Normal 42 year old one week to Posterior Subcapsular Cataract next week.

thats pretty much my story from two years ago. waking up after a sunday afternoon nap. my 2 cents on your questions

1. no they are somewhat similar to other cataracts to treat but given the young age there is a possibility to see lens edge glare (positive dysphotopsia) if the pupil dilates beyond IoL. also younger age is more prone to PCO after surgery. also younger men below 50 are more prone to retina detachment after cataract surgery.

2. i was only looking at edof lenses. so there were only 2 options. symfony and zeiss lara. did not opt for zeiss as i was told zeiss is more prone to PCO.

3. laser was my preference for correctly sized capsularhexis.

4. depends on how much near you get with a monofocal. that is difficult to predict.

5. sometimes.

6. no computer screen is intermediate. 2 to 5 feet.

7. with both eyes open the better eye will compensate. also i was in denial for many days. psc progress very fast. 2 years after diagnosis my 2 nd eye is getting worse.

I am so sorry your wife has to go through this st 40. My own hit early and rapidly as well at 53. I am coming up on 2 years since first surgery and 2nd eye was done 6 weeks after first.

Soks' responses below are spit on so I won't repeat.

Just to confirm - you mentioned your wife does not drive? If that is the case she may want to consider EDOF lenses like Zeiss stLara or Symfony. Most of the issues with lens (whether EDOF or multifocal) are the added halos at night. But during the day they orovide much more range of vision than a monofocal. As Soks mentioned there really is no way of predicting outcome of a monofocal. A small percentage actually get intermediate and distance with them or obtain more range by having a mini monovision done where target of one eye is distance and other is intermediate. Person wears glasses for reading. Or if preferred target near and intermediate and wear glasses for distance.

However with a mini monovision approach if your wife has never experimented with contacts (or is her vision such she could experiment now) I would not suggest going with more than 1 diopter difference as it is not something everyone can adjust to.

I went with Symfony for my choice. I see well at all distances (except for tiny print or in low lighting situations wear I do have readers +1.25). I work full time and prefer to see my computer or iphone/tablet without glasses and don't need glasses for driving anymore either. I do see multiple co centric circles around certain lights at night (traffic and car brakes when applied). It has gotten better (or I have adjusted yo it) but they do not go away as often one reads. There is a very good thread here on the forums about the night vision issues by a201 if you'd like to read through it. Titled Has anyone else noticed this unusual vision issue with Symfony. atLara lenses would have similar issues as well.

I am fortunate that I do not have edge glare as Soks described but that is again something you can't predict as all IOLs are pretty standard diameter of 6mm. I do have PCO developing in LE but so far with both eyes open it isn't causing a big problem now but I likely will have to have a YAG at one point to clear it up.

It is good you are gathering questions to ask the surgeon. Best to shop around to find someone that will dialog with you and discuss pros and cons of IOL selection. It is extremely hard the younger one is as it is about compromises. My own surgeon said the older ones are very happy to have the surgery as they gain something they list years ago but the younger patients have to decide what to lose. I sympathize with your wife as I agonized over this a lot and delayed decision as much as I could. The procedure itself does not hurt. Going to dentist is worse.

Best wishes for a successful outcome.

I am so sorry your wife has to go through this st 40. My own hit early and rapidly as well at 53. I am coming up on 2 years since first surgery and 2nd eye was done 6 weeks after first.

Soks' responses below are spit on so I won't repeat.

Just to confirm - you mentioned your wife does not drive? If that is the case she may want to consider EDOF lenses like Zeiss stLara or Symfony. Most of the issues with lens (whether EDOF or multifocal) are the added halos at night. But during the day they orovide much more range of vision than a monofocal. As Soks mentioned there really is no way of predicting outcome of a monofocal. A small percentage actually get intermediate and distance with them or obtain more range by having a mini monovision done where target of one eye is distance and other is intermediate. Person wears glasses for reading. Or if preferred target near and intermediate and wear glasses for distance.

However with a mini monovision approach if your wife has never experimented with contacts (or is her vision such she could experiment now) I would not suggest going with more than 1 diopter difference as it is not something everyone can adjust to.

I went with Symfony for my choice. I see well at all distances (except for tiny print or in low lighting situations wear I do have readers +1.25). I work full time and prefer to see my computer or iphone/tablet without glasses and don't need glasses for driving anymore either. I do see multiple co centric circles around certain lights at night (traffic and car brakes when applied). It has gotten better (or I have adjusted yo it) but they do not go away as often one reads. There is a very good thread here on the forums about the night vision issues by a201 if you'd like to read through it. Titled Has anyone else noticed this unusual vision issue with Symfony. atLara lenses would have similar issues as well.

I am fortunate that I do not have edge glare as Soks described but that is again something you can't predict as all IOLs are pretty standard diameter of 6mm. I do have PCO developing in LE but so far with both eyes open it isn't causing a big problem now but I likely will have to have a YAG at one point to clear it up.

