What IOL targets work when one eye is comprimised?
Posted , 5 users are following.
I'm trying to figure out the best way to pick IOL and refractive targets for my two eyes with cataracts.
A problem is that I had a macular pucker in my RE that left me with some central vision distortion. My LE sees well, except for the growing cataract.
It seems monovision, where one eye is targeted stronger or weaker to gain some depth of focus with monofocal lenses, is a common approach. But I think my macular issues prevent doing this.
If I choose a single refractive target for both eyes, could I achieve distance and intermediate vision?
I'm so myopic (-10) that I need glasses for reading anyway, so I'm thinking a plano target would work for me. Maybe the Eyhance lens I've read about would get me intermediate distance as, well...
What do others recommend or what experiences have they had when myopic like me, but with only one good eye?
0 likes, 12 replies
rwbil rick18299
Edited
Anytime someone has an eye condition, other than cataracts, I recommend the least risky options.
You could get the Tecnis Eyhance and shoot for -0.5 (D). This should still provide decent distance and get you down to about 2 feet.
rick18299 rwbil
Posted
Thanks, that seems like a reasonable idea.
Perhaps I could target -.25 in the bad eye to provide a little more sharpness to help with the peripheral vision?
Dave13852 rwbil
Posted
rwbil,
Wouldn't monofocal IOL be the least risky option? I too have an epiretinal membrane in one eye.
rick18299 Dave13852
Posted
My understanding is that the Eyhance is considered a monofocal lens but it adds a slight bit of extra power in the center of the lens to extend depth of focus a tiny bit.
I have also heard online that the new Light Adjustable Lens (RxSight) might be a good option for my situation, but this would require travel to a bigger city.
Have you had your membrane operated (i.e. Vitrectomy/peel)?
rwbil Dave13852
Edited
Eyhance falls under the category of "Premium" monofocals, but yes a tradition monofocal is the least risky. But the poster showed an interesting in obtaining better close vision, so I suggestion IMHO a reasonable compromise.
Dave13852 rick18299
Posted
Hi Ricki,
The retina specialist wants me to have my cataracts removed first. I think he could see the pucker better that way. I'm not quite ready for the cataract surgery yet but I pretty much decided what IOL (monofocal) and what target refraction I want to aim from everything I learned here. The retina specialist told me that I might not have to get a peel depending on how well I see after the cataract surgery. I've read elsewhere that a peel may only improve a maximum of 50% of the affected vision from the pucker, if true, not sure it's worth it.
Dave13852 rwbil
Posted
Hi rwbil,
Thanks for your perspective. Before I started reading the posts here I didn't even know a monofocal lens to a monovision. I don't think I would have been able to make the right "one-time" decision about what lens and refraction to aim for if I didn't come across this site.
rick18299 Dave13852
Posted
FWIW, I had the peel done and my distortion didn't improve, but has not gotten worse either. I'd keep a close eye (as they say) on the distortion and, if you see it getting worse, revisit the idea of surgery. The main side effect I got from the peel and vitrectomy was a worsening cataract, which you're already dealing with.
Dave13852 rick18299
Posted
Rick,
Maybe I better get one of the surgeries sooner than later. I mistook the 1 for an i in your handle. My ophthalmologist told me that if I got the peel first my cataract in that eye would blow up in a month (get very bad quickly). He didn't explain the reasoning but I was glad because I'm hesitant about getting any surgeries and I'm trying to hold off on the cataracts for as long as I can. I don't feel like I see any cloudiness yet but the pucker eye is definitely blurry and I see crooked lines on that grid I forgot what it's called. But I can still see fairly well when using both of my eyes instead of one eye covered in the doctor's office. I do feel that my night vision could be better but I never had great night vision even when I was younger.
RonAKA rick18299
Edited
My wife has a lazy eye from childhood. She has very limited vision in the eye and cataract surgery did not improve that vision. We decided that the safest way to go was to get a distance set IOL in the good eye, and not take a chance on anything risky with the one good eye. It has worked out quite well for her, and she uses OTC readers for any close work. She finally did get some progressives, but still mainly uses the readers.
rick18299 RonAKA
Posted
Thanks for the input on this...
Does your wife need glasses for intermediate distance (e.g. watching TV) or just close work?
RonAKA rick18299
Edited
My wife has had no vision in one eye, and excellent vision without glasses in the other eye without glasses for her life, up until age induced presbyopia set in. So, setting the IOL for distance is very normal for her. She does most things without glasses like cooking, driving, and watching TV. She also does calligraphy and does resort to using readers for that. She increases the font size on her tablet so she can avoid needing readers.... Glasses are not her thing, and she uses them as a last resort.