left, effectively giving you distance and intermediate/near vision.  Lots of options with that -1.5 range IOL.

      If you are willing to risk the potential artifacts of a multi-focal/EDOF, you might achieve a greater uncorrected range (right eye IOL set for far and intermediate; left eye for reading), but personally, I wouldn't risk it.  I also would not opt for any type of lasik, due to the potential for compromising eventual cataract surgery.  

      In my case I opted for an intermediate/near monofocal (-1.25D), and am very fortunate my other eye is already close to that (-1.5D) so I'm happy with my vision for now; only needing glasses for distance.

      I agree with George05887 to take your time.  No need to rush into a decision with life-long consequences.

      Good Luck!

  • al26912
    al26912 RichBR

    Posted

    Hi, I think I am in the same boat as you, late 40s with unilateral cataracts in my right eye.  I think you are in a little better position since your left eye is only -3D, mine is -5D.  I found it also very difficult to decide on the lens and focal distance as whatever I do to my right eye now it has to work in the interim when my left eye is still okay at -5D and also after the inevitable cataract surgery to my left eye who knows how many years later.

    So, the first question is - Can you wait?  There are always new technologies coming out every year, especially in Europe.  My suggestion is if you are going to wait and see, at least go to a good cataract surgeon and take all necessary eye measurements first.  In my case I waited too long and the better instrument cannot penetrate pass my matured cataract and need to settle with less accurate ultrasound measurement of my eyeball length.  Lucky it turned out okay.

    Also, ask your optomologist to let you try monovision, or a -1D prescription on one of your eyes.  You can see how blury distance vision is when your eye is set for -1D ( or something like -0.75D).  That will help you decide if you want to set the focal length to intermediate distances.  Same applies to monovision.  You want to try that before your right eye is too blurry to see.

    As you must have know now, you have to choose between monofocal iol and multifocal/EDOF iol.   I asked myself what drives me more crazy, having to carry and switch between glasses all day or seeing a permanent, uncorrectable Halo and starburst at night. 

    One thing you need to keep in mind is something called Anisometropia.  That is having a significant difference in reflective power on your left and right eyes.  If you set for Plano on your right eye, you might have problem using spectacles (your left eye is -3D, right)  and need either to wear contacts or Lasik on your left eye.  That is one reason I suggest going to your opthamologist and ask him/her to give you a contacts for your RE and see if your are okay seeing thru your spectacles with the right lens popped out. If you can get used to it, you might be able to avoid Lasik all together.

    For your reference, I choose toric monofocal for my RE targetting -1D and wear contacts on my LE. LASIK on my LE is an option too but I will wait to see how the cataracts on my LE is advancing. When the time comes for my LE, I will do monovision with 0D. My RE turned out to be -0.7D after surgery. Now my RE's best focal distance is my armength. Computer vision is superb, crisp, clear and color is vibrant, couldn't believe it. I guess I have forgotten how excellent my vision used to be. Using my RE only I can see my phone fine as close as uo to 12 inches without any aid nor bigger font sizes under normal lighting conditions. Reading distance object is more difficult, but at least I can drive without much problem in the day time. I need to wait until they are closer before I can read the street signs, and I cannot read the licence plate unless the car is right in front of me. But that is a compromise I knew in advance. Again, all I am talking about using my RE only. Together with my LE everything besides reading very fine print is from good to great. I will get a pair of distance spectacles later for driving. I probably need readers too, but no immediate need as I can use my -5D LE for up closer vision when I am not wearing contacts.

    Hope that it helps.

    • RichBR
      RichBR al26912

      Posted

      Very helpful. Appreciate the insight.
  • jon98574
    jon98574 RichBR

    Posted

    Hi Your current situation is very similar to mine. Aged 53, just had cataract surgery in RE (2 days ago). My sight was 6.25 in that eye, other eye is 5.75. I've just got a standard monofocal. As i live in the uk, am lucky enough to get both eyes done through nhs (other eye has no cataract but they will do both because of the myopia).

    I'll let you know otherwisr how things go - too early to tell right now! Best of luck with yout decisions!

    • jantje32476
      jantje32476 jon98574

      Posted

      Hi jon98574, Thanks for sharing.  Since you are only Day 2 post-Op, take care and don't spend too much time on computer screen and infront of TV. smile  I learned from the contributors here that the artificial lenses implanted take many weeks ....  to settle down.

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