Monovision plan ?

Thanks for your response.

Mine was done the opposite way-my first eye for monovision was set for near distance. It was my non-dominant eye. It was the eye where the cataract was much worse.

Sue.An has a valid point here. My family doctor while taking my blood pressure, would leave me abruptly to rush to 2 separate rooms to check on the other 2 patients. Outside in the waiting area there are about a couple dozens patients waiting to get in to one of these 3 individual cubicles. And I am allowed only ONE question per consultation. Sigh!

Specialists with extensive training usually charge more than their less experienced colleagues. However, this is not the case of a universal healthcare system or Medicare, where the cataract surgery waitlist could be as high as 25,000 patients in one single metropolitan city. Private clinics are there for those who want a greater peace of mind and a higher likelihood of success; a small price to pay in exchange for an invaluable investment in your eyes.

Having said that, I would choose a highly qualified eye surgeon with a high number of IOL surgeries performed every year. If he/she has hospital privileges, this indicates that he or she adheres to proper safety and ethical protocol.

Boy, I am so with you on this one, BellaD. I don't care how the surgery is paid, you deserve to be treated with respect. Yes, the docs are busy, but a little courtesy goes a long, long way. I was scared to death before my surgery because I just KNEW that I'd have problems (lots of problems), but the doc was great. I walked into the op room knowing that I was in the best hands possible. Even though she's extremely popular and always has clients waiting for her, she never once rushed me...and I have a terrible tendency to talk too much when I'm nervous. I wish you the very best and hope things go smoothly. As SueAn said, they're YOUR eyes.

Maryland - dominant eye is mentioned a lot and perhaps because I went with an EDOF lens it didn’t factor into the equation but due to cataracts affecting my right eye more when I did those tests myself to determine dominant eye it gave me one answer (LE) but since surgeries those same tests indicate I am RE dominant.

Just curious for anyone that wants to weigh in.  Is it possible for poorer vision in one eye to change which eye is dominant?

Perhaps I am phrasing that wrong and it isn’t a switch in dominant eye that is occurring but the fact non dominant eye is having to carry the load?

My left eye is dominant, and I am quite nearsighted, especially due to the cataracts.  I have done a trial of monovision; it was an imperfect trial due to the cataracts but I found my eyes were quite adaptive. 

It is great that you have done a trial of monovision with the contact lenses (I also was lucky to have used monovision with contact lens for years before getting IOLs).

Thus, you can definitely use monovision. This makes the process of choosing the second lens  little easier. After you vision in the left eye settles down , you will be able to get good vision at 2 of the 3 distance ranges (far, intermediate at about 26 inches, and reading at about 16 inches). Although one can work with having good vision only at far and near (and not so good at intermediate) distances, usually it is better to have far / intermediate or intermediate / near combination of distances for good vision (and use glasses for the third one).

Sue.An, both you and my hubby are having a blast with your Ferrari or is it Lamborghini, scuba diving and skiing. The price tag says it all ~ one focus point vs 10 focus points. I don't want to delve in to too technical stuff, beyond me. I bet those of you implanted with premium lenses (multifocals / trifocals / EDoF) do not get tired as easily as me (monofocals). I do not need glasses for near / intermediate distances. According to Dr Por, if you hate glasses, then EDof and trifocals are for you.

Ha ha!!!!   Funnily enough never hated glasses but wasn’t yet into bifocals or progressive lenses - could read well without glasses before cataract surgery.  But I hear that is when glasses become a pain in the butt.  I wore contact lenses years ago for sports and up until I had my daughter almost 27 years ago.  Eyes became too dry for them and I switched to glasses.  Due to work and my age wasn’t too keen on monofocals (but I have more of an understanding now than decision time of ways they could work for me).   But no regrets for sure of my EDOF lenses and I am truly thinking it is individual choice here and more than one solution to bring good results.  No guarantees until the perfect lens comes out which for now - just isn’t there.

Maryland 2018; just reading the word "explant" makes my eye hurt!

