IOL Suggestions for someone needing a prism in glasses

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I have needed a prism in my glasses for distance for a few years now due to double vision (only present when looking through both eyes together). My optometrist said its likely I will still need glasses with a prism for distance after cataract surgery. I am considering monofocals set for close so I can have some range without glasses but I'm interested if anyone else has dealt with this situation and if so, what IOLs did you choose?

One surgeon has suggested Vivity lenses but I'm not sure the additional cost of $3900 per eye is worth it if I'll need distance glasses anyway. I have a consultation with a second surgeon on Friday.

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  • Edited

    I think the safest way to proceed is to get monofocals in both eyes set for distance, and then count on wearing progressives which will give you reading, prism correction, as well as any necessary spherical and cylinder for the residual error not corrected by the IOL.

    • Posted

      Thank you for your response. Can you elaborate on your thoughts of why that would be a safer choice than getting corrected for near and getting progressive glasses to correct where needed?

    • Posted

      I think that way could work too, if you are confident the prism does not have to be corrected for closer distances, then you perhaps could be partly glasses free. My thinking was that wearing glasses for all distances would be the best because all the errors are being corrected at all distances; prism, spherical, and cylinder.

    • Posted

      That was my thought process. I truly appreciate your insights. Thank you.

  • Posted

    One other issue and you may have thought that through too is the impact this will have on your eyeglasses. If you have your eyes left at -2.50 to -3.00 D that should give you very good close vision without glasses (providing the prism does not impact that). But also consider that your distance eyglasses or progressives will need a corresponding -2.50 to -3.00 D lens to correct for distance. That is around what I have lived with for a long time. This kind of lens will be thicker at the edges and thin in the middle. I have used high index lenses to try and limit that effect especially with larger lenses. However since my IOL was done, which in my case fully corrects for distance, I have a lens of 0.00 D spherical correction. The lens in my current eyeglasses is the thinnest and lightest I have ever had, and is of the standard type, not high index. Something to think about.

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