eyhance review

I would caution you not to equate price with quality of the lens. I am convinced that in IOLs "Premium" refers to the price, not the optical quality of the lens. If you had spent more money for example and got a PanOptix or Synergy lens your outcome may have been worse and not better, depending on what your expectations were. With respect to optical quality I believe the basic monofocal lenses probably have the highest optical quality of all lenses and at the same time are the least expensive. They do not play any optical tricks with the light. But, of course they have the depth of focus limitations that do not let you see the full range of distances unless they are fitted in a monovision configuration.

Patients have bad outcomes with expensive IOLs too. Johnson and Johnson isnt a discount brand. Did your surgeon explain why your vision was good at first and degraded? Surgeon skill can play a role too.

My surgeon does 2,000 surgeries a year. Seems like a lot but he seems to know what hes doing. He only offers Panoptix, Eyhance, and Eyhance Toric along with the standard lens. He has used the other lenses but doesnt any longer. i hope you get it sorted out, sounds like quite the ordeal.

I have been debating between Eyhance and Clareon and this post really is significant for me. Thanks for posting that information. That is the type of information that is essential to review before choosing a lens. I have been leaning toward Clareon anyway.

I am looking at Eyhance versus Clareon and am interested in your post as a result. I have not been able to find a lot of feedback after 6 months to one year on Eyhance or any of the others. What Monofocal would you implant in doing it over again? What is the main problem you found with Eyhance that would not be the case with any other Monofocal?

Do you have any further comments on this. I have seen other positive reviews after 6 months with Eyhance?

It probably is a bit early to be coming to any conclusions. It doesn't really add up that using a +1.0 reader lens does not improve near vision with the Eyhance eye. It should make a big difference. Perhaps not enough to read really find print, but it should improve things.

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However, it sounds promising that you got a good outcome.

It doesn't make sense to me either. One observation I made after my last post is that at 1.0, I'm getting magnification from the readers, but not much in the way of additional clarity. The same can be said at 1.25 and 1.5.

I think a more accurate description of what I'm experiencing is that it takes magnification of 1.5 to offset the the lack of clarity to the point where reading becomes noticeably easier, but clarity is an issue regardless of magnification. I can still read the letters and numbers with or without magnification, but I'm still getting a lot of ghosting. Hopefully that just means that my eye has a lot more healing to do, and that clarity at all magnifications will come in time. It's likely that I'm having the same issue all across my range of vision, but I don't notice it as much with distance because my distance vision was never great in either eye to begin with, and the uncorrected eye gets cloudier every day. So what I am experiencing is already a substantial improvement over what I'm used to.

I would think the most likely issue is just insufficient healing time. Pressures can be elevated after surgery. It takes the eye some time to fully recover from having the natural lens broken up, removed, and a new lens inserted. I would reserve judgement until you are at least 3 weeks out from surgery, and ideally 6 weeks.

Agreed. I was 10 weeks out and still having issues with healing. I have my FOURTH follow-up next week (3+ months out). 4 days is too soon to draw any conclusions, good or bad. I went through a lot of changes in the first couple of months. Some good. Some not so good.

@thomas84367 Do you have 20/20 vision for both far and intermediate (+60cm) on your Eyhance Toric eye?

With normal 12 point fonts and no magnification, how close to the computer screen do you have to be before crispiness starts to blur?

Thank you for sharing your experience!

I'm scheduled to have Eyhance in both eyes the first week of March. I've spent months researching them all and decided finally on Eyhance because people's outcomes have been so good, especially with regards to the range of vision they ended up, and the reports of good contrast even in lower light situations. Initially I was going to go with Vivity and PanOptix, but after reading more and more reports of how much contrast people were losing in lower light situations, I decided against them both. I then was considering Synergy in at least one eye and a monofocal (such as the Clareon you mentioned) in the other, but then started reading more and more really good outcomes with the Eyhance, so a couple of weeks ago decided to go with it in both eyes. The Eyhance appears to be working out very closely to a monofocal with regards to clarity under all light conditions, and the little bit of extended vision it provides has been giving people really good near vision also when targeted toward myopia. From what I've read, it uses a refractive design instead of a diffractive one, which apparently gives it smooth transitions and very little chance of light night time disturbances.

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For myself, I've decided to go with -0.5 D in my dominant eye, and -1.0 D in the other, hoping to have similar results to others here (and elsewhere) of really good near yet reasonable distance vision (and all in between). I'm hoping if the outcomes come close to this, then I'll be also be able to benefit from binocular vision as they aren't that far apart. I've been really myopic most of my life (-12.50 & -13.00 lately), and around home I now usually wear my glasses the most as I can see clearly 4" away when I peer over my glasses, which is really, really, really, lol, helpful when repairing anything, especially computers and other electronics (which I've done a lot of over the years). So I've realized that I'd be a lot happier keeping a good degree of near vision, and potentially losing some distance overall. Hopefully I will come out with reasonably good driving vision also and if I need help for distance for driving or at just at night, I'll happily deal with that. Though when I asked the surgeon if I could wear contacts instead of glasses to correct distance, and he responded sure, but it probably would only be a prescription of around -0.5 even with targeting myopia. I was very surprised by his response as he had been really pushing me to target plano in at least one eye so I would have good distance.

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I've always been active, especially outdoors, gardening, walking, biking and I've always loved driving at night (hate traffic), so I'm almost optimistic now. I've been struggling a lot with a final decision for quite a while now, but am now happy with what I've decided. Hoping I'll still be so after the surgeries, lol, but I'll let you all know.

With your power choices I think you have good chances to get good reading vision, with only the occasional need for readers. For distance the -0.50 D target may leave you at little short of 20/20, and probably more like 20/25, which I believe is well above the minimum 20/40 required for driving.

I've been really myopic most of my life (-12.50 & -13.00 lately), and around home I now usually wear my glasses the most as I can see clearly 4" away when I peer over my glasses, which is really, really, really, lol, helpful when repairing anything, especially computers and other electronics (which I've done a lot of over the years). So I've realized that I'd be a lot happier keeping a good degree of near vision, and potentially losing some distance overall.

As a fellow high myope who now has -2 monofocals in both eyes, I can tell you that you probably won't be able to see anything that close with great clarity with -.5 and -1.0. One of my eyes wound up at -2.5, and with that eye I can see perfectly beginning at about 8". With my -2 eye it's closer to 12".

Everyone is different, and you may have good reading vision, but that all depends on what you're reading and how far away you're holding the book/phone/etc. Now perhaps with Eyhance things are different from a standard monofocal, but just be aware that your near vision may not be anything close what you have now.