OK, I had to chime in You're absolutely right about being happy with the trifocals. I'm nearly a week out and cannot get over how good my vision is. I joked with my sister that I haven't had vision this good since I was in the womb. The sad thing is that it's probably true. Like you, the tech stuff was more than I wanted to get into, other than how it would affect me. I was so sick of glasses, but would have been happy if the iols had given me decent far vision. I was expecting so little that the actual results were amazing. More importantly, Claire needs to feel comfortable about what her doc is doing. She may be limited by her choice (mine aren't available in the US or the UK), but that doesn't mean the doc should rush her. This may (or may not) be her only bite at the apple and I think the doc sounds a bit callous and/or burned out.

Are you sure that atLISA Trifocals are not available in the UK?   Credits to "julian1967" and "Nizza594" who had shared their experience on atLISA, it could be 2 to 4 months, or even up to 6 months before things felt "normal". Wow, you are one lucky gal.

Notice how one tends to use the phrase "sick of glasses" to sweep everything else under the carpet.  LOL   A 28yo with high degree prescription on both eyes (LE: -12.00, -2.25 / RE: -14:25, -2:75), have myopic degeneration in both eyes and vitreous degeneration in one eye. His eye-doctor refers him to a retina specialist, who advises him to consider removing his lens out and placing an artificial lens in. If anyone wants the link, let me know.

My heartfelt apologies. I know they're not available in the US and another one (Canada?), but I shouldn't have written it without being 100% sure.

I didn't (refused, actually) wear regular glasses, but contacts. You are so spot-on that "sick of glasses" covers up so much more. For me, there isn't enough space on this site to tell of all of the problems I've had. Believe me, no one has been as surprised as me to have had such amazing results and I'm so grateful. I totally credit the surgeon and the retina specialist. Better, there are quite a few of us ex-pats who are singing their praises.

She looks so young  ~ more like a Miss Universe. smile I have bookmarked her website. What is her staff strength? Her clinic looks small. Is the surgery inside her clinic too?

Oops, I may have inadvertently put something in my first reply to you that's not allowed (maybe the mention of a website?). Sorry about that. Anyway, what I had mentioned is that she has a clinic here in Chapala with the usual exam equipment and the main surgery is actually in Guadalajara. There are at least 4 doctors, but I only dealt with two, Dra. Claudia and Dr. Silva. There is also the usual staff of nurses, assistants, etc. The surgery in Guad is like most buildings in Mexico:  the entrance seems small, but once you enter, it's actually quite large.  

She looks too young and gorgeous to be a doctor, much less a specialist, but I'm 60 and EVERYONE is starting to look too young to me!   On our local ex-pat website, you'll find that there's not one single negative comment about her, but several about other eye docs, and we ex-pats talk a LOT amongst ourselves.

Yes, I hadn't heard of trifocals in the U.S. How are they different than the Symfony multifocal with the concentric rings?

Technically Symfony is not a multifocal lens it is an EDOF (extended depth of focus) lens but many refer to them as multifocals.   Multifocals (be it bifocal or trifocal) provide 2 or 3 focus points splitting the light on the retina.  Whereas Symfony provides an elongated seamless focus (but not as much range as a trifocal).   

Just to expand on what Sue.An said, the trifocal lens have unfortunately even worse night vision issues than Symfony lenses. Also, those are harder to adjust to than Symfony because of the 3 distinct good focus areas, but with the areas in-between not in good focus.

I hate to disagree with you at201, but I'm wearing the Zeiss trifocal iols and I don't have the problems at night. My vision is sharp and clear and I don't have in-between bad focus. Of course, I'm speaking only from my experience with Zeiss, not others. I have a tremendous amount of respect for what Sue.An has to say because she's quite knowledgeable about iols overall, so please take my experience as just that:  my experience.

I am so happy for you that you don't have any night time issues with the Zeiss trifocal IOLs.

