Cataract IOLS - Low Myopes-Anyone use Ray One Emv,Eyehance or plain mono focals with mini mono??
Posted , 7 users are following.
I am looking into eyehance and rayner . I am low myope so challenge is what vision field do I give up if I want to try and get 2 visual fields glasses free. Don't want trifocal ..Don't want edof like vivity. No other eye conditions just cataract.
Do I give up most near to get far/intermediate or go near/intermediate and use glasses far. Now glasses on all day accept to take off if want to read things and ingredients etc.
My potential surgeon just started to use EMV iols now but will do NO mini monovision since just getting used to lens. I cannot find people who have used this EMV accept 3 people-2 complications but don't think from lens. So feedback is limited.
I don't know if any surgeon does near & intermediate target with the Ray one.? Would love to know and outcomes people got. If they got good closeup & intermediate and some distance?
Only found 1 other surgeon far away from me that has done many Ray one surgeries. But have to visit to get questions answered.
Seems from videos seen but no data from a real person yet -if do plano & -50 second eye with EMV iols maybe see at 23 inches.
To get maybe reading at 17 1/2 inches more or less need -1.00 between eyes.
IF both eyes plano maybe see at 31 inches more or less.
Is this much different than eyehance??
-1 beteeen eyes probably be too much for me and no experience with monovision contacts. I would only want maybe -50 or -75 at most between eyes though I understand anything can happen no exact outcomes.
My surgeon old fashioned and only has synergy , plain ole monofocals & now Rayner. Now I can see perfect at 14 and see tiniest of print and can bring that really close. Most activity intermediate. Live on computer.LOL) , in kitchen a lot, but like tv and do bike riding and walking & hope to get more active. Didn't want to be reader dependent on and off.
Seems my choices are limited to mini mono with plain monofocals set -2 & other eye-1.50 if want to maintain near and get some intermediate. But not sure how much -2 would see. Doctor says probably moderate size print but what does that mean. ?? If that means size 14 or bigger than that will most likely means readers on and off. And then that means progressive glasses so not much glasses free in the end.
Not sure if I would get any more range of vision if do the same setup with eyehance if go with another surgeon. or if rayner does near/intermediate set up .
Now I am -2.50 & -3.25. Could be worse since waited very long and cataract dense now in -2.50 right eye. Slight astigmatism.
This is more challenging for low myopes. And everyone makes it clear will never have the close vision again that natural eye has.
Anyone have any comments or experience with these lens. And will it be traumatic to go plano in 2 eyes and have no mini mono and flip vision all together. I think I may need to maintain some reading.
0 likes, 8 replies
Guest loveanimals
Edited
Odd that he would refuse to do monovision with the Ray One as it was specifically designed to be used in a monovision configuration. With Eyhance, if you target distance and nail it you should be able to count on usable vision down to about 26" (or better or worse… results will vary from person to person). That is fingertips basically with arm fully outstretched.
jimluck loveanimals
Edited
You could target -3 in both eyes and have pretty much the same vision you had before the cataracts and use glasses the same way. Or, find a doctor who does Eyhance, do it with a near target like -2.5 or -3, have the same super near vision you had before cataracts, and when you have distance glasses on they should also give you decent intermediate.
Maybe best to get distance glasses that are 1/2 to 3/4 diopter short of full distance correction to get really solid coverage of the intermediate zone. Glasses are cheap ($20 on Zenni). You'll be able to experiment to find the sweet spot.
If distance glasses can also give you intermediate, and glasses off is set for near, you'll have all 3 zones covered with one pair of glasses.
I'm a high myope and am experimenting now with contact lenses, set for reading, and then using cheap Zenni glasses for the other zones. It works great but I am having a surprising (to me) feeling: When I put the contacts in and suddenly have great glasses-free near vision, I'm disappointed when I see the far side of the room is fuzzy. I'm discovering a desire for glasses-free distance vision that I didn't know I had. So, I might end up going for distance and using readers for close. But I definitely would want the Eyhance for that little bit of EDOF without the loss of contrast sensitivity inherent in the Vivity. And I might go for the IC-8 and get the whole range.