Were your surgeon to hit -0.50D on the nose, then, according to my averaging of seven Eyhance defocus curves, the average of those mean results would be logMAR 0.097, which equates to 20/25. But even if my averaging of both monocular and binocular defocus curves is a useful indicator, it's also imoortant to bear in mind that defocus curves report mean results and standard deviations. At -0.50 D you could end up better or worse than 20/25. That said , my wife recently had Eyhance IOLs implanted in both eyes with -0.50 D targets and is 20/25for distance (which sfe experiences as clear.sharp distance vision).

With your very specific targets for your outcomes I would suggest having a discussion with the surgeon about how he sets targets. I recall that you have some astigmatism, and even with a toric lens it will not be reduced to zero. For this reason the common practice is to target spherical equivalent (SE) instead of just sphere. The spherical equivalent is the sum of predicted sphere plus 50% of the predicted residual astigmatism cylinder.

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For example if the target is -0.5 D, and -0.5 D of astigmatism is expected, then the sphere would be targeted at -0.25 D and then 50% of the astigmatism would bring the total spherical equivalent up to -0.50 D SE.

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If the surgeon was to target -0.5 D sphere and then with the cylinder of 0.5 D the total SE would be at -0.75 D. That may disappoint you for distance vision.

Thanks for that post, very informative. I just read a post from a person very unhappy with Eyhance after one year so this is difficult with all the conflicting information. What you targeted sounds like what I might target also and it seems like you will also get good distance vision. I have been leaning toward Clareon but still am unsure, I do want the near vision as I don't wear glasses now except for fine print.

Have you read many reports of people who have had Eyhance or Clareon in for more than 6 months?

All else equal, I'm not sure that Eyhance, which my wife just got and I'm scheduled to get in March and April, will give you measurably better uncorrected near vision than Clareon. At any rate, a study comparing the Eyhance to Clareon's AcrySof predecessor found no significant difference between the two at distance and near. For intermediate vision (60 cm), however, Eyhance showed significantly better results: UIVA 0.31 vs 0.41 logMAR; CIVA 0.28 vs 0.38 logMAR. (The Eyhance results also were better for distance and near , but not, in the article's view, significantly better).

Esat Cinar, et al., Vision outcomes with a new monofocal IOL, February 2021, International Ophthalmology, 41(3): 1-8.

That is interesting and I assume this is an unbiased review from a group without a special interest.

I had not heard that the strong point with Eyhance is intermediate which would be important for me.

Thanks, Ron. I hope so too. Once again I want to thank you and many others here for sharing your experiences. So very helpful.

Yes, I've come to terms with that my repairing habits in particular will change a lot, lol. I'm still mourning, but there's always give and take. Since I'm going to use the Eyhance my near vision should have a bit more of a kick than if I was going for those targets with a monofocal. If I can even achieve ten inches up close, I would be very happy.

That's good to know about your wife's results. I don't want to end up too close to plano, so even if the results vary a bit either way with either eye, I think I'll still get good results. I'd rather be a bit myopic with binocular vision than get great distance vision in one eye without it. I've read that for the Eyhance, it's best to keep no more than .75 D between the two eyes for best results, as opposed to what can be done with monofocals. My pupils are relatively small also, and don't expand fully even in complete darkness, so reading what you all have been discussing here with regards to the benefits of a small pupil, there's a good chance that will work to my favour with these lenses.

Thanks, He seems pretty sure of himself with regards to hitting the targets, but I will discuss that more with him when I go in for the preop this week and do all of the extended tests. My astigmatism is -1.0 and he will be using the ORA after he opens my eye, before deciding upon a Toric, though from just the prelim consult he thinks the left eye will definitely

Glad it helped. Yes, I'm worried about results a year from now also, although I've heard of having the same kind of problems with a variety of lenses, leading me to suspect that the problem might be more to do with the individual's eyes as opposed to a specific lens, well in general at least. I have read that the Synergy has had a host of post surgery complications because it has to be so specific in it's location to work properly. RonAKA has had really good results with the Clareon, and you could even mix the two for a good mini-monovision result?

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I know I'll probably need readers for fine print -- but that's pretty simple -- I already carry a pair when I wear contacts, but in general I want a cohesive near and intermediate result, with good if not perfect distance vision. I'd love to be completely glasses free, but from all of the research I've done, I know that it just isn't going to happen, so I've had to think long and hard about how I live my life and what will work best for me. I've swung back and forth on this, cos the idea of having great distance vision so I could just get up and go and drive the car without organizing and cleaning contact lenses, having to avoid dust, fresh air fans, etc, etc, is highly enticing to me! But I've finally been able to realize that being around the house and doing basic things without having to wear glasses or contacts is going be really freeing also.

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And, if things go alright, I should end up with a heck of lot better vision than what I've been used to for most of my life whether wearing glasses or contact lenses -- being able to see at twenty feet with relatively good clarity is nothing to sniff at in my world, as is even ten inches away (I can only see clearly maybe six inches away without assistance). As others here have mentioned, it's one thing to, say to have to put a pair of glasses on, for sharp distance vision when driving -- that's a specific thing that can easily be prepared for, but having to take them on and off repeatedly when at home and such depending on what you just decided to do... Nope, not for me! With my brain injury I have next to no short term memory, so adding yet something else to have to "plan" for would break the bank so to speak for me at least.

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Have you set a date for your own surgery yet? What helped me to make a decision was to just look around and visualize how I life my life, then go from there. Granted, I'm still constantly second guessing myself. I keep reading results from other people and thinking, crap, why I didn't remember that and take that into consideration, etc, and that really is the path to madness, lol. But on the other hand, I also feel a certain relief that I've solidified a plan and am slowly changing my focus to preparation for the surgery (eye exercises, eye drops, making sure that my surroundings are supportive of the surgery, etc), so to do my part to help the surgeon get the best results for me.

Yes, I have. Both here and via YouTube. Some of the surgeons on YouTube have put up some really helpful videos, but what I found the most helpful was reading through the comments and asking questions myself of those who have had surgery with a lens I was interested in. Especially people who have had it done a while back. A lot of people don't even know what prescription they have, or even what lens they had implanted (in the USA mainly), so it's good to ask some clarifying questions.

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You could do a search there using Eyhance or Vivity, or Clareon, there's quite a few. I also would do google search with the name of the lens I was interested in, then add the word, problems, or reviews. I always do that when researching tech and it's always very informative, no matter what the topic is. Doing that also helps to sift out some of the paid consultant results. This website though has been really helpful for me, though maybe if I hadn't done as much previous research before coming here, I might not be as confident of what people here have had to say as I am now.

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The Eyhance has only been approved here since 2021 (NA), but in Europe, it's been approved and used since 2019, so that is very reassuring to know, for me at least. And the Clareon is a basically a newer version of a standard monofocal. The main differences seem to be only that it uses different materials that don't lend themselves to glistening over the years and has the blue filter. So like most monofocals, the problem rate, both short term and long term, should be pretty low. And even with the Eyhance, I think, because it is just an enhanced monofocal, shouldn't be giving a lot of negative side effects. Most of the long term problems seem to be coming from the mainstream premium lenses like PanOptix, Synergy and Vivity.