As all of us on this forum know, with any of the IOLs available in the market, some (probably a majority of ) people have no issues and are completely happy with their choice. Others have a few issues, specially night time vision issues of glare, halos (or multiple circles around lights), starbursts etc. It is not possible for any one of us as an individual to try different options, except in simulators and hardly any doctor's office has one of those. So, all we can do is to have odds in our favor by looking at the studies done on the various IOLs (keeping in mind that some of the study results may be biased).

My comment on the relative night vision issues probability between Symfony and a generic trifocal lens was based on the initial (biased) studies indicating that the night vision issues with Symfony were comparable to monofocal lenses (and much less than the multifocal lenses), then an article "Symfony Intraocular Lens Haloes Similar to Multifocals' by Laird Harrison indicated otherwise, and then the Zeiss study. The Zeiss study comparing the subjects night vision issues on the simulator indicated the ranking (1 being the best and 4 being the worst) of 1.1 for monofocal lens, 2.5 for Zeiss AT Lara, 3.0 for Symfony and 3.4 for a trifocal lens. This also shows that not everyone thought that the trifocal lens had the worst night vision issues (otherwise its ranking would have been 4.0), but on the whole the Symfony lens was considered better (even if not much) than the trifocal lens.

Regarding the vision at different distances, most of the studies seem to indicate that with the vision corrected for distance, the Symfony lens will provide better intermediate distance vision, but poorer near vision compared with a trifocal lens.

Thus, one has to know what is important to him/her, and then pick a lens which offers better odds to achieve that desired vision (knowing that there will always be compromises)

britkennels - I am so curious about your experience with atLISA.  Not aware of anyone else that has them here.   Was there any adjustment time needed to get used to your new vision.  Do eyes adjust quickly when you look at something near and then look into the distance (any lag or blurriness till eyes focus on a new focal point)?

Fair enough and thanks so much for the very well-written explanation. This is why I said that my experience is only mine. With so many variables affecting the outcome, it's important for each person to do his/her homework before parking buns in chair.

I guess I'm one of the happy exceptions on the trifocals because I honestly don't have any reading/medium/distance issues. I flew through the eye chart and reading sheet the very next day after surgery. Of course, after 44 years of crap corrections, maybe this is my reward?

 

Yes, julian1967 and Nizza594 wear atLISA. Look up "Problems adapting to my Zeiss LISA trifocal IOL's" dated 2018-June-05  (8 replies).

 

thanks - just re-reading now.  

No adjustment time at all. The very next day w/the doc, I had 100% vision. I'm not just saying this; it's absolutely true. I raced through the eye charts and everything was so crisp and clear. I haven't had vision this good since...well, 40+ years. No lags, no blurriness, no adjustments. I look up, out, down, around and it's all the same. There is no adjusting. Frankly, with all of the problems I've had in the past, I never expected such great results. I also don't have halos or flares around lights. Night vision is great. I was doing 18 point counted cross stitch today. Before, I wore my readers and used a magnifying glass on a stand. Today, it was naked eye. It's only been a week, but if this is the best that it gets, it's pretty darned amazing.

So pleased for you.  I am sure life will take on so much more meaning.  I too am enjoying things I hadn’t experienced in years.  I could see well next day too.  Although for some healing and drops prevent that early on and they have to wait it is nice to know it can happen instantaneously too!   

Enjoy cross stitch - that takes patience as well as good eye sight!

It's amazing, isn't it? You're absolutely right that life has taken on so much more meaning. It's like someone has taken off the Saran Wrap that was covering my eyes--I could always see relatively well, but it wasn't crisp and clear. 

BTW, a BIG thank you for all the help you've given to so many of us.

You are so welcome.  Done out of appreciation for the others who supported me through the tough decision and process.   There is only so much that family (even close family) and friends wanted to hear my concerns and waffling back and forth with indecision.  Somehow others going through same experience is better support because they know and feel what you feel.  Silence in this instance isn’t golden and we all need to be heard and bounce our thoughts off one another.

Enjoy your vision - I am sure you will!!!!