New to Cataracts - HAve been lurking and learning

Hello! I'm a sixty-four year old female; have nuclear cataracts in both eyes; have been referred for surgery (consult will take place August 21).

Issues: Exophoria; Myopia; Diplopia; Presbyopia; Astigmatism; Cataracts

LE

Refractive Power - minus 1.00

Astigmatism -- 0.75

Axis cylindrical correction -- x 005

Prism -- 3 BO 1.5 BI

20/50 corrected

LE

Refractive Power – minus 2.00

Astigmatism -- 0.50

Axis cylindrical correction -- x165

Prism 3 BO

20/40 corrected

Here is where I am at the moment. Questions and comments for the surgeon:

Clareon Aspheric Mono or Acrysof Aspheric IQ Monol IOL the best Monofocal choices? (Less chance of developing POC and needing YAG; less inflammation; better quality contrast, clearer vision, less glare and less visual disturbance??)

Does the newest Alcon platform replace the Acrysof Aspheric IQ Monofocal?

What are my risks of Dysphotopsia with a squared edge vs. round IOL? What about retinal detachment or cystoid macular edema?

--- (No need for Toric IOL – I can wear Toric contacts or glasses if needed)

Can we target my non-dominant eye for slight myopia in order to have a more usable range of near /midrange vision – especially for reading books and including smart phone and computer (Micro/Mino-mono)?

For very close up, extremely small print (like on prescription bottles), I don’t mind needing reading glasses. Right now I’m wearing my progressive prism glasses for driving only. I also don’t mind wearing multi-focal contacts or progressives after surgery to resolve any distance issues. What lens power target should we shoot for in each eye in order to achieve the above?

My preference is to do ISBCS binocular cataract surgery because:

--I wear progressive glasses with prisms and will be out of commission and won’t be able to drive until both eyes are done and new prism glasses can be made for me. I estimate that time to be 6 weeks until I can see Dr. M....... for optical measurements for new prescription prisms, plus 3 additional weeks to have them made. And that’s with doing both eyes at the same time. If we do them separately, I am looking at a total of ~ 3 months.

Benefits to me: I will have faster visual recovery (only one recovery period) and my eyes will learn more quickly how to better coordinate with each other; reduction in surgical and post-op visits; (I live near _____ and it’s 58 miles each way to _____; my daughter lives in _____ and is ~70 miles from me, and she will need to travel to pick me up, take me here, take me back home, and then return to her home (256 total miles each time she has to do this). She will be taking time off work to assist each time I need to return.

Additionally there will be less time needed for me to resume driving – I live in an EXTREMELY remote area and driving is a necessity), less overall time needed for help for me at home during the recovery period; and as indicated above a shorter time for me to obtain contact lens prescription, and non-prescription prism glasses to use in conjunction with contacts for driving; plus another pair of progressives with prisms as a backup if for some reason I can’t wear contacts on a particular day and need to drive.

Side note: I’m paying cash, so there’s no issue with decreased insurance reimbursement to your practice…

Side note: I did a bit of research on immediate sequential bilateral cataract surgery and the consensus is there are no clinically important differences in outcomes between doing cataract surgery on one eye and then the other on the same day compared with doing them on different days.

There no statistically significant differences in other complications, such as bleeding or retinal detachment… or infection…

Very common in Europe

I will mention the sources for my information when I meet him.

Is there anything else I need to consider?

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