My surgery date is in early March. I will have more questions answered on Tuesday when I speak with my doctor. Glad this site is available as I have been able to get some excellent information from many informed people! Thanks for the detailed post!

The Eyhance only missed out on being called an extended depth lens because it only gave something like 0.4 D of extra vision and the cut off to designate an EDOF was 0.5 (Vivity comes in at 0.6). Though as I read more and more about it, I'm wondering if J&J did that on purpose because even though they can't charge a lot of extra money for it since it's considered only a monofocal, as it gets used more and more, there is more and more talk of it being officially added to medicare as a supported lens which will bring in a lot more money in the long term. Especially with regards to the design of the Toric version which many non sponsored surgeons are raving about, saying that they can see it becoming the default future design for Toric lenses in general.

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But I understand the Clareon to be just a standard monofocal lens with no claims at all to extended focus, so I don't see how it could rate as high as the Eyhance for near and intermediate vision, unless you targeted a lot more myopia than what the Eyhance needs to do the same job, and which would really cut into the Clareon's long distance range, which as a monofocal, it would naturally rate higher than the Eyhance, cos that's what it's primary job is. Except when it's targeted for myopia, and then it loses a lot more distance clarity than the Eyhance does when targeted for myopia. And when targeted more toward myopia, it's contrast and clarity in the nearer ranges apparently drops below what the Eyhance achieves in similar ranges.

You're welcome. So your surgery might be before mine. I'm scheduled for March 6th and my pre-op is this Thursday. I was "urged" to make a final decision on my targets last week, although I'm assuming that depending upon the results from the extended tests, there could be room for change. Though I'm pretty happy now with what I asked for.

Can you, please, cite me to what you've read? I'm contemplating targeting a 1.0 D difference, which means, standard deviations being what they are, the actual difference could approach 1.5D (hence my current testing with contacts.

Also, FWIW, if you search for "Eyhance Blended Vision", you'll find at the website for Premium Vision Surgical Centres in Canada, first, an article on that subject that appears to recommend a 1.5 D difference, and, second, a reprint of an article by Graham Barrett in which he recommends targeting for a 1.25 D difference (no particular IOL mentioned).

I can't answer in detail but have seen posts listing benefits with both Eyhance and Clareon as well as negatives. I will need to cover that with my doctor who has recommended Eyhance for distance and Clareon if I were to choose the intermediate focal point (which I doubt I would do).

I'll go and look through what I've saved and get back to you. I'm pretty sure there were some references to it here also, but I think it was on older posts, at least a year old. It stuck in my mind because usually 1.0 D to 1.25 D difference for a monofocal is considered acceptable, and when I initially was setting my targets for the Eyhance, I was following that rule of thumb, but then after finding this information, changed my mind. It has to do with the extended focus aspect of the Eyhance and the way that the lens was designed. Though it might be only something to consider if aiming for binocular vision. And no, if it was just something I'd read with someone speculating about the subject, then I wouldn't have paid much attention to it.

No problem. But I would think that the Clareon would be the lens to target for distance and the Eyhance for near and intermediate.

"Except when it's targeted for myopia, and then it loses a lot more distance clarity than the Eyhance does when targeted for myopia. And when targeted more toward myopia, it's contrast and clarity in the nearer ranges apparently drops below what the Eyhance achieves in similar ranges."

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Not sure I can agree with that conclusion. The defocus curve left of the peak 0.0 D value does not decrease any more slowly for the Eyhance than a monofocal lens. The advantage of the Eyhance is on the right, or closer distance side. The loss of distance vision when you target myopia will be basically the same with Eyhance as a monofocal like the Clareon.

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And the contrast and sensitivity does not decrease at nearer distances when it is targeted for myopia or nearer distances. The contrast sensitivity actually increases, and depending on where the Eyhance is targeted, the monofocal targeted for myopia likely exceeds that of the Eyhance.

What exactly is targetng for myopia? Who should do that?

A recent post said that both Eyhance and Clareon were similar for near vision but Eyhance better for intermediate.

On blue light filtering, why are all IOLS' made with blue light filtering if the natural eye has it? It seems it is not deemd essential?

I know they all have UV and wonder if the natural eye has that?

Yes, the natural eye has UV filtering as well as blue light. Keep in mind that the natural eye UV and Blue light filtering is in the lens. The natural lens is chopped up and removed when you have cataract surgery, so the natural filtering is gone.

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Why wouldn't all IOL manufacturers use blue light filters? Well some must feel that allowing in more light including the blue light has some benefits. And possibly they justify this by the fact that the average age of someone getting cataract surgery is likely 70 or more. And at that age the remaining life of the person is not long enough for the eye to be damaged by the extra light that the eye has never seen before. They would probably not say that, but it could be the reason.

Targeting myopia is what you are doing when you target intermediate or close vision. It is the myopia that gives you the closer vision. When you target -1.5 D of sphere, that is mild myopia.

Don't get that one but will see if I can find it somewhere.

I can see why lots of people don't know what lenses they have or their prescription. I am finding it hard to get any information from my doctor and HMO. I have had to be very aggressive requesting telephone consultations which would not have been offered. Many of these doctors just don't want to waste their time and give out much information. It all comes down to cost management I am sure but it has made my life difficult. I wrote a suggestion to them asking why they don't give a basic packet of information describing the IOLS etc. in detail. I had to start out with zero information other than I would have to get a monofocal because of AMD and not a multifocal lens.

That is the only information I had!

Thanks for the additional information on google searching. I have been using google to find a lot of groups on patient.info which I did not know about which are much older groups.

When you have an eyeglass prescription of say -2.0 D sphere, that indicates you are myopic or short sighted. To get full distance vision you need a -2.0 D lens. Without that correction you can see very well at short distances. That is why it is informally called short sighted. With monovision that is what you are doing but in a more controlled manner. Full monovision will be leaving one eye -2.0 to -2.5 D myopic or short sighted. Mini-monovison uses about -1.5 D myopia, while micro monovision uses about -0.75 to -1.0 D myopia in one eye.

All I can add is that the authors declare in the article: "None of the authors have any conflict of interest related to this research."

I'm very interested because I'm currently contemplating implanting two Eyhance IOLs in a mini-monovision arrangement and haven't run across any journal articles suggesting that the effective limit with Eyhance is 0.75 D, which would be concerning both because I think I want, and testing so far with contacts suggest I can accommodate, at least up to 1.5 D of difference without any negative side-effects or loss of binocular vision and because a 0.75 D limit suggests the need to target for at most 0.5 D of monovision because there's always the risk that the surgeon will overshoot the target. (If a 1.5 D difference works for me, then I can ask my surgeon to target a 1.0 or 1.25 D difference.)

