Second guessing my cataract replacement lens

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Hi, I've spoken to 2 different doctors regarding my cateracts. I'm a younger cataract patient in my 40s. My left is has a big cataract that really interferes with my vision. My right eye has a very early-stage cataract which doesn't affect me yet.

I don't know what these numbers mean really, but my left eye is -3, and my right is -1.

I have worn glasses since I was young. Now, due to age, I must take my glasses off to read a book or look at my phone; which doesn't really bother me.

The first doctor says I should get one eye adjusted for far and the other near(I think he said -.75 and 0).

The 2nd doctor says I should just get the bad eye done now, and keep it at -3. This would mean I would still need glasses, but I could take them off when reading. So I guess nothing would change except I wouldn't have the bad cataract anymore.

But now, I'm wondering if I should do the bad eye now and get a lens for distance, but still do the right eye later. Would that be too much of a difference for my brain to handle?

My only thing is, I DO NOT want to need reading glasses. That is my only concern.

Thanks!

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  • Posted

    I too have a one eye with a siginficant cataract that affects my vision and the other eye with only a very early stage cataract that doesn't affect my vision yet.

    I plan to have surgery for the eye with the worse cataract soon and plan for setting it for good distance vision (0 to -0.25D) with a monofocal IOL.

    Later perhaps months or longer in the future I can get the other eye done and plan to set that for good intermediate/computer distance vision (-0.75D to -1.0D).

    So that sounds similar to what your first doctor recommended.

    To reduce the need for reading glasses, I might also consider a Symfony extended focus IOL instead of a monofocal IOL for my second eye in the future. But I want to start with a monofocal IOL for my first eye (dominant eye) to try to get best distance vision with little or no night vision artifacts.

    Best is to prioritize the zones for your preference: distance, intermediate, and near(reading).

    You might only be able to get two of the zones well, at least reduce glasses needs for only the one zone you use the least.

    I put highest priority on distance and intermediate/computer zones, so those are the two zones I want to try to eliminate glasses for, its a tradeoff, so would accept using glasses for reading fine print and/or in low lighting for example.

    Full monovision might give better near/reading viewing but at the possible reduction of good stereoscopic vision.  Multifocal and extended focus IOLs may also give a wider focus range but at the expense of night vision artifacts.  So its all a tradeoff, and prioritize, since you can't have it all...

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    • Posted

      You said you might consider a Symfony extended focus IOL instead of a monofocus IOL....can you get the symfony lens under the NHS?

      Thanks

      Anne

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    • Posted

      No NHS will only implant a monofocal lens.   You would have to have surgery done private if you wanted a premium lens.  In Canada our national Medicare which is similar to UK will do the surgery if you want a premium lens and surgery is covered but patient pays for the lens upgrade.  I recently learned one of our provinces is covering now premium lenses as of July this year.  It is likely a matter of time before other provinces follow suit.
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    • Posted

      So if I had one eye set for distance(0 or -25) and the other for close up, that would reduce my stereoscopic vision?  Would getting glasses correct that?  thanks!
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    • Posted

      The affect of monovision on stereoscopic distance vision (depth perception) depends on how far the near vision eye Rx is set.  Full monovision (+2D or so) would definitely affect it, but mini-monovision (+1D or less) may not affect it or have very little effect since the near vision eye might still get decent distance vision 20/30-20/40 instead of 20/20.
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    • Posted

      Also yes, even with full monovision you could get a pair of eyeglasses say for driving that could correct the nearsightedness of the eye set for near vision and make it good for distance vision along with the other eye while wearing the glasses.
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  • Posted

    I agree with night hawk.  You will have to prioritize what you want as there is no having it all with cataract surgery.  If your other eye doesn't need doing you could also wear a contact lens to eliminate glasses.  Who knows by the time you need it fine there could be better options for lenses.  

    I didn't want to wear glasses either and needed both eyes done - cataracts in both eyes at 53 impacting my vision.  I opted for Symfony lenses in both eyes and haven't worn glasses since 2nd surgery 2 weeks ago.  May need them for fine print like pill bottles but so far haven't come across anything that I could not read at work or home.  Trade off though is the night vision.  If you do a lot of night time driving these lenses mightn't be for you.  I can see well enough to drive in lighted areas with overhead streetlights but on dark roads oncoming car headlights have lots of glare and halos.

    Good luck.

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    • Posted

      Thank you.  I do drive a lot at night for my job.  So I might be best sticking with monovision lenses.
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    • Posted

      My surgeries were completed three weeks ago as follows: dominant eye set for distance, other eye set for intermediate vision.  Both are monofocal toric IOLs, mini mono vision (-1.25D).  I can see just about everything including very small print (medicine bottles), no night time halos while driving. I am quite happy with my outcome.  For the very tiny print I just hold the bottle out a little further and have no problems reading.  I like to look at my iPhone up close at night in bed, so I do use readers (+3.5), but if I hold the phone out to about 14" I can see it. Other than that I have not used glasses.  Hope this helps.

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