At Lisa, lentis or monofocal lens and distance (near 50's)
Posted , 4 users are following.
Anyone tried out At Lisa lens? I was recommended lentis due to my power limitation. I did some searching and read some negative reports with it, and am ending to figure that monofocal seem to be most reliable, although I strongly wanted multivision type lens in the beginning.
However I also read At Lisa as 3 focal and very popular in europe. So before I decide to mono, I'm wanting to gather some real voice, data regarding At Lisa lens reputation or experience.
(I'm thinking of 1 eye for now, and wait for the other until real necessary. I am very near sighted)
Regarding the distance, I'm thinking to ask for around 40 cm, considering PC work and paper reading at work.
however I'm also passionate with outdoors, such as diving, animal tracking, hiking, surfing and sorts.
I'm imagining glasses will do for land outdoors, and hopefully contact lens for diving. If there are divers I'd like to hear how they are working out with their implant lens....? (or recommendations...)
Thanks!
0 likes, 14 replies
RonAKA righti
Posted
I have no experience with that lens, only a monofocal lens in one eye corrected for distance. It turned out to be right on with a 0.0 D spherical correction needed for my eyeglasses. While you can no longer focus real close with it, I start to see quite well and can read 10-12 point text at 18" or half meter or so. Reading the instruments on the car dash is perfect. Reading the very small print on an over the counter medication (the stuff they don't want you to read) is impossible of course. In short though don't under estimate how close you can see with a monfocal set for distance. The one trick is to make sure they don't take you into the +D range. Normally they target to be -0.25 D.
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For my second eye I am still thinking about it, but probably will go with a similar monofocal (AcrySof Aspheric) but under corrected by -1.25 D. I am currently simulating that by using a contact in my non IOL eye. Reading on a computer screen is no problem. 95% of the time I am glasses free, and only occasionally use some lower power reading glasses for the fine print. I also have a pair of prescription progressives which I wear when I need to do real fine work. But, for the most part they just collect dust.
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This is called monovision, and if you consider it, it is best to test drive it with contacts to see what you like. Normal practice is to correct the dominant eye for distance and the non dominant one for close up.
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I think the most important question you need to ask yourself is how do you want to see with no glasses. I am short sighted (prior to IOL) and snorkeling was always a pain. It didn't do it enough to justify a prescription corrected lens in the mask, so I used contacts. It worked but was a real pain, as I would only wear them a few days a year. And until I could get them out of my eyes I could not read anything. I now know that monovision would be perfect for snorkeling.
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Hope that helps some,
righti RonAKA
Posted
Thank you and congratulations for getting a fine view recovery. 10 points at 1/2 m sounds very clear.
I understood that closer is tough, but how about further? do you use glasses in daily life when you walk, etc, for you get along without them? (this is also my curiosity, considering life after my surgery)
I get your idea that monovision is recommended for snorkeling, and it might be a good way to think if I get a monofocal lens for my bad eye. (then for the rest I will have to see with the outcome I believe.)
My views are already some sort of monovision, as cataract made my single eye short sighted heavily.
My aim is to get clear focus bit shorter than 1/2 m, which is perfect for office work. for rest, I will tune with glasses, rather than having to have to wear glasses during work.
RonAKA righti
Edited
I only have one eye done with cataract surgery. It was set for distance. In my non operated eye, which has a minor but progressing cataract I use a contact lens with the eye under corrected by about -1.25 D. I am short sighted and need about -2.0 D in this eye for full correction, but the contact I am using is -0.75 D. My purpose is to simulate mini monovision to determine if that is the way I will go when it comes time to do the second eye. Currently I am liking it a lot and 95% of the time all I use for TV, on the computer, or driving is the one contact with no eyeglasses. If my IOL is powered the same (-1.25 D) when it is done I should be essentially eyeglass and contact lens free the large majority of the time.
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The ideal distance for reading with my under corrected eye is about 20-30 cm.