Although I haven't seen any journal articles relevant to the points you raise, the presence of "Eyhance Blended Vision" by the Canadian Premium Vision Surgical Centres at least strongly implies the viability of a 1.5 D difference. "Unlike monovision, EBV offers a greater range of sight (focal depth) in both the dominant eye and the non dominant eye. The advanced design of the distance Eyhance lens allows it to offer vision throughout far and intermediate ranges, reaching as close as 60cm away. This is complemented by the near eye’s ability to see from a meter away, to as close as 40cm. Together, these lenses overcome the weaknesses of monovision by covering the entire range of vision, from distance up to 40cm, without creating a Blur zone in the middle. Essentially, this new Blend Zone makes it easy for the brain to merge the images of both eyes thereby achieving true binocular vision. Overall, EBV helps adaptation and depth perception. The brain is typically good at blending images together seamlessly so that you don’t even notice which eye is being relied upon, but EBV shrinks the disparity between the two images to make that even easier. Many patients after surgery can’t even tell which eye is predominantly near or distance."

An illustration accompanying the text posits the dominant eye at 0.0 D and the non-dominant eye at -1.50 D.

The article also does say: "Unfortunately, all currently developed options for correcting near vision may encounter night vision issues. While driving at night, patients can sometimes experience halos around sources of light, but it tends to improve with time as the brain adapts by suppressing these halos as noise. In other corrective lenses, such as multi focal lenses, this is due to the rings on the lens and cannot be overcome with glasses. On the other hand, with EBV, halos are caused by the nearsighted eye’s focus on the intermediate and close range. To resolve this issue if it persists, we recommend using prescription night driving glasses to allow both eyes to work together and give the best possible vision at night."

Hi again. Sorry, I've looked through my saved articles and I can't find the specific references now. Though there's a good chance I didn't bother to save them because I wrote it down in my own "correction" notes and highlighted it so I'd make sure to follow up on making the change, so didn't feel a need to keep them -- I have a lot of stuff saved, lol. I did read the article you reference a while back, but then came across the other information that strongly recommended keeping the difference lower, citing pretty much the same reasons. It gets pretty confusing. It seems that a little dab with these lenses goes a long way. I'm going to keep looking though, so if I find them again, I will post it. I wouldn't have been looking for that information specifically, I was just reading articles, and watching videos about the lens, and this information was part of that -- which is probably why I'm having problems finding them again.

Oh, really? That is very different than here in Canada, at least for my own experiences in Ontario. My optometrist has always given me a printout of my prescriptions for contacts and glasses. Though I think there's a law here stating that they have to as they aren't allowed to hold you "hostage" over their services. You would think though in the USA that since you are paying for the service, one way or another, they would be more forthcoming in giving you your own information. Even the two cataract clinics I did consults with gave me a package with descriptions of the lenses they prefer to use, and information about cataract surgery itself. Yes, I've had to do my own extended research on them all, but at least I had a starting point to work from. Now I understand more and more where you're coming from, and why you're so stressed over this whole thing. I mean, we're all stressed to some degree about cataract surgery, but you've really been dumped in the middle of this without any starting point at all. Have you been able to get a second opinion about your eyes?

I appreciate your looking. I know from my own venture into this area how difficult it sometimes can be to keep track of what I find.

Personally, I've been experimenting with contact lenses and a 1.5 D difference. So far, after one week, I'm not experiencing any negative side-effects. All going well, this would give me confidence to talk with my surgeon about targeting a 1 D difference in my two eyes. According to my averaging of mean visual accuities in Eyhance defocus curves in seven articles I've been able to find on the web, if the surgeon hits the targets (-0.50 D and -1.0 D), the resulting vision indicated, but of course not guaranteed, would range from 0.0971 logMAR (20/25) at distance, better through 40 cm (15-3/4"), and 0.1136 logMAR (20/26) at 36.36 cm (14-31/100").

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I fully realize that the distance vision falls short of 20/20, but my wife, with two Eyhance IOLs both targeted at -0.50 D, experiences her distance vision--measured as 20/25--as clear and sharp. Further, my experiment with contact lens has me appreciating more and more the importance to me of good intermediate and near (albeit not super close) vision. Having worn glasses all me life, I don't think I'll mind possibly needing single vision distance glasses to drive at night and readers for close up tasks.

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That unfortunately makes a lot of sense regarding the lack of concern about blue light filtering in IOLs, especially considering the general attitude towards seniors in the medical field. I observed a lot when I had my brain injury, and subsequent stroke, at the age of twenty-two, and had to undergo speech and memory therapy. Then there were very few people who had suffered a brain injury such as mine, and recovered enough to even require speech therapy, so they didn't quite know what to do with me, so I was put in with a variety of "groups", and because of the stroke and it's resulting aphasia, one of the groups was seniors. There was a distinct difference between how I was treated, in particular with regards to long term results as opposed to the people there over seventy plus. So much so that I and my family actually made multiple complaints regarding it.

No problem. What I wrote is my analysis of what I've read (and watched) about the two of the lenses and their outcomes in case studies.

Thanks for your reply. I am with an HMO which has a mixed reputation. Many don't like it as they find it to be rather streamlined I have had to be very proactive with them and keep on my toes to make sure I get the best care. I can't believe you actually got a package with IOL descriptions which I think should be standard procedure. I am going to register a complaint with my HMO about that.

The U.S. has a problem with the health care system as it can be very costly. This HMO is one of the best deals around and can save a lot of money for budget minded individuals. I have rarely used the plan as I am very healthy.

Anyway you are lucky n Canada as I am sure it is very cost effective in addition to offering good care. I am glad I found this site as it has been very helpful and informative

Good luck with your surgery. Mine is March 2 and am getting prepared!

It's not true, I don't have any blue light filtering and my vision is almoast the same as my natural (I'm 30) whereas I know someone who has a blue light filtering IOL and has much of a diffrence.

Blue light filtering has a very minor effect on the colour balance as detected by the person.

In the limited research I've done, I haven't seen support for the claim that the natural human eye has a blue light filter that cataract surgery removes. If it exists, I'd be most interested in seeing it as I still have time to alter my IOL choice. To the contrary, however, according to the American Optometric Association article Blue-light hype or much ado about nothing?: "While anterior structures of the eye block and absorb most UV rays from reaching the retina, visible blue light passes through the cornea and on to the light-sensitive tissue."

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There may be other reasons to be concerned about blue light, for example, disruption of one's circadian rhythm an digital eye strain. But there also are reported benefits from blue light. For just a little more information you may want to see the separate "Blue Light" thread I recently started.

That is exactly what my doctor said yesterday when we discussed it!

That aspect is probably only a consideration for those doing digital dark room work and have concerns about how other people see the product compared to we see. Getting skin tones exactly right in digital darkroom work is always a challenge. That is why photographers usually calibrate their monitors so they more accurately reflect what the print will look like and what others will see.

