Questions on mini-monovision and dominant eyes
Posted , 16 users are following.
Hello All,
I have cataract surgery for my right eye scheduled in a couple of weeks. It will be laser assisted. My astigmatism is slightly more pronounced in that eye, so I will be getting a monofocal toric lens to clean up whatever astigmatism the laser can't. The lens will be set for distance.
After a LOT of reading and research, I've decided against multifocals. I'm risk adverse and don't like the wide range of possible outcomes. However, I am seriously considering mini-monovision.
The cataract in my right eye is so bad that if wasn't for my left eye, I'd probably be on short term disability right now. I'm in front of a computer all day, and if I cover up my left eye, I can't barely read the word "Test" with a 36 font.
My left eye is currently dominant, but I am right handed.
Questions:
Has my left eye likely become dominant as a result of the cataract progressing so much more quickly in the right? Unfortunately, I have no idea which eye was dominant prior to the cataracts.
Considering that my left eye is currently dominant, if the monofocal in my right eye is set for distance (since I'm getting that one done first), and then the monofocal in my left eye is set at, say, -1.5, is that going to be a problem, or will my right eye just naturally become the dominant one? Personally, I don't care which eye is dominant as long as I get good results.
My surgeon told me (and I read in a few different articles) that the ideal patient for monovision is easy and outgoing. Apparently, Introspective, detail oriented introverts like me don't adapt as well. I'm not sure if that applies to mini-monovison. Can anyone here with personal experience confirm or refute that?
Thanks in advance. I spent most of the day reading through posts here, and everyone that has contributed has helped to create a treasure trove of information.
0 likes, 40 replies
paula29996 thomas84367
Edited
Had I known the results of a multifocal ahead of time, I definitely would not have gone with that choice. Hindsight is foresight & I now regret my decision but wish my surgeon was more proactive in helping me make that choice. Now I'm going to be stuck with blurry vision in that eye & a lens exchange is much too risky for me. Best of luck to you & I think you are making a very wise decision. Wish I would have found this website a long time ago.
Captainbbb thomas84367
Posted
Hi, can you share what happened with your surgery? I was fascinated by this thread & I'm getting my left eye operated on in 6 days. Hopefully making a last minute switch from Panoptix (that my surgeon recommended...$5k extra) to mini monovision with Clareon monofocals...
Unfortunately, the surgeon is old school and not interested in having in depth discussions but I've waited a year for the surgery & he has the best outcomes in my area apparently. I'm really curious how your vision turned out. Also, for anyone reading this I have a question...I was really taken aback during my pre-op phone call that my doc REQUIRES I.V. anesthesia! I thought virtually everyone just uses drops?? When I indicated that I did not need "sedation" (I guess it's not full general but still!) the technician said "well you can discuss that with the anesthesiologist when you arrive for your surgery! Ya, as if he or she is going to say "oh, no problem, I am all set up but I'll just go home now and not get paid". Is this remotely normal?
I will add that the surgery is not laser assisted and they don't restrain your head....maybe he needs to knock people out so they don't move or distract him?? Any thoughts? Thanks.
RonAKA Captainbbb
Posted
I think you will like your mini monovision with Clareon monofocals. The key is hitting your targets. My left (near eye) is a little off due to astigmatism but on a spherical equivalent basis it ended up at -1.40 D. My distance eye spherical equivalent is -0.25 D. This has worked out quite well for me despite having some astigmatism. I think the ideal targets are -0.25 D distance, and -1.50 D near.
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If you can get a copy of the IOLMaster Calculation sheet you can use on line calculators to get "second opinions" on whether the power of IOL selected is correct. I think the best formula is the Hill RBF-3.0 one and another good one is the Barrett Universal II. If the power from these formulas agree with the one the surgeon is choosing your odds are as good as they can be to get the best results.
Bookwoman Captainbbb
Posted
I had IV anesthesia (as have all my friends who have had the surgeries), and for the first eye I was still aware of what was going on, but felt nothing. For the second I was out. In either case I far prefer that to being completely awake, which would make me very anxious. YMMV.
karbonbee Captainbbb
Posted
The IV anesthesia they give you in a clinic doesn't completely put you out, it just a combination of a mild sedative and possibly a muscle relaxant and/or hydromorphone. It is to relax you but also to help make sure that you don't inadvertently flinch or otherwise move during the surgery, which could cause the surgeon to make a mistake. They also put numbing drops in the eye being operated upon so you can't blink etc. You can decline using the IV, but there's probably also something that you sign stating that if you move during the surgery, interfering with the surgeon's job, then that's on you. Unless you are allergic to something, the sedative isn't a big thing. I was a little wonky afterward, but could walk on my own immediately afterward, and since I felt that way for the rest of the night, it made sure that I relaxed and slept instead of overdoing it. It is a surgery after all. I hope they told you that you have to be escorted to and from the surgeon by a support person. If you show up in a taxi, the clinic I went to said that they'd do the surgery, but you wouldn't be sedated. Some people have reported that not using the sedative wasn't a big deal, for others, it was the opposite. For me, I'd rather be safe than sorry.
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Remember that whatever surgeon you use is being paid for his services by you, or possibly medicare, so it is your right to change your mind about what lens you want to use. They might have to postpone the surgery if they don't have the lens you want on hand, but that's a lot better than ultimately paying a lot of money for something you don't want (and results you don't want). Most surgeries done in a hospital, in Canada at least, aren't laser assisted as most of the hospitals don't have that level of equipment, so your surgeon should be practised in inserting the IOL manually. Both of my eyes were done a couple of weeks ago manually in a private clinic, without the laser assist, and the surgeon did a great job. Most of what the laser assisted package offers was already done anyway during the pre-op appointment by an IOLMaster or a Lenstar scan, and there's many surgeons who think that manual insertion ultimately does a better job, so I wouldn't worry about it. If your surgeon is a good as you've heard, then he should be skilled manually, especially if he's old school.
RonAKA Captainbbb
Posted
I have had both eyes done now. The first was done in a hospital with an IV sedative that pretty much put me out but I was somewhat aware of what was going on. The took me out and eventually to my wife's car in a wheelchair. My second eye was done in clinic with an Ativan tablet under the tongue just before surgery. I was much more aware of what was going on and walked away fine after it. I walked out and flagged my wife down in the parking lot to get a ride home. Both methods work well.
stephen53955 Captainbbb
Posted
Straight monofocal implants set to plano are the lowest risk and best potential outcome. Sedation or "twilight sleep" makes you sleepy and calm (no panic and minimized movement) during a procedure. You're typically awake, but groggy, and are able to follow instructions as needed.
RonAKA Captainbbb
Posted
You made a good decision to switch from the PanOptix to mini-monovision with Clareon monofocals. I have a good friend that has PanOptix in both eyes and she feels she wasted the $4500 they cost her as she still needs +1.75 reading glasses and does not have the best distance vision. I have mini-monovision with AcrySof IQ and Clareon monofocals and all around have much better vision than she has.