How long to get used to new IOL?

I am trying the -0.5 lower contact lens power for 4 days now and dont think it made much difference!

Do you think i should go lower in contact lens power?

Yes, you could try going further off full correction of the myopia in your non operated eye to see if it helps. But, in the long term if you have to do that, you are probably back into glasses for distance vision. Just time to get used to it, may work too.

Doctor said to give it a month for lens to settle before getting refracted!

A monovision trial run before cataracts developed would have been more helpful. So now it is difficult to know whether you can tolerate monovision. Whatever the final refraction of the first surgery eye is, be conservative with a projected power difference for your second eye surgery lens. I wore monovision contacts for years, so I was willing to try it with the recommended EDOFs.

Doctor said to give it a month for lens to settle before getting refracted!

For maybe $65 from a local place, you could get an earlier refraction to give an early indication. Then share the numbers.

yes, if you want an earlier refraction you could get one done elsewhere, but I would insist on just getting the refraction done. I wouldn't let the optometrist dilate you or touch the eye as it's still healing from the surgery.

Since my first eye target missed, it is likely my second eye would miss too. How should I go about the target for second eye?

1. if target the same as first eye at -0.6, it target hit, i will have -1.1 between eyes, caj I adjust to it?
2. If target at -0.6, and after surgery it shifted to about where the first eye at (-1.7), this would be perfect to balance both eyes.
3. If target at -1.0 and hit targat, the difference of -0.75 should be easier to adjust?
4. If target at -1.0 and shifted to more myopic-2 or -2.5, then i might not have a distance to see clearly without correction?

I am only assuming i will have myopic shifr. Would it be possible for second eye to shift the other direction?

The target miss if there is one, can be in either direction. Perhaps in your natural state, myoptic would dominate. Was your sight in each eye before cataracts, the same or different? A target between your #2 and #3 seems good. Everyone needs glasses of some type or another (whether they admit it or not) after cataract surgery, so don't let that bother you. We still don't know your first eye final refraction. I trusted my surgeon's opinion, and recommend doing that, as well.

What do you think is the incidence of optometrists dilating for a refraction? It seems to me that dilating before refraction would be a positive under normal circumstances, but others very much disagree. In particular, refraction is done before a LAL adjustment. Adjustment requires big-time dilation. So it seems to me that refracting after the first dilation drops would be more accurate in predicting what adjustment should be performed.

I understand not getting dilated this early after surgery.

Jo,

were you myopic and have both eyes done? my original rx for L is -11.5 and R is still -10.5.

Did your surgeon suggest a target for second eye after your first eye stabilized? how far apart were your surgeries?

LAL is not offered by my surgeon

Often optometrists want to dilate after the refraction to examine the fundus and check on the general health of the eye. They consider this part of the annual exam that they are providing the patient. Since sam36130 is already under the care of an opthalmologist and just went through eye surgery, I would not think there would be any benefit to them in including a dilated fundus exam at an optometrist's office if all that was wanted was to know the refractive status. sam36130 said that the opthalmologist already said to wait one month for a refraction. Since the eye is still healing I think I wouldn't want anyone other than a medical professional at the opthalmologist's office to touch the eye unnecessarily.

Dilation for an LAL adjustment is done in order to get unobstructed access to the IOL so that the UV light can hit the optic and make it change power. If the pupil is not dilated then the UV light would hit the iris instead of the LAL optic and the optic would not change shape in a desirable way.

Not myoptic probably slightly hyperoptic originally and after cataract surgery. Presbyopia started around age 38. I never found wearing eyeglasses comfortable - mainly the weight of the frames or slipping down my nose. I tried MF contacts, but monofocal monovision with daily disposable lens were better.

The cataract surgery experience of those with your degree of myopic vision would be more helpful than mine. One of my first comments as a poster was that most people on the forum seem to be myopic.

Of people that have refractive errors requiring correction, about 92% are myopic, while 5% are hyperopic, and the remainder only require astigmatism correction.

Interesting statistic. I've read that myopia and high myopia are increasing world-wide. One theory is lack of sunlight in early childhood. Could be that myopia is a dominate trait passed down to children, and increasing time spent indoors leads high myopia.

Not sure of the cause, but hyperopia may be underdiagnosed especially in those are younger than presbyopia age. Accommodation in the eye can correct for hyperopia up until prebyopia starts to impact vision. So, younger people may have it, but are not aware of it, and don't get glasses for it. But, since virtually all IOLs have no accommodation it becomes an issue when it is time for cataract surgery. The eye no longer has any way to compensate for hyperopia with an artificial IOL in place.

The operated eye no longer has any way to compensate for myopia with an artificial IOL in place, as well.

Not sure of the point you are attempting to make about hyperopia and cataract surgery. Unless you are explaining the reason for fewer refractive problems with this group.

What I am saying is that accommodation in the eye which is the ability to focus closer can compensate for hyperopia which is focusing too far even for distance. When you lose accommodation when an IOL is put in, then all of a sudden the focus point of the IOL becomes much more important. Your eye cannot make up for a miss to the hyperopic side.

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And I am not so sure about fewer refractive problems with cataract surgery in a hyperopic (short) eye. A hyperopic eye requires a much higher power IOL than a myopic eye. This makes the overall vision and refraction much more sensitive to the lens position in the eye when you are dealing with the position of a higher power lens. It is harder to get IOL power accuracy with a hyperope than a myope for this reason.

The other issue with hyperopia, or short eye, is that axial length measurement error is the same as with a long eye, but the same error is more significant with a short eye. Higher % of error. This is what is puzzling about Sam's significant miss. This is more likely to happen with a short eye, than with a long eye.