Similar target versus result difference for both eyes after IOL?
Posted , 6 users are following.
I have now had one IOL implanted (vitrectomy and IOL surgery) and am considering adjusting the lens target for the other eye based on the first result. I was aiming ideally for around -1.25D to -1.50D for one eye and -1.75D to 2.00D for the other using monofocal IOLs after deciding against multifocal/EDOF etc.
The first eye had a target of -1.39D and the result is -1.00D (astigmatism reduced from -0.50D to -0.25D ).
My surgeon says it's likely the other eye will have a similar offset, and suggests allowing for an expected error of 0.4D, or half that if being more cautious.
So I am curious what people here have experienced with target versus result differences across both eyes?
1 like, 27 replies
robert20416 pg128
Posted
You're so meticulous. I'm impressed. I got two sets of contact for tryout and was afraid of what contact department lady would think of me....haha.
What do you mean by your left eye having 0.5D accommodation?
pg128 robert20416
Posted
Before my first surgery I tried to estimate what accommodation was left in my natural lenses to help with IOL calculations as it flatters any target simulations using contact lenses.
It's tricky to estimate but I used my distance versus close measurements and focal points to get a figure and I think it was 0.5D or a little more. I needed readers from my late 30s which means I am at the lower end of the range for accommodation throughout my life and likely to be sub 1D once mid 50 (I am 51) and older.
Comparing my IOL and remaining natural lens with glasses or contacts over shows that 0.5D is a good estimate. I am using consistent light levels to ensure similar pupil diameter to avoid that affecting focal range so I am being pretty thorough, although that's not quite the phrase my wife uses :-)
It's easy to overthink all this as I even factored in a drop in astigmatism due to incision placement. All this calculation is great for working out the perfect target, hitting it is another matter.
robert20416 pg128
Posted
Just wondering if you have your second eye done?
pg128 robert20416
Posted
Not yet as I had one of my other significant medical problems flare up and dealing with that and second vitrectomy/IOL as the same time was too handle. The second surgery is now rescheduled for a few weeks time.
I used the time to try some more contact lens tests and am still in two minds over choice. My right eye has settled at about -0.75D to -1D with 0.5D astigmatism. For the left eye tests with contacts I've found anything over -2.00D seems hard work. So it looks that 1.5D of mono vision is my limit allowing for astigmatism. I know some people cope with more but for me the blur limits the usefulness too much.
So the choice is still difficult due to the target versus outcome error. I would be happy with -1.5D to -2D and a little astigmatism but if its outside that then less myopic would be my preference and my -1.64D and -1.99D targets aren't ideally placed. I expect the vitrectomy adds a little more error into the proceedings as well.
How did your -1.63D target come out in the end, did it move a little more myopic as your other eye did?
CoolP pg128
Posted
PG128,
I read your discussion forum with much interest and really appreciate your points of view. I’m -6.5D Right and -7.5D left and will be getting the Tecnis monofocal IOL. I’m also afraid of losing my near vision and don’t mind wearing distance glasses to get 20/20. I believe you ended up -1.00D (astigmatism reduced from -0.50D to -0.25D ) in your first eye. Did you get your second eye IOL implanted yet, and I would be interested in learning your final results for both eyes.
Can you provide me a range of vision you see both near (e.g., J-Chart No. 5 .75M @ 14”) & far (e.g. 20/40) in both good and bad lighting conditions. How far away do you have to hold you smart-phone? In layman’s terms how would you describe your range of vision, and are you happy with your end results for near vision?
I’m confused on what would be the best target range (between -0.75 thru -1.75) for me to AIM. I was thinking of -1.25D RT / -1.75 LT or just go with both eyes at -1.75D to be safe for near vision; and leave some weak distance vision. If you had to do it over would you make any adjustments? I don’t think I would want to go any higher than 0.5D differences between the two eyes. What was the end difference between your two eyes and where you able to adjust ok?
Sorry for all the questions I’ve stressed over this decision for 4 years and now have to get this surgery done. Thank you for any insights you could provide!