RonAKA loveanimals
Edited
I was in the -2.0 to -3.0 range before surgery. The first eye was done for distance and ended up at 0.0 D sphere, -0.5 D cylinder, or -0.25 D SE. I have 20/20+ vision with this eye and can read normal text on a computer monitor at 20" or further, but would not be comfortable for computer use, as I only have a 24" screen. No problem at all with things like the car dash instruments.
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The second eye was to be the close eye in a mini-monovision configuration. Another monofocal was used and I ended up at -1.00 D sphere, -0.75 D cylinder or a SE of about -1.4 D. In a perfect world without astigmatism I would have asked for a -1.5 D target. If I had it to do over again I would get a toric to get rid of at least some of the astigmatism, and be closer to -1.5 D sphere.
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I can see down to about 10" or so, and have no problems with computer work and almost any reading except for the very fine stuff like 6 point or so. In sunlight I can read J1 on the Jaeger chart quite easily. In dimmer light I do occasionally use reading glasses -- perhaps once a week or so. I have some progressive glasses that do improve vision in both eyes, but virtually never wear them. It is just too convenient to go without them.
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I sounds like your surgeon is a J&J client, so my recommendation would be to stick with the Tecnis 1 monofocal. I would pick the Eyhance over the Raynor EMV if you want to go with an EDOF option. But, I really don't think it is worth the complication. I would just go with the Tecnis 1 targeted to -0.25 D in the distance eye (preferably dominant eye), and -1.5 D in the closer eye. If the surgeon hits the targets you should have a full range of vision, with only the occasional need for some mild readers for very small print in dimmer light.
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If you currently have reasonably good vision, I would get some contacts that correct you to the 0.0 D and -1.5 D to see what you think of it.
jimluck RonAKA
Edited
Bear in mind that astigmatism and other cornea aberrations give natural EDOF. Someone with a more spherical cornea is not going to get as much depth of focus out of their IOL . I was shocked at the loss of natural EDOF when I started using scleral contacts (hard contacts that simulate perfectly spherical corneas). People get widely differing results on depth of focus, probably because of differences in their corneas. Some get a distance monofocal and can't see their dashboards clearly. Someone else (like you, Ron) with more cornea aberrations gets the same monofocal with the same target and sees their dashboard just fine.
RonAKA jimluck
Posted
My conclusion is that there is nothing good about astigmatism. Yes, it can make you a little more myopic, but not in an ideal way. While I get away with -0.5 D in my distance eye without much impact the left close eye which has irregular -0.75 D cylinder is not so good. I see a double image at distance and close up when reading. I would trade astigmatism for just the correct sphere any day. I am sure -1.5 D would be much better than the -1.0 D sphere, and -0.75 D cylinder that I have now.
soks loveanimals
Posted
with absolutely no data to back myself i am leaning towards low myopes like myself -2 and -2.5 to go with -0.5 and -1.25. i would love to know what near this would give. add another -0.5 with eyhance for near. -2 will distort distance on an iol eye significantly. also i think or would like to believe without any data again that contrast quality and binocular summation are highly underestimated.
RonAKA soks
Posted
The -0.5 D eye is not going to help at all with near reading vision in the 8-12" range. All of the near reading will be provided by the -1.25 D eye. The -0.5 D eye will start to help with the intermediate range of 18 to 30", but vision will be pretty good already in that range with the -1.25 D eye.
indygeo loveanimals
Edited
I was pretty much exactly where you are several years ago. Low myope. At that time, the Rayner EMV lens wasn't available in my most affected eye. I opted for a mono-focal (Zeiss) set for distance in (as it turns out) my non-dominant eye.
My plan was always mini-monovision and when I went to get the second eye in September 2022 my surgeon, the first to implant the EMV, recommended it. Now, it's his go-to lens. He has abandoned Eyhance and standard monofocals. He offset the Rayner EMV 0.75D from my monofocal. I'm J1 near to intermediate (from about 10-11 inches to about a metre) and 20/15 at distance. Never in my wildest dreams did I think I'd ever be glasses free when all this started going down as I slowly lost my sight. Enthusiastic thumbs up from me on the Rayner lens.
Indy G