I don't like HMOs. I think they restrict freedom to choose whichever physician or hospital your prefer. But they can save money and work fairly well if you are relatively healthy. I have heard good and about things about Kaiser. I don't want to

scare you, but you may want to read this story about how a routine cataract surgery at a Kaiser clinic in Delmar, CA on Feb. 2022 went terribly wrong.

Google "from open water to a dark room cbs8." You can also just Google Kaiser Permanente lawsuit malpractice" and you will get some links.

I will say, though, that what happened to that cataract patient in Delmar CA is EXTREMELY RARE.

I like my doctor and trust her and Kaiser has been fine but you have to be proactive sometimes (which I am). You have to understand the system and make it work for you!

The lens have a yellow tint to them for the blue light filter. You have said that you can't tell the difference with the blue light filter. I wonder if vision is slightly darker than brighter because of it?

The image brightness in the blue light zone will be similar to or slightly brighter than the natural lens. Keep in mind that the pupil is almost never fully open, so your eye is adjusting for it all the time. Clareon overall has a higher light transmittance than the AcrySof IQ lens that preceded it. I have one of each in my eyes and I can't tell the difference between them. My eye adjusts for it. The other thing to consider is that while the Clareon blocks blue light to a similar degree as a natural human lens of someone that is 5 to 50 years old, it actually transmits significantly more of the normal light than the natural lens does. Google this document and see Figure 3 which shows how the Clareon compares to the natural lens of a 4.5 to 53 year old.

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P190018 Physician Labelling Clareon™ Aspheric Hydrophobic Acrylic IOL PDF

Corrections: I mistyped the near target, it should be -1.50 D (a 1 D difference from the -0.50 D far target). Also, the 0.1136 logMAR (20/26) mean visual accuity is at 40 cm (15-3/4"). To get 0.1136 logMar at 36.36 cm, the near would have to be -1.75 D.

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And just to re-emphasize: there are no guarantees. First, the surgeon may not hit the targets spot on. Second, the defocus curve data I used are the reported mean visual accuities. Third, I averaged together both monocular and binocular defocus curves. So long as these limitations are kept mind, I think the information has some indicative value.

I read something indicating the natural lens has a VERY small amount of blue light filter but does have some? Therefore Clareon would have a small amount also and as you indicate will actually transmit more natural light. Does the AcrySofIQ have a blue light filter? It appears not?

You are wasting your time for this blue light thing. It doesn't matter. And please don’t treat anyone here as a surgeon, including RonAKA.

I'd be interested in what that something is and, if it exists, whether the amount of filtering is clinically significant. As I've noted, according to the American Optometric Association's 2019 article, "Blue-light hype or much ado about nothing?", "While anterior structures of the eye block and absorb most UV rays from reaching the retina, visible blue light passes through the cornea and on to the light-sensitive tissue....Visible blue light that reaches the retina is absorbed by the retinal pigment epithelium (RPE) and certain photoreceptors, generating localized oxidative and thermal stress. In laboratory studies on rodent and primate models, direct retinal exposure to bright blue light for a prolonged time accelerated rates of RPE and photoreceptor death. Yet, in at least one of these studies, cell death was only noted at an energy level much higher than that typically emitted by electronic devices."

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The AOA article concludes (emphasis added): "So, where does all this leave our current understanding of blue light? Karl Citek, O.D., Ph.D., Pacific University College of Optometry professor and member of the American National Standards Institute's Accredited Standards Committee for Ophthalmic Optics, says while there is a possibility that excessive blue light exposure can affect melatonin release and thus affect the sleep cycle, there is no new evidence to suggest that device-derived blue light exposure increases the risk of ocular damage. If anything, the evidence emphasizes the importance of wearing UV-A and UV-B blocking sunglasses when outdoors."

I am NOT treating anyone here as a surgeon! No, I think the blue light filter is worth exploring and investigating and I have an open mind which many here have also! Exploration and sharing information is what we are doing here!!

It may or may not be clinically significant. That is something I have not been able to find but am curious?

Data based on studies done on eyes donated for medical research at death, the natural eye has a very significant amount blue light filtering even in very young people, and it increases with age. If you look at the transmittance graphs the higher range for the natural eye is for younger people, and the lower side of the band is for older people.

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Since 2018 or so, Alcon has offered clear lenses as well as the blue light filtering versions. I believe the blue light ones are much more popular, and it may actually be difficult to get a clear one. My AcrySof IQ (SN60WF) has blue light filtering as does my Clareon. I am not sure Clareon is available in a clear version. I think the Clareon is being brought out in the most popular lenses first. When I got it, there were no toric version available.

Yes, they do have a clear one. I just want to make sure with AMD and the dimming of the central vision over time that I will be getting enough light in with the blue light version. I have just left a message for my doctor asking that question

That is not a concern at all. The lens will not impact the light available in the important visible part of the spectrum. You will have much more light available than other people at your age with natural lenses in their eyes.

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My thoughts are that at this point the aspect of your decision that will have the most impact on what you will see is the choice of targets for each eye. Blue light filtering is just a "be safe" decision. It will not impact what you see. But, the targets you choose for each eye will have a major impact on your vision. That is where I would focus my attention at this point.

The blue light question appears to be highly-contested without definitive evidence that it should be a concern in choosing an IOL. Previously, I've quoted from a 2019 American Optometric Association article that includes the statement: "while there is a possibility that excessive blue light exposure can affect melatonin release and thus affect the sleep cycle, there is no new evidence to suggest that device-derived blue light exposure increases the risk of ocular damage." I just found a December 12, 2022, American Academy of Ophthalmology article, Factors to Consider in Choosing an IOL for Cataract Surgery, that doesn't mention blue light.

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Following your suggestion, I searched on P190018 Physician Labelling Clareon™ Aspheric Hydrophobic Acrylic IOL PDF, but that took me to the January 7, 2020, FDA premarket approval of the various Clareon IOLs, which does not mention blue light.

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Fortuitously, perhaps, I did find a 2015 article in the Journal of Ophthalmology by Patrick Logan, et al., arguing that "cumulative epidemiological and experimental evidence indicates that blue light is a credible risk factor for the development of UM (in Uveal Melanoma). Additional studies are required to clarify the risk associated with blue light and the protective potential of blue-filtering IOLs following cataract surgery."

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But this article disagrees with your statement that "the natural eye has a very significant amount blue light filtering even in very young people". According to the authors, "The young crystalline lens and cornea together filter UVA and UVB while allowing transmission of most blue light (defined as 400–500 nm) to the retina. Around 80–90% of blue light at 450 nm can pass through the young lens....Blue-light-filtering IOLs are designed to filter up to 50% of blue light. This models the natural filtering ability of the middle-aged eye, reducing potentially damaging radiation while not impacting on vision." (Alcon's blue-filtering claim is illustrated in their white paper, Blue Light Filtering IOLs and Ocular Health by Anna Katarzyna, et al.)