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Ideally with monovision you want the dominant eye corrected for distance, and the non dominant eye for closer up. I ended up the opposite way with my distance eye non dominant and the close eye the dominant one (crossed monovision). It works but I think it would be better still to have the dominant eye set for distance.
righti RonAKA
Posted
Thanks Ron, I have a similar situation. right is my dominant originally. Vision dropped lots with cataract. now left is my distant eye! it was really weird during process, I was almost getting headache in seeing as my right power dropped and seeing opposite ways. however thanks to human adjusting ability, my left is working fine as main viewer... (lol).
So I am positive that I can adapt to monovison, despite that it may need some time. ( few months, I forgot now) I will go with the flow which eye will be a distant or near. as orders of the surgery eyes cannot be changed.
It is good to hear your experience to gain more confidence with it!
RonAKA righti
Posted
In that situation if you are considering monovision I would get the right cataract eye done first for distance with a monofocal lens. Then when it is done use a contact in the left eye to simulate monovision. Try different powers of contacts to see what you like and can tolerate. Most are going to like an under correction of -1.0 to -1.5 D. You may find like I have that this is a semi permanent solution until you need cataract surgery in the second eye. I found this article very helpful in understanding the pros and cons of monovision and the impacts of selecting different amounts of anisometropia.
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Optimal Amount of Anisometropia for Pseudophakic Monovision Ken Hayashi, MD; Motoaki Yoshida, MD; Shin-ichi Manabe, MD; Hideyuki Hayashi, MD
righti RonAKA
Posted
Wow, thank you Ron, scientific data really supports! Will read it.
I was thinking of getting 40-50 cm (PC and desk reading focus for 1st surgery. see the outcome. and fix the 2nd later, like you said by trying the contact pre hand practice.
If I fix to distance in 1st eye, like you suggest, I'm afraid balance with my other eye will be more difficult (as I'm very sho t sighted) . also since my left is already working as distance and dominant (?) , to fix it again to opposite I will have to go thru another headache time to adjust my vision.
Do you suggest fixing near side first and getting the distant later a bad option? (so I'm thinking to test distant with contact like you said.)
I'm also wanting to avoid the head ache of everything blurry when I need to read, so I'm going form near might be better for me.
cheers.
RonAKA righti
Edited
I suspect eye dominance is hard wired and if you were naturally right eye dominant before, you still will be going forward. I think the brain makes the best of it if you switch, but it does not get hardwired in.
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Although some do select a short distance focus for a monofocal I do kind of question that strategy. It pretty much locks you into glasses for general purpose vision. As I type here I am switching back and forth between the computer screen at about 30 cm and the TV screen about 3 meters away. With monovision this is no problem at all without glasses. I am obviously switching between eyes to do it. I very occasionally use OTC reading glasses for fine work. I kind of dislike it as everything in the distance is way out of focus when I look up from the close work. I find I am constantly putting the glasses on and off. I kind of think that may be what it would be like to try to work with IOLs set for closer up without glasses. I think you would end up getting prescription progressives and leaving them on all the time.
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If you are very short sighted there is a bit of an issue with an IOL in one eye corrected for distance and the other eye corrected with eyeglasses.. It kind of gives you a dizzy feeling. I think the issue is due to the plane the correction is made in, causes a change in the size of the image on your retina, but I am speculating that based on what I see. What I find is that when I correct the non IOL eye with a contact instead of glasses the issue goes away. Based on my experience I would think there would be no issue with an IOL for distance in your right eye, and a contact either for distance or undercorrected for monovision.
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You may want to get your surgeon's opinion. Mine was insistent on correcting the first eye for distance. I think what they are concerned about is a miss on the first eye for power. If they under correct the first eye, then it leaves the option of making that the close eye, and then try again for distance in the second eye.
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How near sighted are you in each eye now?
righti RonAKA
Posted
I see your point it must be consulting with doctor. I will have to find a fine trustable one.
I could not find a free article of your suggestion nut will read the abstract.]
I am bit lazy to look for the paper i recorded my powers...
lots of info to search while no time... 😦
RonAKA righti
Posted
I found a free pdf of the "Optimal Amount of Anisometropia for Pseudophakic Monovision" at this website. Perhaps try adding pdf to your search.
