Yo yo land. Final thread about choosing surgeon (promise)

I think you and your wife have done the best research possible

Have we? Feels like we are chasing our tails 😃

and sharing it in this group has been (and still will be) helpful to many others.

Thanks. Yes if they can go through tons of garbage that I have typed 😃

Well - now that I ended up with one of each type of lens to be able to compare, why don´t your wife have one eye done at each surgeon? 😃

You think we did not think about that already too? 😃 Although don't forget that you still have to get both your IOLs replaced for Mini-Monovision to give us the full true comparison 😃

I think the difference between -1 and -1.6 could make all the difference between something you can live with and something you enjoy,

So you prefer something like -.2 and -1.6 (depending on selected IOL /biometry)

Dr Rockstar might do that too if I ask him. Plus he is open to using Zeiss CT Lucia.

Yes, I you are right, I will get monosion next month then 😃

Personally I would be worried that -1 might not gave me enough midrange in the near eye, -1.6 is clearly better.

I think many surgeons tend to think that near vision does not matter, and they don´t see glasses as a problem. But personally I would hate having to bring reading glasses with me all the time.

So I think that -1.6 or -1.5 is better than -1.

Even that the difference does not sound like much, it can be the difference that make or break if your arms are long enough to see stuff without glasses.

Why are your surgeons doing the opposite of each other on targets? Is one assuming RE dominant and the other assuming LE dominant?

One is assuming that wife could be RE dominant based on her being right handed.

The other says we can't truly know which eye is dominant anymore and thinks if she had good vision in both eyes before cataract then it should not be an issue and brain will adapt.

No matter how much research you do on her behalf, it is her vision, her life.:)

Agreed, which is why I am typing her thoughts and questions and not purely mine. She reads all the posts here. Ultimately she will choose.

keep in mind that -1.5 may not give enough near.

keep in mind that -1.5 may not give enough near.

What other option do we have?

I think you might have suggested something like -.62 combined with -2.00 or -1,65

That would mean no far vision? Also needing 2 set of glasses? Or you think -2.00 would definitely secure near vision?

That Dr Hagan on other forum suggests plano and -1.5! He says he would never operate with a surgeon who even offers to do both eyes at the same time (Dr Zeiss).

Dr Zeiss I think said, he is doing some clinical study to demonstrate that operating 2 eyes at same time does not lead to worse results than operating separately. Either way we won't be doing both at the same time.

near is very tricky and the span it covers is very limited. for example +2 glasses only give me 10 inches to 14 inches. (only 4 inches of good close up vision). at -1.5 you risk not having good near or good far and be a bit disappointed. u may need glasses for both near and far. can you reconsider LISA?

is -1.50 the same as -1.5?

If it is, that is my left eye iol. i can see , but not crystal clear my ipad print (11-12 font ) That is with my right eye closed ( un corrected eye) i can see intermediate distance.

I had to understand, which was very difficult that monofocal lens is a comprise. I couldn't get multifocal iol due to a cornea problem.

near is very tricky and the span it covers is very limited. for example +2 glasses only give me 10 inches to 14 inches. (only 4 inches of good close up vision). at -1.5 you risk not having good near or good far

Ok but far and intermediate can be secured, no? So close to plano in left dense cataract eye like Rockstar recommended and then say -1.50 or -1.25 in the right eye. Exact numbers obviously depending on lens/biometry.

Dr Zeiss approach of doing -1.6 on the left eye instead of plano seems more risky. Say it ends up being -2.10 in the left eye? Then what the hell do you do in the right? Can't do more that 1.5 diopter difference anyway. Probably would have to aim for 1.0 or 1.25 diopter differences to take possibility of error into account.

can you reconsider LISA?

If it was my eye, I might. Although I panic when it comes to eyes so not sure in reality what I would do. Wife is the one who is normally calm and she is 100% against Trifocals, she feels the risks are too high!

Also not knowing which eye is dominant is also a mind twister.

True, with monofocals you don´t have any other options, you don´t want to go too short with the lens set for far, then you far vision would suffer.

And even -2.0 will not secure near vision so you are guaranteed glasses free, you can not "secure" near vision with monofocals, if you also want to cover far and intermediate.

You only have two eyes and there are three distances to cover(far, intermediate and near), but you can get great far/intermediate and "enough" near so you can do driving, shopping, sports and socializing without glasses, which is what most people aim for with monofocals, and then use reading glasses for close up work.

Some few have a rare good outcome, and are practically glasses free with monofocals, but most need glasses for near.

Bifocals often have 3.25 for near, earlier 4.0 was common, later years a 2.75 have made it into the scene, because people don´t have enough intermediate with the higher adds.