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And yet, four years after the Logan article, the American Optometric Association, in the article cited and quoted above, did not think there is conclusive evidence. As I said, therefore, the issue lacks definitive evidence and is highly-contested.

I just wrote her about the targets she chose. She had different targets for Eyhance and then changed them when I selected Clareon. Her Eyhance targets were -25D RE and -75D LE. She claimed she had to change them for Clareon. We are not doing mini-mono. as I could not test it with contacts.

I also had found that article that the natural eye filters out about 10 to 20%. I did not know how much the blue light filter in the IOL filters out, however and have not found any information on it?

People with AMD use blue light filters generally in the event that it could possibly help just like taking the Areds Vitamins (which has a study claiming they help....but some think the study was not done property ). You basically try anything that might help!! There is no proof, however, on the blue light filters and AMD.

If you search for the Alcon white paper cited in my last post, you'll find Alcon's illustration of how much it says their blue light filter blocks. I won't try to summarize the information here because it's something of a moving target.

Ok. Thanks for the info.

An Alcon White Paper said ". For example, Alcon AcrySof® BLF IOLs

contain a proprietary yellow chromophore that approximates the light transmission of a natural lens

(Figure 3).46 As shown in Figure 3, not all blue light is blocked. AcrySof® blue-light filtering IOLs reduce transmittance of blue light wavelengths from 62% at 400 nm to 23% at 475nm

I am glad you chose Clarenon. It is a great "pure" monofocal and a very safe choice for your AMD.

I am afraid I do not understand the numbers you are are quoting. Here are some examples of targets:

-0.25 D - Distance

-1.0 D - Intermediate

-1.5 D - Close

-2.0 D - Very close

The numbers I first sent you for the Clareon are the only ones I have. I did sent your input to her so if I hear anything, I will let you know.

"Her Eyhance targets were -25D RE and -75D LE. She claimed she had to change them for Clareon."

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I think there are some decimal points missing in your numbers. If they were -0.25 D for the right eye, and -0.75 D for the left eye that would make some sense. The right eye would be essentially full distance, and the left eye would be about intermediate.

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If converting to Clareon the right eye could stay the same but it would make sense to increase the left eye to -1.0 D. But, this will not give you good reading vision, and I would expect you will need readers.

How does your wife like Eyhance? I am assuming because you are getting Eyhance she likes it. I am still trying to decide Eyhance or Tecnis 1. Can't decide it I should go for the sure bet monofocal or get the Eyhance for those few extra inches of intermediate vision.

She likes it very much. But if our surgeon had recommended the Tecnis 1 or Clareon I suspect she would have gone along.

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She feels as though she has clear vision from distance through to her MacBook. For closer in she's using readers. Based on talking with our surgeon and my own experience with progressives, however, she's likely to get Shamir Workspace 'computer' glasses so that she can shift her view from her computer screen to papers on her desk without having to put readers off and on.

So, by searching only on P190018 Physician Labelling Clareon I found Alcon's Directions for Use for Clareon, which appears to be the document Ron was referencing. Alcon's source for its claim regarding blue light transmission/blocking of the natural lens for people up to the age of 53 is Boettner, E.A. and Wolter, J.R. Transmission of the ocular media. Invest. Ophthalmol. 1962;1:776-83. According to the abstract, the paper was based on nine eyes "from persons ranging in age from 4 weeks to 75 years." Of these, five eyes were from people aged 4-1/2 to 53; two were from people 63 and 75.

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Measurements were made "using freshly enucleated eyes", that is, surgically removed. In the body of the paper. The authors state: "The measurements were made in the ultraviolet, visible, and near infrared portions of the spectrum, covering the wavelength region from 220 to 2,800 mµ. The components measured were the cornea, aqueous humor, lens, and vitreous humor."

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I don't claim knowledge or expertise sufficient to understand the paper, much less opine regarding its modern-day validity. But it does seem to me that Alcon, and those who rely on the Clareon DFU, are putting a lot of weight on a sixty-year-old study of five eyes, especially considering that, as I have noted previously, neither the American Optometric Association nor the American Academy of Ophthalmology seem to share the concern underlying Alcon's claim for the importance of blue-light filtering in an IOL.

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Of course, if the facts change, including the presentation of authoritative, independent opinion supporting the importance of blue-light filtering, I'll change my current view.

Interesting. I am not sure now I want a blue light filter and may get the clear one that Clareon offers. Blue light blocking has become popular and many blue light glasses are sold but may just be a new fad and a way to make money!

There are no downsides to blue light filtering. It is simply returning your eye to the condition it was as a youth. The upsides are that it gives you a natural colour balance and with AMD there is a chance it may help prevent it from progressing. Yes, that has not been conclusively proven, but that is difficult to do. With no downsides to blue light filtering, why take a chance with a clear lens?

There does seem to be some reason to think that blue light before going to sleep may adversely affect melatonin production and that excessive use of devices emitting blue light, such as computers, smartphones, etc., may cause digital eye strain. Cutting down on use before bed or changing the color of the light to more amber are said to be helpful regarding sleep. Taking periodic breaks during the day from using screens is the standard recommendation to prevent digital eye strain. Some also recommend blue light glasses or prescription glasses with a blue light filter. Personally, when I bought the glasses I wear when using my desktop computer or iPad--Shamir Workspace--I got the blue light filter because I use the computer in my work throughout the day, thought it might help with digital eye strain, didn't seem to have any negative consequences, and wasn't very expensive. While I'd by the glasses again in a heartbeat, I'm not sure I get the filter without doing more research.

There is a bit of controversy out there on this topic and I would need to get a lot more information on it.

I have been using blue light glasses for over a year for my computer.

In difficult decision situations doctor are trained to "Do no harm". To my thinking that makes the decision simple. Although the evidence is not perfectly clear, the lack of the natural eye blue light filtering exposes the eye to blue light intensity it has never seen before, and MAY do harm and in particular to someone that has AMD. However, there is no harm in choosing a lens which replicates the natural eye blue light filtering. It is the "Do no harm" choice.

I would need to research it more but thanks for your input.

The Do No Harm principle well may argue against blue-light filters. A March 10, 2021, on-line publication from the American Academy of Ophthalmology--Should You Be Worried About Blue Light?--has as its "bottom line": "taking preventive measures against blue light even though there is no evidence of damage could be more harmful than the blue light itself. 'It’s premature to take preventative action against blue light—there could be unintended consequences'”.

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No optometrist I've seen professionally has ever recommended for or against blue-light protection. They've always said that there isn't a settled answer.

And, of course, many ophthalmic surgeons, my own included, recommend IOLs that don't filter blue light.

This stands in sharp contrast to the apparent consensus about the importance of UV-filtering.

Obviously, the FDA has approved IOLs that do and do not filter blue light. Ophthalmologists recommend both kinds. As I don't consider myself better informed and wiser in these matters than them, I suggest people decide as seems best for themselves.

