Monofocal set for distance... what should be my expectations?

I am very pleased with my distance mono focal IOLs. I can read the information on my car’s display without any issues: text etc on the sat nav. I have a prescription for reading glasses. My optician seemed to think that I wanted to read text at about 3 inches from my face. He also suggested varifocals but in truth I do not need them. I took the prescription and ordered 2 pairs of prescription glasses for £35 from an online lab. One pair I use for reading: the other pair has had the prescription adjusted for using an iMac at about an 1 1/2 arm’s length in front of me. I find that I can also read quite happily with this pair as well.

Having worn glasses for 35 years, I still find it slightly annoying when I sit down and find that I have left my reading glasses are in another room! I can see why some people elect to put them on a chain.

I also have a cheap pair of ‘readers’ in my coat pocket in case I am out and about need to read a menu etc.

I'm one of the lucky ones.  I don't need glasses for anything, near or far.  I was pretty farsighted prior to the surgery so I don't know if that has something to do with my vision now.  I was told that I would likely need glasses for reading, but I don't.  As for physical activity - I was told, also, that I can resume any activity I choose.  I run, bike, and hike with no problems.  The only thing I was advised against doing for ever is rubbing my eyes too hard or too vigorously.  

If you want distance and intermediate vision without glasses, and OK for using glasses for near/reading the usual option is mini-monovision with monofocal IOLs.  That targets one eye for good distance vision and the other eye for slight nearsighted for intermediate vision (computer, smartphone screens, etc) thats usually about -1.0D or so difference between the eyes.  Another alternative is the Symfony IOL that gives a wider focus range of distance and intermediate to some near vision.

I have one monofocal IOL in my right eye so far set for distance vision and I need to use about -1D glasses for computer and smartphone reading.  So I plan when my other eye  eventually needs cataract surgery to either set it for a little nearsighted with a monofocal IOL to get intermediate vision without glasses or possibly go for a Symfony IOL in that other eye to get both distance, intermediate, and even possibly some near vision.  I currently am using my old progressive eyeglasses with the right lens popped out - so that simulates that  and has been working well for me.

I almost never wear glasses for anything.  After my first surgery I was quite upset because I thought my near vision was gone.  But, we decided to go for "mini monovision" so my other eye was set for distance also but about 1/2 diopter set in for near.  I would never advise full mono vision because few can tolerate it.  But, most people already have mini mono vision anyways since their eyes are not exactly the same even before surgery.  So, my eyes are working together and I see great.  There is some advice I can suggest you consider and talk about with your doctor:

1.  Be sure you find a really good doctor.

2.  I believe there can be error factor of about 1/2 diopter which means if you set it to distance, the doctor could miss by 1/2 diopter and you could be a little far sighted making your near even worse (although it can be correct by a laser, but it's best to try and get it right the first time).  So you might want to consider going 1/2 diopter in when doing the first eye.  See how everything is after that and then decide about where you want the second eye set to.

3.  Before I had my cataract surgery with an Alcon toric mono focal, I was used to looking at everything around 5 inches away and I could even read a 4 point font.  So, rather than run for the reading glasses for everything, I had to retrain my brain to hold things around 12" - 18" away and over time it just got easier and easier.  I also found that early on if I used my LED light from my iphone it was even easier to read  (harder to read in dim light which is normal).  It just continued to get easier to read everything over time.  But, I usually don't struggle and try to read things less than 8 point font.  If it's a medicine bottle around 6 point, I can read it in good lightlng but if it's a lot to read then sometimes I'll get lazy and just throw on a pair of reading glasses or use my credit card magnifier that I carry everywhere (it's in between my iphone and a nice but flimsy rubber protective case).

Good luck to you.

 

You seem to understand the vision options well.  My answer is it depends.  IE how much myopia you had prior to surgery.  If you were corrected with glasses to say R -1.5 and L -1.25 then your mid will be ok, and close up you'll need readers.  However If you wer R -5.0 and L -6.0, your replacement lenses will put your mid/near in a poor situation.  Which is what I have.  So solution is progressive lenses that work close and mid range nicely.

Note that when they remove your natural lenses the tiny muscles that shape the lens for different distances are cut.  So new lenses are fixed.  When younger this muscle allowed for far and near focus.  Older not so much, seems to get stiff.  Remember your child eyes?  Anyway the little focusing you had with natural lenses are gone after surgery. 

 

Good luck to you Miguel - guess you must be getting close to having your surgery.  I wish you success.

As you know I have Symfony lenses which I am happy with.  Have good near vision from 11 inches to distance.  I think after cataract surgery good lighting is important for reading.

I do contend with the concentric circles around some light sources (outside).  I have adapted to these and still drive comfortably at night but the circles likely won’t magically disappear.

I think you could even consider mix and match a monofocal set for distance and a Symfony set for .75 diopter in and get a better all round experience.  And setting the Symfony Lens nearer should eliminate the concentric circles somewhat and whatever those are the monofocal would compensate.

It’s a matter of deciding which trade-off you can live with as there will be a compromise to make.   But as mentioned in previous posts the lens power comes in increments of .50 diopters so that combined with how the IOL settles could account for why the target is missed by .50 diopter either way and why some with monofocals say they can’t see intermediate vision very well and others do.  The suggestion to target first surgery at .50 nearer and not plano is a good one to consider as I think there are better options being slightly near sighted than left slightly far sighted.

Do wish you well Miguel and will look forward to hearing how it all turns out.

I'm still healing, but mono was not a good choice for me. My near vision was great before, now even with reader it's blurry. But you might not better judge your decision on me because of the central blur I'm experiencing. If I could redo...would go for clear near vision & glasses for distance. If seeing up close is dear to you, better reconsider mono.

As some of the other people have alrady mentioned:

1.The best choice will be to aim for about -0.25D for the first eye (preferably dominant eye), as your surgeon has suggested.

2. Don't make any decision for the second eye for at least 2 weeks after the first surgery, to know exactly the prescription you end up with the first eye.

3. If you do end up close to the target of -0.25D in th first eye, then aim for about -1.25D for the second eye. That combination with mini-monovision should provide you good far and intermediate distance vision (without the night bision issues of multifocal lenses or Symfony), needing only reading glasses.