Trifocals have powers in the range 3.2-3.5 for near depending on manufacturer.

So even 1.5 is far from what is considered near vision, and 1.0 is even further away, both powers are in focus at intermediate distance.

But all that said, I know a guy with monofocals, that are almost glasses free, he only use glasses for extended reading or seeing really small stuff, so monofocals can give goods results, and often have much less side effects. There is no right or wrong, it is a matter of opinion.

yes -1.5 is same as -1.50.

if i went with monofocals i would shoot for -0.5 and -1.25. i would only have -0.75D difference between the two eye. i would plan on wearing glasses as i like crystal vision from both eyes and being glasses free is probably not an option for me with what i expect from my vision.

You only have two eyes and there are three distances to cover(far, intermediate and near),

Can the cosmic third eye be brought into play? 😃

I find having far and intermediate in the bag most appealing.

if i went with monofocals i would shoot for -0.5 and -1.25. i would only have -0.75D

So you then carry two different glasses? One for near and one for far? Correct?

Let me weigh in on this - soks's suggestion of -0.50 and -1.25 is what I would choose for myself if opting for monofocals. if targets achieved it would cover far and intermediate distance vision.

i thought i already replied to this but yes i would carry 2 glasses or get used to bifocals or progressives. indoors i would not need glasses except for reading.

also i would do the -0.5 eye first to see if i am one of the rare lucky ones who gets all distances with a monofocal.

Off course third eye can be used, but then you need to close the two other eyes 😃

I believe most surgeons in Denmark aim for a difference about 1.5, because this is the sweet spot were you don´t feel any gap between the two focal points in real life, and you cover the biggest combined range with the two lenses.

Closer focal points with more overlap could be seen as waisted range, the same way as if you shoot over the target with the lens set for far.

But off course, the bigger the difference, the fewer people can adapt well, and the bigger the risk for some of the visual side effects.

One surgeon in Denmark explains, that he will let the patient try out monovision with contacts for a while before surgery, most will adapt well to 1.5/1.75 he says, and most people will be glasses free for many tasks with monofocals this way, with use of readers from time to time.

If a person can not adapt to monovision, he normally offers Symfony with micromonovision, because everyone can adapt to that he says, and it gives somewhat same result, and people get glasses free for many daily tasks.

He only offers trifocals to people that have a lot of cataracts, because then the person does not feel the contrast loss he says, he does not do clear lens exchange with trifocals, as many other surgeons do.

By the way, this guy also say, you can live life as normal day after surgery, actually he says it is a good idea to exercise and keep in shape, it speeds up healing he says.

So many different opinions 😃

Me too has that foes happen

Let me weigh in on this - soks's suggestion of -0.50 and -1.25 is what I would choose for myself if opting for monofocals. if targets achieved it would cover far and intermediate distance vision.

So if you hit -.50 in the far eye. Is that good for far vision? If yes then why would you carry 2 glasses? Is it because it is good for far for normal life but not good enough for driving? We don't drive anyway.

also i would do the -0.5 eye first to see if i am one of the rare lucky ones who gets all distances with a monofocal.

This is the problem! Left eye has worst and very dense cataract. Chances are that right eye is dominant (educated guess by us and Dr Zeiss).

So going by your suggestion that would mean operating the right semi-good eye first for far and then still being stuck with the bad left eye and no intermediate or near vision until the next operation.

This is one of the reasons why Dr Zeiss wanted to operate both eyes at the same time. His assistant said that he suggested that because he thinks my wife is a good candidate for it.

Dr Rockstar on the other hand does not care about dominant eye in my wife's case and wants to operate left bad eye first and set it for far.

About dominant eye - I have never been able to use right eye before to anything other than orientating, I have mostly seen with left eye all my life, so left eye is off course dominant.

It is less than two weeks since i got the trifocal in my "bad" right eye, and when I do the dominant-eye test now, right eye is dominant at 5m distance.

So an eye with really bad vision for 45 years, have become dominant in 10 days.

Based on this, I think I agree with Dr. Rockstar, I don´t think it matters that much.

If the far eye hits -0.5 you would (in theory) have about 20/32 vision, if you natural vision on that eye was 20/20.

I think it would feel like quite a step down, if you have been used to normal far vision on both eyes.

You can have drivers license in Europe with 20/40 vision, this is what I had on a good day with cataracts both eyes.

Updated pros and cons of both surgeons after one meeting and one email exchange with both surgeons-

Dr ROCKSTAR

Negative points of Dr. Rockstar-

1- Suggesting 0.00 . As it could potentially end up at +.50

2- Setting left eye for far (potentially not dominant eye) but I can see his logic as that is the eye with bad cataract and it needs operating first.