This article of course is not about IOL blue light filtering in IOLs. It is actually about the value of additional blue light filtering to people with natural eyes. I agree with the conclusion that there is actually no value in it, and the whole blue light special glasses thing is a bit of a scam, like many other specialized eyeglass claims. My wife has some of these so called blue light filtering readers, and the lens is absolutely clear. We only got them because that was all Costco had in the power and frame she wanted. I suspect they do no significant blue light filtering because they have no yellow tint, and may at best just take out some UV. It is just a marketing thing. Blue light filtering IOLs have a noticeable yellow tint, are FDA approved, and obviously do work.

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I suspect you know that cataract surgery involves removing the complete natural lens. This removes all of the natural blue light filtering that the eye has built into the lens. This is a totally different situation than someone with natural lenses. The question is whether or not you restore that natural blue light filtering or eliminate it when cataract surgery is done. I would maintain that the do no harm approach is to restore it to the condition that a young healthy eye would have.

Unless one wants to argue that surgeons who implant IOLs without blue light filtering are committing malpractice, I think we've exhausted what usefully can be said on the subject.

I never said anything even close to accusing surgeons of malpractice. I would suggest it is time you stopped posting misleading information about IOL blue light filtering and move on.

That makes sense that she would have to recalculate them for the Clareon since it is a straight monofocal and doesn't provide any intermediate vision naturally as the Eyhance does. From what I've read of other people's targets with a monofocal, she will probably suggest around -0.50D RE and -1.0D to -1.25D LE in order to achieve the same results.

It would not make sense to adjust the target for the distance eye in switching from Eyhance to Clareon. Distance is distance. The normal target would be -0.25 D for distance with either lens. But, yes, if the same outcome was desired for closer vision, it would make sense to increase the myopia in the close eye from -1.0 with the Eyhance to -1.25 D with the Clareon. However, if my memory serves correctly the the targets seems to have been switched to about -0.50 in both eyes... That does not make sense to me, unless the decision was made not only to switch to Clareon, but also to no monovision.

Yes, I read what Spring1951 reported from his surgeon after commenting here. You're right, I went in the wrong direction for the distance eye. What his surgeon suggested doesn't make sense to me either, as I thought @Spring1951 wanted some near vision. Though those targets should give him decent intermediate and excellent distance.

I had asked my doctor but haven't heard back but happy to see an explanation on here as I didn't have a clue!

I will have time on the second eye as I am waiting 7 weeks between surgeries. Now you think -1.25D would be a good target for better close in as you had said -1D. Having not tested mini-monovision hoping it will be ok but really want better close in vision if possible.

Also, soks explained why Clareon targets are different than Eyhance. See his post to me.

I will try and explain it as follows. If you are using Clareon the default targets to get good distance and good close vision would be:

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Distance Eye: -0.25 D

Close Eye: -1.50 D

Differential between the eyes: 1.25 D

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Now if you want to reduce the differential between the eyes to be more conservative you could increase the myopia in the distance eye from -0.25 D to -0.50 D. It will cost you some distance vision, but it reduces the differential between the eyes.

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You could also reduce the myopia in the close eye from -1.50 to -1.25 D. That will reduce your close vision.

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Or, you could do both. I would worry a little about that option as you are compromising both close and distance vision.

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The Eyhance would be very little different, and the same targets could be used for the distance eye (no change), and in the close eye, they could be reduced by 0.25 D.

You may want to think about getting some very dark glasses to wear after surgery. Sunlight and the lights from car headlights etc can be somewhat painful for a couple of days after surgery. At least that was my experience.

I get all of that but was hoping to go to -1 or -1.25 in close eye to get a bit more close vision. You had suggested yesterday -1D and I thought -1.25 might work but haven't been able to test with contacts. You thought -1.50 would be too much without testing first.

I am well stocked already!

I really think the amount of myopia in your close eye is your choice. For better close vision you need more. If you are willing to give some close vision up and wear readers more often then you can give some of that up.

Take the dark glasses to the hospital or clinic where you are having the operation done. I wore them on the way home from the clinic, but when I really needed them the most was the next morning. I think all of the numbing eye drops had worn off and bright lights were a significant issue. I can't forget getting up on the morning after the first eye was done, and was thinking that the dark glasses were not necessary. Then I turned the lights on in the bathroom and got a major "hello". I couldn't get the dark glasses on fast enough! I was scheduled for an exam the morning after surgery and it was still dark when my wife drove me to the eye clinic. Street lights and brake lights from the vehicles ahead were also major pain triggers.

After my surgeries I was given very dark, wraparound glasses before I went home. Stylish they are not, but they worked very well.

I got the same as part of a package I bought along with the post surgery eye drops. I kind of thought they were unnecessary until that morning after. Then I knew what they were for.

Oh, that is excellent advice. I don't like a lot of light to begin with so I am sure this will be difficult.

Good to get that valuable information. I also have an early 9AM the next day....I usually have had a pair with me at all times for a number of years because of AMD and not liking too much light.

I just realized I was told I would get a pair the day of the surgery so they should be darker than my own.

I will wait and see how the first eye is before deciding.

The brightness comes from the shock of not having the cataract and I guess you adjust in time? Also, the eyes are still dialated the next day they told me.

I too am struggling to make a decision between Eyhance and Tecnis monofocal. So many things in everyday life where that extra few inches Eyhance gives you would be helpful. My eyes/brain could never learn how to use progressive eyeglasses, so with the change in "power" of the Eyhance from the edge to the middle I wonder if I would have problems with that too. Have you heard of that happening to anyone.

Good luck with your surgery.

It is just my personal theory, but I don't think the pain from bright lights, and especially a sudden change in light (like turning the lights on in a dark room) comes simply the brightness from having the cataract out of the way. I think it comes from the pupil dilation and contraction. It may not happen with every surgery, but I think some muscles or whatever in your eye must get damaged from the incision and insertion of a lens. Then when the pupil contracts or dilates the injured area gets disturbed and lets you know about it. The numbing drops and pupil dilation drops minimize it for the first day, but I found at the 24 hour mark it was an issue.

Thank you. As with many (most?) aspects of cataract surgery, I guess that many important issues are unsettled, here: the optimal difference between the 'far' and 'near' eyes for purposes of mini-monovision. That's why I'm wearing contacts to see how I experience it.

And yes, I've seen the Park article. Its defocus curve is one of the seven I've found on-line and used in making an Excel spreadsheet to calculate the average mean visual acuities of the Eyhance IOL. (If I knew how to make a good-locking graph in Excel, I'd try showing my results as a defocus curve.)

