Having cataracts surgery in only one eye.

I had a similar situation, except I delayed surgery in one eye and the other did not have cataract at all. I delayed the surgery for one year, during which I could see only 20/60 in the cataract eye or worse. The other eye was 20/20. I could function normally. Most of the time I didn’t even think that I could see with only one eye, but sometimes I did notice the lack of binocular vision. For example, I could make a wrong guess about distance, which was puzzling. It was not uncomfortable, but I do find the vision after the surgery much more enjoyable and exciting.

Yes, my second eye was done about 15 months after my first eye. I am in a public health care system and you get approval for surgery based on how much your vision has deteriorated. My first eye was at about 20/40, while the other was still 20/20 corrected. I got progressives which corrected both eyes after the first one was done. But, I also did a trial with a contact in my non operated eye to simulate monovision. I preferred the monovision to the progressives and almost never wore the glasses. Now I have an IOL in my second eye when it reached 20/30, and have permanent monovision. It works well.

Thats what I have. My right eye developed a cataract a few years ago first and gradually got bad enough it couldn't be corrected for good vision with glasses anymore, when it was worse than 20/40 distance vision best corrected I had cataract surgery only in that eye. My left eye still corrects perfectly to better than 20/20 with glasses so I haven't had surgery in that eye, probably won't need it for years. Its been almost 5 years now for me and I have no problems with only one eye corrected with an IOL and the other with a natural lens. I still wear progressive eyeglasses as I did for years before the surgery, just different Rx for the right eye which only needs a small cylinder adjustment though even without glasses it gets about 20/25 distance vision - 20/20 or better corrected with the glasses. My left eye with natural lens get about 20/70 uncorrected and better than 20/20 with the glasses.

The key to be able to do this is both your eyes should need similar eyeglasses correction, not more than about 2D difference between them. My eyes now after the right eye has been corrected with the IOL, is about 1.5D difference so eyeglasses still works OK for me to correct the left eye.

But if you have too much Rx difference between the two eyes, the eyeglasses will cause the image size to be too different between the eyes that can cause problems like headaches and other difficulties. In that case, its possible to use a contact lens in one of the eyes instead of glasses since the contact lens is closer to the eye and then the image size difference is a lot smaller.

One of the issues with these MF (PanOptix) and EDOF (Vivity) lenses is that they can reduce contrast sensitivity. The extent that it impacts vision, especially at night, can be reduced by only using one of these lenses instead of implanting it in both eyes. The normal practice would be to implant a standard monofocal lens set for distance in the dominant eye, and then use the MF or EDOF in the non dominant eye, to allow closer vision. This is called hybrid monovision. Something to think about before you get the first eye done, so you get the correct lens in the correct eye, if you want to consider this option.