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"semanticscholar.org"
righti RonAKA
Posted
Thank you ron! just found it will read it....!
assia99778 righti
Posted
Hello righti and welcome!
I' ve got two AT LISA implanted. It's five months now after the surgery. I'm very nearsighted, too.
First question: Do you have astigmatism in addition to your myopia? If yes: how much?
I'm asking this because then you will need a toric lens. I had rotation of one lens after the surgery and needed rerotation in a second surgery. In both eyes they did not hit the point and I'm left with significant residual astigmatism. Therefore I do need several glasses now. Before surgery I never wore glasses (only rigid contact lenses). As you I'm doing outdoor sports where glasses are not possible or very uncomfortable. For reading and computerwork I have to put two glasses on my nose. Those trifocal lenses are very demanding. You can't correct with varifocals or multifocal contacts after the surgery. Nobody told me this in advance. In addition those trifocal lenses are much more difficult when it comes to laser correction or enhancement post-op if needed. Maybe they will hit the point, maybe not.
And there is another thing: Have you been informed about dysphotopsia? What did they tell you? Are you driving during nighttime? A trifocal lens has a diffractive optic - up to 12 rings on the surface. Everybody gets trifocal halos after the surgery - some people more than others. In my case - and I'm not alone - I see huge and very bright concentric rings around headlights, brakelights, traffic lights, street lights and other point light sources. Even tiny LED lights are surrounded by these rings. Depending on the sun you might get this during daytime as well. The photic phenomena look like spiderwebs. The rings are very huge. Sometimes I can't see the object behind the light, asking myself whether it is a car, a motorbike or a bicycle. The PanOptix lens is similiar to the AT LISA and you will find many reports here on this subject. Maybe you will have a look into them.
It's a good idea to do only one eye and see how it works. I'm not diving but the surgery reduced my ability to wear contact lenses. I can't go back to this solution anymore. The procedure and the drops you need after surgery cause dry eye. Usually your eyes will recover. But sometimes not.
If it works - and it works very often - you can be a happy spectacle free person after the surgery. Demanding computer work, which means intermediate range, is not a strength of the AT LISA. Maybe you will need readers afterwards but if everything is alright that's - in my opinion - neglectable.
Hope I could have helped you a bit in the decisionmaking process.
righti assia99778
Posted
Hi assia! Thank you so much for real feedback of Zeiss lens. I also read your first few reporting in this forum too. I'm sorry to learn what you went through. I figured it's about the same with other multifocal lens. If I do I take the risk, kind.
The information of this lens was difficult to find, while they sugar coated it as premium lens etc. If I can find the best doctor, maybe it might work. at the moment I am having difficulty in finding real data regarding these and I would rather take the safe route... Thanks again for shouting out and sharing information. At the moment the lens came to my mind, as one of the last options, while net surfing. So it was before seeing the doctor who offer these lens.
I did read downsides of dysphotopsi, and sort of moved on from multifocal to monofocal. To be honest my cataract is already giving me enough of halo and glears, and shiny lights under the sun (LOL). So I see what you mean with scary night drive. Personally I am not that desperate to be glasses free in change to keeping these. (altho i used to hate glasses! now it sounds a better option)
I think I do have weak astigmatism, I am not sure if I will be getting toric or not (doctor I saw never clarified regarding this). I hear doctors here usually try to avoid toric as financially no merit to them... I wonder if the toric issue is only with At Lisa only or also difficult with monofocal lens...
Anyway, I hope your issues have improved as time passed after surgery.
Thank you again.
RonAKA righti
Edited
One thing to remember about astigmatism is that with eyeglasses the needed correction is the total of the astigmatism in the lens plus what is in the cornea. With the lens removed during cataract surgery it is no longer a factor. These errors may be additive or one may subtract from the other. For that reason your astigmatism may improve or decrease with the lens removed. The surgeon deals with this by measuring the cornea only prior to surgery and the need for astigmatism correction is based on this cornea measurement only.
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The steps in toric lenses are quite large and for that reason they usually do not attempt any correction with a toric lens unless the corneal astigmatism is more than 0.75 D.
righti RonAKA
Posted
Thank you ron, its new info to me. toric seems more tricky,