Monofocal IOL for NEAR: How far can you see?

Thanks at201 . . . started my post before you posted this.  The more information, the better!

Thanks for the reply.  What do you mean by monofocal is set to -2.25 and -0.25?

I do have astigmatism in one eye but vision in that (dominant) eye is still clear.

 

Thanks for the reply.  I do not want to do monovision as I am with monovision right now.  Right eye is good for distance and affected eye is still good for near.  It bother me a lot when things out of sight from the good eye are blurry and then become clear.

Are the results that BellaD and micheal74313 describe typical?  And do you guys see any halos or night issues?

Correct - I'm not suggesting mono vision but rather, check into "mini monovision" for a better range of vision.  My eyes are only about 1/2 diopter different.

I had my first eye done 7 weeks ago and second eye done a week ago with monofocal IOLs set for distance. I can read my laptop at a foot away with a regular size font, see my cell phone at normal size (but that can be made larger if need be), see my car dashboard perfectly, see the TV, see the food I'm eating, drive my car, etc. without glasses (I thought about asking for minimonovision on the 2nd eye to try to make it even easier to read small print without glasses, but decided against it since I had lasik a long time ago and calculating the correct power for cataract surgery can be harder for them to do after someone had lasik). I only need reading glasses to read the smallest print or if I'm doing extended reading. I posted a study on here done by Abbott where they found only 5% of people couldn't see at intermediate distances of 2 to 5 feet without glasses after cataract surgery with monofocal IOLs set for distance (therefore don't believe what your doctor tells you about that, but be prepared for possibly being one of the 5 people out of 100 who need glasses to see at intermediate distances after cataract surgery with monofocals set for distance).

Sounds like you got an email xcellent result Nina.  And there has been a number of people asking about that intermediate distance.  I recall my doctor telling me I would likely need glasses for computer distance too and it did play into my decision to opt for Symfony lenses.  Had I have known perhaps I would have investigated monofocals more or if I were retired and didn’t need to be on a computer or reading spreadsheets so much.    In the end although I paid $1,800 for Symfony lenses I too ended up with a really good result.

Hi nina234, Great result!  Do you happen to know if your vision ended up at 0D, or a slight + or - number?

Do you see spider webs at night Sue.An?

I am younger for cataract too at 41.  I may have gotten it early due to steroidal cream I used for an eczema infection on cheek.

But then again my mother got it when she was 41 in 1987.  She says that with whatever IOL she got back then gave her both clear near and distance vision.

Hi Sims - at first few weeks with Symfony didn’t see spider webs but did see strong glare/glare from lights.  Those have subsided substantially (and when I ask my husband or others what they see I don’t think the glare around noon or other light sources is any different than they see - and they don’t have cataracts).

But yes do see the spider webs around certain types of light sources at dusk and night.  These are much lighter than the glare and I do not find them overly bothersome (still wish they weren’t there but accept them).  Mostly see them around brake lights and amber turning signal lights or porch lights that are LED.

Everyone has to compromise on something as perfect lens doesn’t exist. I am younger too and active.  Like to run walk bike racket sports and work full time and raising a daughter.  For me Symfony allows me to do all those things without glasses for first time (nearsighted since a teen).

My surgeon told me at 6 week check up he knew it was a hard decision and he said younger patients who have good near vision like me find the decision and compromise the worst to make.

I am though pleased with the outcome and as days go by think less and less about the negatives.

I wish you the best as I think you are in my position trying to decide between night visuals or losing near vision.  I too have eczema so wondered if creams affected me.  Also had to go on prednisone when I was in my 30’s.  No one in my family has early cataracts and my parents are in their 70’s and still aren’t impacted with them.

nina, your results with monofocal (Abbott?) IOLs set for distance are excellent if you also have good intermediate (2feet) and decent reading vision for smartphone, etc!

I too am starting with my right (dominant) eye first for cataract surgery with Abott Tecnics toric monofocal IOL set for distance, surgery later this month.

After that right eye heals and then evaluate if I get good intermediate distance vision with that eye. That will determine my plan for the left eye in the future, whether I will need to make it a little nearsighted for mini-monovision with another monofocal or consider a Symfony in that eye to expand the focus range.

But your result with monofocal IOLs set for distance gives us others hope to get a wider focus range than expected!

I'm not sure Bella but I will try to find out at my next doctor's appointment.

I don't have an Abbott monofocal Night-Hawk (mine is made by B&L), but from what I've read, they're all basically the same as far as general results go. I hope your surgery goes well!

