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Great wall of China text/questions/thoughts...RE OP

Posted , 8 users are following.

W-H
W-H

Approaching business end of the 4 months cataract drama, second operation in 3 days and I have too much nervous energy to expend....

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image

Taking the above Zeiss image as reference...

My wife's LE,

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Astigmatism: Pre OP -0.64 or -0.58. Post OP -0.75 (Autorefractor )

LE Axial length is 22.45mm

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IOL was set for near, and based on autorefractor reading, the IOL it has settled at -1.50 (instead of target of -1.25)

-1.25 would have apparently given sharp vision at around 80cm

Her sharpest focus point currently is at 42cm to 52cm roughly...but decent usable focus up to 72cm.

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My question 1-

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Can -1.50 really give such sharp vision at around 45cm range?????? Wouldn't you normally need something like -2.0 or -2.5 to get sharp near vision? Am I missing something? Does the auto refractor measure at IOL plane or eye glasses plane?

Right Eye far target -0.25 operation coming up next and currently -

Astigmatism: -0.24 or -0.34 or -0.29 or -0.75 (Autorefractor ). Variation I think is based on the machine that was used at different clinics. Maybe Keratometer vs Autorefractor too?

LE Axial length is 22.35mm

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My question 2-

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As the RE's axial length is practically same as LE and as same formulas have been used. Would it mean the RE will undershoot slightly too like left eye did or it can still go either way? I guess it can move either way because of where it settles in the capsule???

RE far eye will be targeted for -0.25 but realistically it can land at any of these numbers-

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  1. +0.25 (Difference between the eyes would be= 1.75)
  2. 0.00 (Difference between the eyes would be= 1.50)
  3. -0.25 (Difference between the eyes would be= 1.25)
  4. -0.50 (Difference between the eyes would be= 1.00)
  5. -0.75 (Difference between the eyes would be= .75)

Such a mind twister this cataract! Stay tuned FINGERS CROSSED NERVOUSLY!!!

0 likes, 14 replies

14 Replies

  • Mutti3
    Mutti3 W-H

    Posted

    ok, i will try to answer youR question based on my very recent experience! FIrst off, i am a USA citizen, and cm are not in my lingo! i can see computer distance ok Close distance is a challenge because i need plenty of light. i can see about an 11 font in good lighting. My distance is great! i have worn glasses since i was 8 years old!

    i used " reader' +1.00 to 1.25 to read fine print. or to sharpened the print.

    my post op visit last friday, was told, my brain / vision can still improve!

    in review left eye was suppose set at -1.50, right eye plano. i didnt get a copy of my records. at this point i am very happy with my new eyes!

    • Sue.An
      Sue.An Mutti3

      Posted

      Being Canadian conversion to metric did happen but went through high school years on old system so I relate more to inche

      40cm = 15.75 inches

      80cm = 31.50 inches

      So hard once you relate to a system and try and concert. I still have to convert to inches to get a sense of distance.

    • W-H
      W-H Mutti3

      Posted

      Hello Mutti, my American friend 😃

      So your near LE was targeted for -1.50 (where my wife has ended up)

      You struggle close distance without glasses but she does not at all, very interesting. By close I mean reading a book, mobile phone, doing paper work, make up. Correct?

      Computer distance you see ok, she does too but her PC screen is around 60cm/24inches away and not 80cm(31.5inches) like in above Zeiss example. Laptop is bit nearer so falls even more in her sweet spot.

      Although as you did not get the readings your real readings could be slightly different from my wife. Maybe you are closer to -1.25.

      Thanks for replaying 😃

      P.S- I use my PC screen anywhere from 60cm/24inches to 100cm/40inches lol

    • Mutti3
      Mutti3 Sue.An

      Posted

      at 15 inches , i can read 11 font i can see ok, but need reader to" sharpened " it up. computer distance is fine. but i still use readers because my work entails different size fonts and spacing . i read medical records .

    • Sue.An
      Sue.An W-H

      Posted

      This may just muddy the waters but from my discussions with people I really don't think one can associate a specific distance with a particular target. There are people that without any mini micro or monovision that can see well believe it or not at most ranges. May be why I see better than most with Symfony. Perhaps one more reason surgeons like to target best distance too with monofocals.

      There was someone here on forums when I first was diagnosed with cataracts (think Andi - she had to change her ID name from Nina) who had B&L monofocals implanted both targeted for distance that said she could see all distances and needed glasses for small print only. Also found evidence that is the experience of many - not just of few.

      All to say a target combined with an individual's particular eye may see better than another who would up at same target,

  • Deb03
    Deb03 W-H

    Posted

    I will summarize my experience with my 3 surgeries so far, including target and results. LE I don't know the target but I asked for distance. Post op it was 0 at one month, .25 at 2 months, and .5 at 4 months.. RE I also asked for distance and again don't know what the target was. I was .25 at one week and .5 at one month. At 3 months I was still .5. I have since exchanged that lens. Target for RE exchange was -.4/-.5 and I am currently at -.25. One week and one month measurements for RE exchange are about the same. So my experience for both eyes and 3 surgeries is that I end up more hyperopic than the target. For my first surgeries I had the same diopter IOLs placed in both eyes so I presume my measurements are about the same between both eyes.

