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How to get good vision from reading distance to about 6 feet (or beyond)?

Posted , 7 users are following.

allen43308
allen43308

Hi. I had an Eyhance IOL implanted in my right eye (plus laser-assisted LRI) 1.5 years ago. The surgeon was targeting SPH 0 and CYL 0. I ended up with SPH +0.50 and CYL -1.00. (Prior to surgery it was -3.50 and -1.50). As a result, I don't see clearly near and intermediate, my more-or-less decent vision begins at about 6-7 ft out. Distance vision is about 20/40 without correction, so I can drive and hike without glasses.

I'll be more deliberate with my left eye now in surgeon and IOL selection. I'm thinking that I should target my left eye to have good vision from reading distance to about 6 feet out. This way the left eye will kick in at 6 ft and closer where the right eye starts being blurry.

Is there an IOL that would give me good vision in the left eye from reading to 6 feet out? I don't quite understand the defocus curves and how to translate it to the range of good vision.

Any insight and advice is greatly appreciated.

Thanks,

Allen

0 likes, 52 replies

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  • freddi23948
    freddi23948 allen43308

    Posted

    I just saw a consulting opthalmologist who tested my vision and said I was wrong about the eye that had surgery and that the vision test and refraction shows that eye has plano vision, so I was wrong about the +1. I am still considering whether to go with -1.5 or plano in the other eye. I will have a toric lens but still will have astigmatism at least in one eye with either choice.

    • RonAKA
      RonAKA freddi23948

      Edited

      If you have 0.0 in the first eye, then I would for sure go for -1.5 D in the second eye. Essentially that is what I have, and I can read down to about 1 foot quite well.

      It would still be worth doing a contact lens trial just to be sure you are OK with it.

  • jimluck
    jimluck allen43308

    Edited

    There are two types of IOL that eliminate or greatly mitigate the worry of not hitting targets: (1) IC-8 and (2) Light adjusting lens (LAL). Why not choose one of them?

    The IC-8 uses the pinhole effect to correct up to 1.5d of astigmatism. There is no cylinder to get right or get wrong. It's the same pinhole whether you have astigmatism or not and the same for any amount of astigmatism up to 1.5d. And the pinhole also gives you fabulous depth of focus. They set the conventional lens part of it with a slightly myopic target and then the pinhole effect gives you the distance vision and mitigates any miss on the target for the lens. A pinhole, of course, inherently has tremendous depth of focus. (I am so myopic I can't hardly make out the big E at the top of the chart without glasses. But if I make a tiny hole to peer through by curling up my index finger, I can see it and many lines below it sharply. That's the pinhole effect -- defocused light beams are blocked out, instead being bent to a focal point by a lens, or being allowed to fuzzy up your image as they do when there is no lens and no pinhole. What's left is just the sharp image, regardless of how far the image is from the retina. ) User satisfaction data on is great. You would think it would be bad for night vision, but they say that's not a problem.

    The light adjusting lens allows you and the doctor to keep fine tuning sphere and cylinder after surgery until you hit your ideal. Then and only then the doctor locks it.

    The IC-8 was only just approved by the FDA in July, but it's been in use in Europe for years -- I think since 2014. The LAL requires the doctor to buy special equipment, so most don't offer it. In my area (Boston metro) only one practice has it -- Boston Vision -- but they have many offices. So, you may have to wait a few months for full USA rollout of the IC-8 or you may have to switch doctors to get the LAL. If you don't want to play refraction roulette, check out one of these more forgiving options.

    (Note: I know you said your glasses prescription is 1.75d cylinder, but hopefully that's not all corneal and some will be gone when the lens is taken out. In my right eye, my glasses prescription is 8.25d cylinder, but "only" 7 of that is corneal, according to the topo, for example.)

  • allen43308
    allen43308

    Posted

    Jim, thanks for the info. I was very interested in LAL, but I read that there's a chance that after it's refraction power is locked, it may drift a little. IC-8 is definitely worth some consideration. There are several innovative accommodating IOL's in the pipeline, Juvene is one, and it's now in human trials. Wonder how long it takes from human trials to availability.

    An accommodating IOL that works would be an ideal solution.

    • allen43308
      allen43308 jimluck

      Posted

      Jim, I tried searching for that article, but now it doesn't show up in my search results. If I remember correctly, the idea was that there's a potential for the drift, not necessarily that the drift is inevitable.

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