And I'm especially "lucky" with my outcome since I had lasik for myopia correction over 10 years ago and any refractive surgery done prior to cataract surgery makes it harder for them to figure out the calculation to be used to set the IOL power.

Lin59, Can you please tell me which B&L lens you have?

I just had cataract surgery on my right eye set for near vision 3 days ago. My left eye will be done in three weeks. I needed this surgery because i was diagnosed with narrow angle closure glaucoma. Unfortunately my concern was on the glaucoma so I didn’t research which iol to choose and let the surgeon decide. Because I’ve worn monovision contact for 20 years that was his deciding factor. 

My question; where can I find the survey you referred to?

Also, day 3 and my close vision about 12 inches is clear but everything else gets blurry after that. Will that improve at all?! Everything more then an arms length is like vasoline is on m eyes-complete blurr. I practiced different distances with my reading glasses and intermediate my fine-dr says that’s because natural lense can contract but iol can’t so don’t expect to get clear vision for anything but 12 inches. I literally woke up with panic attack thinking i just destroyed my vision! Dr said next eye will be set for distance. So does that mean I’ll next loose all my other vision?? Please anyone advise me. Im 48 and thought i chose a highly qualified dr. Now what?? (My surgery also included a procedure to open my narrow angles: gonio... -basically dr cut out adhesions blocking the drainage of my eye.)

With cataract surgery and monofocal lens you lost accommodation.  At 48 you are a young patient and the impact of losing accommodation is higher.  

?I would have expected your near vision to be farther that 12 inches with the choice.  You can still tweak it with lasik.  Instead of 0 to 12, I would make it 12 to 24 (intermediate).  Noone really needs clear vision from 0 to 12.

?You are used to monovision so after your other eye is done for distance you should have good distance vision in that eye.

Who was your doctor if you don't mind sharing?

I don't know what your doctor tried to set your right eye focus to, but it seems that he missed the desired mark by a wide margin.

I have monovision with my left eye set for a reading distance of about 17 to 18 inches (corresponding to a prescription of about -2.25D). I can read all day long without any problem. No one needs to be able to read at a distance closer than that. Instead of ending up with about -2.25D, you seem to have ended up with about -3.25D or -3.5 D.

You can get LASIK (or PRK) enhancement done to correct your right eye for reading at about 17 to 18 inches. That will also correct any astigmatism you may have in your right eye.

Don't make the decision for your left eye until you get the right eye corrected (or you are close to getting that corrected).

However, having the left eye set for distance (as your surgeon suggested) will probably not be a good decision. Even though you have been used to monovision and could probably handle the difference in the 2 eyes, your intermediate distance vision will leave a lot to be desired. A better compromise may be to get the left eye set for about 40 inches (about -1.0D). Your distance vision will only be about 20/30 (thus needing glasses for driving in unfamiliar places), but you will probably be a lot happier with day-to-day living.

 

I remember him saying he was setting it for 2 in the right eye. He also mentioned i would see my pc clearly. But i have to lean forward to clearly see pc right now. He mentioned my vision may change as I heal. Im day 3. 

What did you choose for your second eye? What are your results?

He may have aimed for -2.0D, but if your vision is best at 12 inches or so, he achieved about -3.25 D. Thus, he did not go a good job of figuring out the power of your IOL

I have a Symfony lens set for distance in my right eye. It provides me good day vision, but I don't like the night vision issues related to the Symfony lens. If I would have had a monofocal lens, I would have aimed for the best vision at about 40 inches (or -1.0D)

I have a new account on here now (this is Lin59), but I generally don't follow the convos on here anymore anyway. I'll private message you.

My implant card says Model PCB00 Diopter +32.0 D

what does that mean?  When I was in the office we talked about my current contact RX being +3.75 but he was implanting a 2 diopter because he said a 3 would be too much.  What did I end up with?? 

An eye examination in a few days should tell you exactly the eye prescription you have ended up with. It may still change by about +-0.25 D in the next few days.

I am basing my estimate of your being at about -3.25 D  only on your observation that your vision is best at about 12 inches.

The target of 2.0 D by your doctor was a good one because that would have given you the best vision at about 20 inches, which works out well for reading when using monovision. However, because of the errors in your cornea and other eye measurements (which are sometimes hard to do), the use of the "Model PCB00 Diopter +32.0 D" lens seems to have ended up in your prescription of about +3.25 D (and not -2.0D). The same IOL with the same prescription will result in a different eye prescription for different people.

Meant to say -3.25D (and not +3.25D) in the second sentence of the last paragraph in my response above.