  • Guest
    Guest W-H

    Posted

    As I said many times before - your wife will have a great result! 😃

    My thoughts about the distance thing - I think our brain cheats us.

    I think if you have sharp vision at 45 cm and equal sharp vision at 70 cm, the 45 cm point will always feel more sharp simply because it is closer, even that in reality the sharpness would be the same, or maybe even worse at 45 cm.

    Don´t know if it makes sense, but at least I know exactly what i mean 😃

    I think your wife´s lens have hit just were you want it, I don´t think you could have asked for a better result.

    -1.5 monofocal gives usable vision to -2.5 so you are right - kind of right anyway.

    And question 2

    Dr. Zeiss is on top of this, the outcome will be great! 😃

    Remember monofocals have 1.0 usable vision both up and down, so even a spread between the lenses of of 2.0 will be somewhat covered, so don´t worry about the spread.

    And even in the range where the lens don´t give usable vision, it still adds to the overall vision.

    My Lara is not at all sharp at 30 cm, my Lisa is struggling at 30 cm as well, but with both eyes combined I see quite well at 30 cm.

    So the -1.5 will add to the far vision even that it is out of focus, and the "far" lens, will add to midrange and near even that it is out of focus.

    Whether the second lens hits a little bit here or there, both eyes combined will be a killer combination compared to what she have now.

    You wife will have a great result! 😃

    • Sue.An
      Sue.An Guest

      Posted

      Your Lisa lens struggles to see 30cm well? My RE sees that distance well. I used to have that with LE but that eye sees blur now so struggles but not noticeable with both eyes open.

    • Guest
      Guest Sue.An

      Posted

      Well, I guess it is all relative 😃

      I would say the clarity that Lisa has at 30 cm is similar to the clarity Lara has at 65 cm.

      Preferred distance for reading with Lisa is about 35-40 cm, and true clear vision with Lara starts at about 70 cm, although that is too far away for reading.

      I can see closer with both lenses if I want to, just not as clear, it was only to explain the binocular bonus... 😃

      And yes you are right, as I have told you many times before, you are one of the lucky few, you have a much better result with the Symfony than most will get 😃

      In the studies I have seen, I would say you are in the 5% best, mean value for near vision with Symfony is 20/40, and some a lot worse than that.

      So in this matter, you did win the lottery 😃

    • Sue.An
      Sue.An Guest

      Posted

      Not feeling it is like a lottery - just find varying results puzzling.If you get a chance to look at Andi's post if they are still there - claims that monofocals set for distance give some people vision at all distances.

      Yes do get your point about binocular bonus. Always better with both eyes open.

      I thought your Lara would provide better near vision than 70 cm but that likely is the result of overshooting plano target. Do you know if the aim was plano and the settling push it over plano or if the formula used to calculate power was a little off (perfectly knowing those calculations can be).

    • soks
      soks Sue.An

      Posted

      technis did not have a trifocal. so they came up with a distance/intermediate bifocal. they implanted it in you. you could see at all distances. technis felt they had discovered elixir of vision. this got zeiss scared and in panic they copied symfony design and invented lara which wasn't better than lisa that they had had for 5 years. see what you did now Sue.An?

    • Guest
      Guest Sue.An

      Posted

      Sue - I really mean well 😃

      But fact is that Symfony only adds about 2 diopter to plano, and this is backed up by statistics based on outcomes from thousands of surgeries, there really is solid statistics about this.

      I am so happy for you, that you have got the great result you have, I would wish that result for anyone.

      But Symfony or Lara does not deliver that good near vision in the normal patient, only the very few with a super adaptive brain, that can somehow see clear from an unclear image on the retina, and these few patients get good near vision like you with Symfony.

      Surgeons often makes micro/mini monovision with two Symfony´s, to give extra near vision on one eye.

      Danish surgeons that are using Symfony makes micro/mini monovision, and by doing this they promise vision from 45-50 cm and to far with both eyes combined.

      If you see the youtube video with the surgeon Shannong Wong, that decides on a clear lens exchange with a Symfony on one of his own eyes, he also moves it to the myopic side too add near vision, he does not have clear far vision on this Symfony eye.

      To see the youtube video you can search

      Dr. Shannon Wong's Symfony Lens Experience! The doctor is the patient

      And the same surgeon Shannon shows a very simple explanation to the range that Symfony covers by the end of his follow up video, you can search

      2 weeks after symfony lens. First-hand experience from ophthalmologist

      But I any case, I truly am happy for you, you have got a great result, I wish everyone could have a result similar to yours.

  • soks
    soks W-H

    Posted

    good luck to BOTH of you! her for the eyes and nerves for you.

    • W-H
      W-H soks

      Posted

      Thanks guys. I feel psychologically really drained 😃

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