Cataract Surgery - Below Age 40 - Best IOL Choice?

Just to give us some background, what is driving the need for an IOL? Is it just your right eye only, or both eyes that will need an IOL?

1. Setting the eyes for intermediate is a good idea. More diopters areneeded for near vision so setting for near gives limited range. For example -2.5 gives me great near vision from 8 inches to 12 inches only. setting both eyes to intermediate would give you better near due to binocular summation. Common approach with this set up to be glasses free is to set one for intermediate and other for distance. you will get binocular summation for intermediate and near with this approach as well.
2. Edge glare is a real problem. I experience it. Softport may not necessarily prevent it.
3. PCO will happen for younger folks.
4. I believe the tradeoff is between accommodation by choosing a multifocal vs nighttime artifact.

Hi there!

This is a little long but I'm a bit starved for social contact, haha.

Sorry you're dealing with cataracts at age 30. Are they bilateral? How far along?

I started with symptoms age 45, very active and outdoorsy (sailor and other things). Also lots of computer work though. Got IOLs put in age 50 finally once blindness was no longer correctable with contacts. I had not lost all my accommodation but the central cataracts made me even more nearsighted than I was at baseline (which was mild).

I have a few thoughts/experiences .

1. It's great you're doing your own deciding because all ophthalmologists have a preference and they all differ. So knowing that YOU made the choice of pros and cons is what will help your satisfaction in the end.

2. I got a Tecnis ZKB00 multifocal in my non dominant eye first on the ophtho's recommendation. I did minimal research. Turned out to have lots of halos and ghost images at night. Also very startling to have my non-dominant eye suddenly see farther than my dominant eye. Like when you interlace your fingers the wrong way, but far more disturbing neurologically. It generated unease that took some months to adjust to (and which got better when I corrected my dominant eye for distance).

3. With the multifocal, near (17") and far were both clear. Intermediate was a little blurry which I noticed mostly in a museum.

4. After five months of adjustment ànd deciding what to do, I got the lens you're considering in my dominant eye, set for far. It is much better, but does have some haze around stoplights. One ophtho told me it's because my retina is still young.

That eye ended up with a small astigmatism too that creates a little ghost around marquee signs so my dysphotopsia issues are not really fixed. Time just wears one down and sometimes we have to accept one fault in order to get another benefit.

5. Both lenses cause starbursts with headlights and bright white lights, about equally. I have heard that from many IOL patients so I expect that is just sort of standard.

6. The quality of the silicone image is more natural than the acrylic (Tecnis) image. The acrylic is very sharp and a little startling. That eye did end up a bit farsighted so could be that affects it too. The color of the silicone is a tiny bit richer too. That may be due to contrast loss in the multifocal. With both eyes, the brain merges color and I don't notice.

On first gut reaction, when I compare eye to eye, I prefer the silicone image quality.

7. The industry-funded studies about multifocals, in my opinion, probably underestimate the numbers of patients who see halos, but I haven't looked at them carefully. Different ophthos told me different things because they each have their preference.

8. So the B&L is probably the best quality monofocal out there (three different ophthos told me that). It would be a great choice.

9. Whether you want to see near or far principally is a personal choice.

I do stare at a screen a lot now and since I only have one near eye, it fatigues. The monofocal eye gives me a good amount of intermediate which helps for the computer: I got lucky but apparently it's a good percentage of folks who do.

10. I know one person who got monovision and loves it . Another who is a huge reader surprised me by getting both eyes for distance. th

I sometimes wish my near were more effortless or without ghost images, but I am definitely happier not needing correction when outdoors, looking at sunsets or birds or city skylines . Wearing light cheaters for extended computer work is not so inconvenient....just store them with the computer like you do the power cord and no biggy. I can make out most labels and can use my phone to shine a light on it in a pinch. Usually I don't need to magnify.

11. Losing accommodation does suck and at age 30 you would totally feel that. It feels odd, like your eyes keep trying to move something (the muscles) to make the image clear. It took some time and some mindfulness to tell my brain and face to stop trying to see it better. I probably still squint some.

There are other youngsters who have had IOlLs implanted and they could tell you even better what the accommodation loss is like. I had already lost some and my same-age friends are all dealing with it so we feel like dorks but what can you do. Now I only need cheaters for prolonged reading which is better than some with natural lenses.

12. From the little I've read/heard, there's basically no preventing PCO so maybe don't get your hopes up on that. The ophthos I met with didn't seem to think it was a big consideration.

13. Overall, this was a way bigger change than just getting a new contact lens prescription. It's permanent and that had a different feeling for me. Others seem to just take it in stride so maybe I'm over-sensitive (perhaps) or overly perfectionist (haha definitely).

All that said, when I think about how blind I was becoming, there's no doubt that the operation is miraculous. What we can do for our bodies sometimes is beyond belief.