Advice and your experiences with cataract surgery
Posted , 8 users are following.
Can anyone advice with regarding with
"Mini mono vision"
One eye for distance other eye for near
Using "edof" lenses ("extended depth of field vision")
One eye for far distance and/until computer range (about 45 cm) and the other eye for near (close reading and until about 45cm including computer use)
Meaning for far distance only one eye is used
For near distance close reading only the other eye is used
And for computer distance (the overlap zone) both eyes are used
Please comment and advise
0 likes, 8 replies
laurie30147 moshe63924
Posted
This is what I have, and I am very happy with it. I had Vivity lenses implanted in both eyes in early 2022. I had been moderately nearsighted previously and wore glasses all my life.
If you search, you can find a number of my comments in this forum,
RonAKA moshe63924
Edited
This is the type of vision that I have. One eye is fully corrected for distance with a monofocal lens. The other eye with a monofocal is left myopic and requiring a correction of -1.4 D to get full distance. This gives me closer vision. The vision for each eye does not drop off a cliff and there is some overlap between the two eyes. My distance eye allows me to see a computer monitor at 18" or more, and I can easily see the dash of my car. The close eye lets me read comfortably down to 10" and starts to get less sharp at TV viewing distances. With both eyes open I can see from 10" out to the stars very well.
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Some use an EDOF in the near eye, and that is called hybrid monovision. Since EDOF can bring some optical side effects, I think the benefit of going to a hybrid arrangement is debatable. I considered it but got cold feet. Cost was not a factor in the decision. I was looking for the best vision quality without optical side effects.
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The standard targets for mini-monovision with monofocal lenses are -0.25 D in the distance eye, and -1.50 D in the near eye. Ideally one should simulate that with contact lenses to ensure you are ok with it. However, most are unless the differential between the two eyes is pushed to more than 1.5 D. The original full monovision targets were to target -2.5 D in the near eye, but that approach is falling out of favour due to people not being able to adapt to that much of a differential and to it leaving a gap in vision at the intermediate distance.
Spring1951 RonAKA
Posted
I will be getting LE -57D and RE -39D with Clareon.
One question for you is do you have a blue light filter in one eye and a clear filter in the other but can't tell much difference?
RonAKA Spring1951
Edited
Those numbers are out of the range that the Clareon and other lenses are available in. You may want to recheck the values. The normal range of IOL powers are from 5.0 D to 30.0 D. The range lower than 19 D or so is typical for someone that is short sighted, and above 19 for those that are far sighted. That said the actual IOL power used is not very relevant. What is really important is what your residual correction will be after the surgery. For standard mini-monovision you would target -0.25 in the distance eye and -1.50 in the near eye. And something less than mini-monovision would use targets tighter than that. These are the numbers you should be asking for and agreeing with the surgeon so you are not surprised by the outcomes.
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Both of my lenses have blue light filtering. It would not be possible to tell the difference in colour effect unless you had one of each type. When I had a blue light filtering lens in one eye and a very mild cataract in the second eye, I could easily tell the difference between the colours. The cataract eye gave whites a noticeable yellow-brown tinge. My point is that a blue light filtering eye will look much whiter to even blueish in comparison to a cataract eye. The tint in a blue light filtering lens has a major effect on blue light filtering, but a very minor effect on the colour balance you see. It just returns the colour balance to that of a younger child.
Spring1951 RonAKA
Posted
We are not doing standard mini-monovision. I will write her and get her input on that
amy99928 moshe63924
Posted
my dad has this and he is happy. he adjusted right away. i asked for this for my two iol implamts and my dr said no. like maybe my brain would not be able to adjust bc ive never had a rx? or maybe she wanted to sell me this vivity which i regret buying.
RebDovid moshe63924
Edited
Moshe--I can offer advice but not (yet) experience. In consultation with my surgeon, I'm currently wearing contacts--for the first time in my life--to trial mini-monovision. All continuing to go well, I expect we'll agree on some degree of mini-monovision using the J&J Eyhance IOLs. They do not qualify as EDOFs under the American Academy of Ophthalmology Task Force Consensus Statement for Extended Depth of Focus Intraocular Lenses because the extension of focus they provide is slightly under the 0.5 D minimum requirement. On the other hand, they do not suffer from the loss of contrast associated with, say, the Alcon Vivity. Nor are they associated with the negative optical side-effects some Vivity wearers report.
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The key to figuring out what is achievable is to examine defocus curves for the IOL, or IOLs in which you're interested. On-line, I've found seven defocus curves for the Eyhance: one originating with J&J; the others in journal articles. Inspecting mean visual acuities shown in the curves, which involves a certain amount of 'eyeballing' them, I averaged the results to prepare comparative tables for myself.
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Bear in mind that there are any number of reasons not to put too much weight on my results, but I'm only using them as indicative and I haven't found anything better. The first limitation is that I've combined both monocular and binocular defocus curves. The second is that every result has an associated standard deviation, and there's no guarantee that my, or your, actual result won't fall on the 'bad' side of the s.d. Third, there's also no guarantee that the surgeon will hit the target spot on.
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With all that in mind, I think your goal may need refinement because the closer your distance eye is to plano (0.0 D), the more it will fall short of your 45 cm target. With the Eyhance, for example, my calculations indicate that, targeted for plano, the result at 44.44 cm (or -2.25 D) would be logMAR 0.36 (or 20/46). Were you to target and hit -0.50 D, which my surgeon recommends, the indicated result at 44.44cm would be 0.25 logMAR (or 20/36).
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If you're willing to let your near eye do more of the work, and depending on what you mean by "close reading", then you may be happy with the possible results. For example, assuming -0.50 D for your distance eye and -1.50 D for your near eye, the indicated result at 44.44cm with the near eye would be 0.08 logMAR (or 20/24), down to 0.197 logMAR (or 20/31) at 33.33 cm. To get really close vision with the Eyhance, you'd either need readers or full-on monovision. (And just to add a little more data regarding blended vision: At -1.50 D, the indicative result for the near eye would be 20/25 or better out to 1 m. At -0.50 D, the indicative result for the far eye would be 20/25 or better from infinity to 80 cm.)
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Because I don't want the (potential) negative side-affects associated with the Vivity IOL, I don't know enough to say much about your ability to use it to achieve your goal. But my general understanding is that it may offer up to 1 D more depth of focus than the Eyhance.
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Good luck.
indygeo moshe63924
Posted
Hi Moshe,
I have mini-monovision. My non-dominant eye got a monofocal for distance over 4 years ago and my dominant eye a Rayner EMV back in Sep 2022, offset by about - 0.75D from the distance eye. I'm super happy with it. I've got great vision from around 11 inches to "infinity". Nice overlapping focus in midrange and beyond. Great for reading and computer work. Life changing for me.
Regards,
Indy G