My Eyhance Experience

Thanks for posting Xen42188. I have same question as Night=Hawk. Im going down that road like really soon. Prayers for best vision and recovery

Yes. I can see very sharp from 14 inches to 35 inches. This range is very comfortable for me for cell, laptop and external monitor. Pls keep in mind though that although my target was -1, I probably ended up close to -1.25. However, I still think -1 is the right target and would've been equally happy if that's where I ended up.

Thank you and all the best.

Had surgery two days ago. Asked for -1 cuz im naturally myopic wanted leave some near sightedness. I can see near, intermediate and distance the colors the contrast the brightess sharpness are excellent. beyond any vision i thought i could have

Hey Ron thanks for the advice. Xen experience that he is happy but might lean towards mono etc i dont really understand in real time visually how that works with both eyes not making me dizzy etc im going have both set distance no mono how different would vision be with mono is it more 3d like

I would suggest that mini-monovision with monofocal lenses is not that big of a deal. Based on my experience the perfect mini-monovison arrangement would be to have the dominant eye end up with a residual needed correction of -0.25 D. This would be the distance eye. The non dominant eye would ideal at -1.25 D residual. This leaves a difference between the two eyes of 1.0 D. This is not much, and should not lead to any loss of 3D vision or ability to judge distance, or being dizzy.

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When I get up in the morning before I put my contact in my non IOL eye it is about -2.0 D, while my IOL eye is 0.0 D, or a 2.0 D differential. I do not find that uncomfortable and sometimes I forget to put my contact in. I don't have any issues judging distance and cutting my throat while shaving! I usually realize it when I go to use the computer. Having a 2.0 D difference between the eyes at computer distance leaves a hole in my vision. The screen is too close for my 0.0 D eye, and too far for my -2.0 D eye. I don't get dizzy or anything. I just get annoyed that I don't see the computer screen well, and go put my contact in which brings my IOL eye to -1.25 D and almost perfect for the computer screen distance.

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The wild card in all of this is that we can sit at our computer and dream up the perfect residual eye correction where we want to be, but it is not a perfect art. The surgeon has choices of lenses that come in fairly course 0.5 D steps. They hopefully can come close to what we want, but there is always going to be some error. The good news is that any error in the choice of a monofocal lens is easily corrected with eyeglasses. While that may not be ideal for some, it is a reasonable backup plan B. I would suggest for most it is realistic to count on getting progressive glasses in any case for those cases when you want the very best vision, like driving at night. They will correct for any residual spherical error or astigmatism error and give the very best vision.

Ron this is real important you do use a contact in iol eye too? and if i follow you i ask this im myopic got real good vision with contacts but this is all I know. and all i will compare it too my real eyes are to to blurry. the question is when you use contact in iol eye is effect same as using contact in non iol eye or eye before it was corrected with cataract surgery is the contact lens able to correct iol eye same as non iol giving the same vision whatever the reason or prescription might be. in other words do contacts have same great vision enchancement with iol lens as before

i think i read what i wanted to Ron Your description of how you use contacts to correct error is really helpful. I dont see much about people using contacts in iol eye to tweak vision im getting iol in both eyes. i think i can just pop them in to correct residual error if any whether near or far to correct vision like i do now with natural eyes why dont more people use contacts instead of glasses after iol replacement? as always thanks for your great help with others on this forum

No. I do not use a contact in my IOL eye as I do not need to. My eyeglass prescription for the IOL eye is 0.0 D spherical and -0.75 cylinder (astigmatism). I suppose I could get a toric only correction for the IOL eye, but it would not help vision a lot, and it would be one more contact to put in every day.

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But, yes, if you do need correction in an IOL eye, you can use a contact. The primary objective would be to get an IOL power that does not need one.

Ron, we can all do our calculations but at the end, there is a certain amount of "luck" (call it accuracy of calculations, surgeon skill, eye chemistry, even manufacturing and surgery room quality controls, post-op issues and so on) involved in determining the final result.