Thank you. I will report back after the surgeries. There have been a number of posts here in particular, that explain how the eye uses that change in power the Eyhance has. It apparently utilizes the size of the pupil, and really benefits a smaller pupil size, which gives me extra confidence in choosing it. My pupils never get very big naturally even in near darkness. I don't really like the progressive glasses either. Even though my glasses have that feature, I always end up just peering over top of them for near vision anyway cos it's faster -- won't be able to do that any more after next week, lol. And if I'm reclining while watching TV, I find that they interfere with my distance vision.

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I'm having them done a day apart -- surgeon's suggestion and I agree. My prescription (-12.50 D and -13.00 D) is so strong that trying to wait between doing the eyes would be very stressful for me. Everything is reduced so much through my glasses that objects are at least a third smaller than their actual size -- now that would be one huge whopping monovision setup to try and adjust to, lol. I know I could try using a contact in between, but then I'm trying to race around trying to find a contact lens to wear after the first surgery, and then I'm back to spending yet another month blind in one eye before that next surgery and I've already completed that stretch now. Also there's the waiting through yet another six weeks of healing for the second eye.

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I know that many here (and elsewhere) disagree with doing both eyes this close together, but truthfully, after reading through all of the targets people had and what their actual outcomes were, I'm pretty confident that what I've chosen for targets would not change even if I waited longer between the surgeries. I do think that my eyes (and my brain) ultimately will be less stressed by doing both eyes together. And I have read quite a few studies and articles that report that the results for binocular vision worked better when the eyes were done close to each other -- I guess I'll find out.

Where can I find the Park article? Thanks!

It's good that you have an idea of what you can handle with monovision, but I really don't think that you would need that much of a difference between the eyes for good near vision with the Eyhance. I can't remember exactly what your targets were, but i'm assuming that you're going for -0.25 D for the dominant eye? I've read multiple reports of people targeting -1.0 D and ending up having decent vision at 8". Ron even got really good near results targeting -1.50 D with just a monofocal.

I am at closer to -1.50 D on a spherical equivalent basis.

And your dominant eye ended up at Plano, correct? So do you find that you have a good degree of binocular vision with such a large difference between the eyes?

Google "Visual outcomes, spectacle independence, and patient satisfaction of pseudophakic mini‑monovision using a new monofocal intraocular lens"

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The first result in my search just now took me to an open access article at the nature [dot] com website. The publication date give is 15 December 2022. The publican name is scientific reports (lower case for some reason).

At least for Eyhance, my surgeon favors -0.50 D in the 'far' (dominant eye). At first, I was taken somewhat aback. But, on the one hand, he did that for both my wife's eyes; she ended up at 20/25; and doesn't need glasses to drive. On the other hand, looking at Eyhance defocus curves, if our surgeon hits the -0.50 D target, then -1.50 D in the 'near' eye, only a 1.0 D difference, indicatively gives mean visual acuities of logMAR 0.1136 (20/26 Snellen) at 40 cm, and better between 40 cm and distance (0.0).

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The plus/minus of this strategy is that no surgeon can guaranty results. So, I need to decide how risk averse I am.

Got it!

I am going with -0.50 D in my dominant eye also. The surgeon is pretty sure that if I do need corrective glasses, it won't be more than -0.5 which I'd be more than happy with. I requested -1.0 D for my non dominant eye, based upon other outcomes, but the surgeon suggested I consider -1.25 D for that eye, but no more than that for near vision and just blended vision in general. I figured that I might end up at that anyway, and don't want more than that, so I'm staying where I am -- just in case he isn't as good at the target as he thinks he is. You know, pretty much all of the actual outcomes I've read with the Eyhance have been far better than the projected ones have been. If I hadn't read about so many better outcomes than anticipated, I'd probably want to target more myopia myself.

My latest eyeglass prescription from my optometrist is:

Right Eye: 0.0 D Sphere, -0.50 D Cylinder, -0.25 D SE

Left Eye: -1.0 D Sphere*, -0.75 D Cylinder, -1.375 D SE

.* I have had one eye test at a Lasik screening appointment that came out at -1.25 D sphere in my left eye. So, it is possible that I am actually somewhere between -1.0 and -1.25 D. Eye testing is no more precise than that, and it may depend on the day tested and the method the tech uses.

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The Spherical Equivalent or SE numbers is the combined Sphere and Cylinder which is an estimate of the overall power. It includes 50% of the cylinder. IOL Power Formulas frequently target based on the SE number, not just the pure Sphere number.

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I really do not notice any loss of distance or 3D perception. But, that said I know that from 18" out to 7 feet or so, is the only range that I have really clear binocular vision from both eyes. I just don't see that when I am looking at things with both eyes. If there is a loss in 3D vision perception it is at really close distances like less than 1 foot.

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In the scheme of things this is not full monovison which would be more like a differential of 2.0 D or more between the eyes. That is why it is called mini-monovision. It is not an extreme amount.

-.50 D in your dominant eye and -1.0 D in your non dominant eye sounds like it could be a very good outcome for you.

Your choices seem entirely reasonable. I think they should be at least somewhat tentative in that the actual result for your first eye may warrant at least thinking some more about the target for your second eye. That's one reason my contact lens trial of mini-monovision has been trying out a greater difference--1.5 D--than I think I'd ask my surgeon to aim for. I also will want to know, and am waiting to talk to him about, whether, in his experience, results from the first eye enable greater accuracy (how much?) for the second eye.

Would that be considered monovision?

Yes, here's hoping.

That is a good idea. asking the surgeon what he thinks about one eye enabling better accuracy for the second. My surgeon didn't disagree with me about doing the non dominant eye first that I'm targeting for myopia, rather than the usual other way around, as I think he's considering that my dominant eye, might be problematic. Because of the retina of my once dominant left eye trying to detach years ago, leaving me even more myopic, yet farsighted, in that one eye, I've been living with a certain amount of monovision, especially over the past year when my eyes really deteriorated from the cataracts (even though they are early stage). Because of the farsightedness in that eye, I had to ask them to back off the distance vision as I felt sick when anyone was within a couple of feet of me. So I lost the excellent distance I used to have in that eye (my right eye ended up becoming my dominant one), but even with backing off the distance in my left eye, I still didn't have good near vision from it either.

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I had to use readers of about +1.75 for that eye, even to read my phone, which in turn started to mess up my other eye, with which I could see up close with (to about 8") and still had very good distance with. But then the good eye started to get farsighted also from using the readers it seems, so I started to just ignore the bad eye and read up close with the good eye without using any readers at all. So my eyes have been using a form of monovision dealing with those discrepancies. But I wanted to end up more with a mini-monovision though after the surgery, as the differences between the eyes when using contacts over the past year has been bothering me. My prescription has been fluctuating a lot, and the optometrist hasn't been able to get consistently clear vision from the left eye with either contacts or glasses. It's been pretty much a blur for me, messing up what vision I have with the right.

That would considered more of a mini-monovision, as the difference between the eyes won't be very much.

What lens does your friend have? I would prefer a clear lens, but Clareon is only available with a blue light filter. And I am hoping I will not see yellow.