It is good you are gathering questions to ask the surgeon. Best to shop around to find someone that will dialog with you and discuss pros and cons of IOL selection. It is extremely hard the younger one is as it is about compromises. My own surgeon said the older ones are very happy to have the surgery as they gain something they list years ago but the younger patients have to decide what to lose. I sympathize with your wife as I agonized over this a lot and delayed decision as much as I could. The procedure itself does not hurt. Going to dentist is worse.

Best wishes for a successful outcome.

2. Who makes the best IOLs that are reliable and excellent quality?

When I researched monofocals, I rated Tecnis and Bausch & Lomb over Acrysof, although Acrysof is probably the most implanted here in the U.S. Most with Acrysof are happy with them, though. Drawbacks with the Acrysof are the potential for glistenings and "diamond eye," which is a certain kind of glint when seen from a particular angle. However, there is a possibility for dysphotopsias with any IOL. As soks noted, with younger patients, the eye sometimes dilates beyond the IOL rim, causing edge glare. I don't know if any of the above IOLs are larger than the others, which could possibly lessen this effect.

3. Definitely go for Femto laser for the cut or not stress over it?

Most eye surgeons are skilled at manual implantation, but there can be a degree of precision with laser.

4. Wife is group fitness instructor and also works in office. Would long distance mono IOLs in both eyes be the best and safest option?

If she is going with monofocals, I would suggest blended vision (mini-monovision), with her dominant eye set for distance and her other eye set for intermediate vision. She would need reading glasses for near vision, but would not need to wear glasses for intermediate and distance.

5. Mulitfocal IOLs too risky?

It's not that multifocals are risky, but she is very likely to have some degree of night vision issues (halos, starbursts, or other effects) around lights, including headlights. There can also be gaps between the two or three focal points with multifocals where vision can be blurry. The Symfony IOL is not a multifocal, but an "extended depth of focus" lens (more like a better monofocal), but most with this lens see concentric circles around points of light at night, so your wife would need to be willing to tolerate that.

3. Laser or Traditional?

I will be getting Laser Cataract Surgery, but I appreciated the fact that my opthalmologist did not "sell" the Laser option at all. In fact, the doctor said that studies show that outcomes with laser and traditional are pretty much the same after a year.I'm going with Laser because of faster recovery, I've only one set of eyes and added cost is not that much when I look at it that way, and there may be a slightly higher probability of better results.

5. Multifocals Too Risky

Many of the posters here are from the US. And the US has gone more to EDOF like Symfony due to some risks with traditional multifocals (which were really bi-focals). The risks included not as good intermediate vision, reduced contrast sensitivity, and thinks like halos, shadows, etc...

I was diagnosed in December, and was thinking I'd go EDOF. But the latest trifocals are getting extremely good reviews after 5 years of use in Europe. I posted some comments in the AT LISA vs AT LARA thread. My research has made me very comfortable with the latest generation of tri-focals. I will be getting the PanOptix tri-focal by Alcon.

In particular, Search: "eyeworld" and "Trifocals outperforming other premium lenses" for a recent article outlining why opthalmologists believe that the tri-focals may be the appropriate for many.

6. Intermediate Range Vision

That is one of the benefits of the latest tri-focals -- excellent distance and intermediate vision, and very good near vision for most, as in the modern world, intermediate distance is very important.

2. Best IOL

Each generation of IOL improves on the prior generation. As per the article I suggest you search for, the three leading tri-focal IOLs are (from newest to oldest) Panoptix, FineVision, and AT LISA.

1. Nothing to add from Soks. Definitely look up edge glare.
2. Seems like there are pros and cons to most of them. My surgeon used Acrysof but I might have picked Tecnis if I had the choice. I was looking at lenses which minimize risk of PCO but already have trace PCO in one eye a month out.
3. I went with laser. I was between 2 doctors (one used it, one didn't). I asked my retinal specialist his opinion and he said either choice was good. For me, it provided a level of comfort.
4. Not necessarily.
5. Not risky as far as surgery goes. It's really an individual choice. Many people get multi-focals and love them. I knew it wasn't the best for me as I wanted the best possible vision even with glasses. Of course, I'd rather not have to wear glasses, so I did pay extra for the laser to get some glasses independence. For intermediate and near reading, I need glasses.
6. No. Consider mini-mono, monovision, or multifocal lens, or wear glasses.
7. I don't know the answer, but I just had both eyes done, a little over a month apart. Was pleased with the first eye (probably about 20/30), but I was comparing it to my cataract eye with 20/200 vision. Had my second eye done and so far it seems to be spot on - close to plano with no astigmatism. Now I definitely see blurriness in my first eye.

Wow so many replies!!!!

I just came back from my wife's 3 hrs of hard group fitness classes. I will read them tomorrow morning with fresh mind as I am psychologically and physically drained 😦