When I was in the surgery room, the surgeon told me according to ORA the lens power of 17D will land me at -1 while the one higher up (17.5D) will land me at -1.3 . So likely there is more going on with calculations than a straight line addition of .5D steps.

Having gone through mini monovision, I still favour bilateral/binocular implants if I had to do it all over again. Either both target for near/intermediate or both for slightly under plano.

One more observation: With my astigmatism gone and the virtually no spherical aberration, the sharpness of vision in my right eye is unbelievable. I didn't think this level of sharpness existed! However If I were to design the Eyhance, I'd make it with neutral SA. That would provide even greater depth without a dip on sharpness.

My left eye is still healing but it has been an entirely different experience than my right. I'm seeing ghosting at all distances and not much depth. Hope that changes but not a happy camper right now!

I believe these IOL's have a corneal plane value for power and a lens plane value. Then there is also the eyeglass plane. We had a discussion about the value of a toric IOL with the surgeon on my wife's upcoming cataract surgery. I asked what amount of astigmatism she had, and he gave me two numbers that were actually quite far apart. He followed that with the comment that his experience was that the true value falls right about in the middle of the two methods used. That was a good match for the minimum cylinder power for a toric, so we agreed to go with the toric. Her other eye has 7.3 D of astigmatism and I believe the maximum power is 6 D. He said there was no other choice than to go with the max power available.

Two week update:

My right has has landed at -1.25. It was targetted at -1. I can read one line better than J1 and the vision is sharp. I'm happy with the result, although if I knew the lens will settle where it has, I would have considered -.75 to eventually end at -1 which I think the best near for this lens.

The left eye has settled at -.25.

I'm happy with where it has landed however, with that eye, I see double! I just came back from the opthalmologist and he said the lens is properly centered, not tilted. Astigmatism in that eye is .25 so not much to cause double vision. He said to give it a month.

Does anyone have any thoughts on what could be causing it? The vision is sharp, however, when I look at an eye chart (or street names etc), I see ghosting and that affect how well or how far I can clearly see.

Thanks!

Seeing double should not be an expected outcome. If it does not go away I think I would be asking to see the surgeon for an exam to determine the reason.

Might be a higher-order aberration not correctable with cyl. I am myopic with lots of astigmatism. I have slight ghosting in my right eye, with glasses, which I can only correct with a positive 2d cylinder lens held at 50 degrees in front of my glasses. (I have a trial lens set I have been playing with -- that's how I discovered this). I have not had surgery yet. My eyeglass prescription includes -8.25 cylinder at 90 degrees. I took this information about the positive cylinder lens to my optometrist, hoping she could use it to improve my glasses prescription, and she said I must be correcting some higher-order spherical aberration with that weird combination of cylinder lenses. She said she could not give me a prescription that would mimic what I was doing with my glasses plus handheld lens. She said, "We only do sphere and cylinder. Nothing higher-order than that. No lab could make that for you." So, perhaps the ghosting is some higher-order thing going on with your cornea, induced by the surgery and perhaps post-surgical swelling. Hopefully, if so, it will go away as it heals. Just a shot in the dark.

I think my higher order aberrations give me some EDOF , because, despite my being 73 years old and having cataracts, I can read my phone easily, do computer stuff, and see distance well enough to drive comfortably night and day without progressives. I wear monofocal glasses with under-correction of -0.75 d; they are wonderfully versatile. I do take them off for really tiny print. I have weird corneas (keratoconus). I'm still pondering what this means for my IOL choice and targeting. The only choice for the 9 or 10d of cyl my right eye needs is a monofocal (available in Canada from Zeiss). My doctor wants to use Eyhance toric in the other eye, which has just moderate astigmatism. I'm thinking of -2 for the right eye, even though it is dominant, and -1 or -0.75 for the Eyhance. I don't mind wearing distance glasses if i have to, but never want to lack for at least one very myopic eye for tiny print and fine work (I do metal work). I don't think it would make sense for me to set an Eyhance to -2, right?