Positive of Dr. Rockstar-

1- Let us talk, good eye contact with both of us and answered all our questions one by one without interrupting us.

2- Willing to use different lenses and adjust his settings to our desire (within reason)

3- Recommended by our eye doc, although she suggested Dr headstand too.

Dr ZEISS

Negative points of Dr. Zeiss-

1- Wanting to operate both eyes at the same time.

2- Not letting us talk because he was talking non stop like a possessed scientist.

3- Looks like uses Zeiss Asphina lens only for monofocal. Email asking about Zeiss Lucia part went unanswered. Will bring it up again.

4- Does not care about PCO delaying lenses as on a young patient it will come anyway (I care as the more we delay it, the better)

Positive points of Dr. Zeiss-

1- Seems down to earth and passionate.

2- Spoke with 3 people directly who got operated by him and all are very happy (1 for cataract,both eyes at the same time. Two for other patients for major eye operations. One of them was from USA and had visited various surgeons in USA who could not help him. His eye doc told him to see Dr Zeiss and also said that if Dr Zeiss can't help him then probably no one can!

I think Dr Zeiss could set left bad eye for far too if we ask him. He was not too bothered about which eye to set for far. We are meeting him for second time next week. Hopefully things will be clearer before we make our next move, either 100% towards him or away from him.

u will not be able to try your luck then!

i would carry 2 glasses because my distance glasses will be correcting -1.25 in the other eye and the -0.5 plus astigmatism in this eye.

my near glasses would be providing different powers for reading in both eyes. like i said earlier i would like for both eyes to be giving me good vision for the task at hand. that is how it has been all life and that is how i want it to continue.

i have realized that pursuit of spectacle independence is not worth compromising binocular vision. without glasses i would have good functional vision.

i may also consider -0.75 in both eyes and again use glasses for both.

good luck!

"So if you hit -.50 in the far eye. Is that good for far vision? If yes then why would you carry 2 glasses? Is it because it is good for far for normal life but not good enough for driving? We don't drive anyway."

u will not be able to try your luck then!

Well could always ask Dr Zeiss to set left bad eye for far like Dr Rockstar. Meeting Dr Zeiss again, next week.

u r in similar position as me. my non dominant eye was the first to go and i went plano with it to try my luck. 😃

"Me too has that foes happen" - u mean u lost your post?

Btw did you decide what to do for your second eye? 😃

i am confused but here is my immediate course of action. getting prescription for second eye adjusted on Monday. that will eliminate the start of triple vision and ghosting. don't know for how long it will work. seeing lens exchange expert next month to see monofocal will help or aging it out will help.

i also need to decide on YAG. currently only lights are impacted a bit. would prefer to wait 6 more years till YAG. i will be 50 then.

options for second eye: another symfony, wait for pan optix to be approved in US, wait for Technis Eyehance, avoid dysphotopsia with Bausch and Lomb softport, get good near with LISA, go 7mm with ASPHIRA. want to make decision for me too?

btw i saw on my report that it says artificial pupil diameter is 7mm. if this is same as your wife she should be OK.

Jeez lot going on for you!

I am not sure you can hold out YAG for 6 years though.

Lens exchange after 10+ months? Choose the replacement lens wisely.

Soks, that´s easy, Lisa will blow you away 😃

options for second eye: another symfony, wait for pan optix to be approved in US, wait for Technis Eyehance

MEDIA RELEASE – TUESDAY, AUGUST 27, 2019

Alcon Introduces AcrySof IQ PanOptix Trifocal IOL in the U.S., the First and Only FDA-Approved Trifocal Lens

at this time the PCO has impacted the lights and somewhat near vision. visual acuity will make it problematic.

i believe safran has exchanged someone who has had an iol 10/12 years back. not a preference but waiting right now.

danish

your experience has been interesting between LISA/LARA. i was regretting not going lara route. it offered more range than symfony but was more susceptible to PCO and I would have to travel out of country. well PCO is a moot point anyway. i can practically see the PCO and the cataract in the other eye if i squint the right way.

both you and janus mention having to get used to the near and intermediate of the respective trifocals so i am trying to understand what that is. janus more so than you. i am trying to figure what near range is trifocal really giving.

wow. thanks for sharing coppp. i saw a surgeon 4 weeks ago and he said it would be available by end of this year. we had that conversation because he asked if i was happy with my near vision with symfony. when i said no, he said most people get symfony and then multifocal if they are not happy with reading. i said in that case i will wait for trifocal. and zeiss is not going to make it here any time soon. he is a local surgeon and pretty much said that nothing can be done for dysphotopsia except miotic drops. he also said forget lens exchange if you get YAG.

Near vision with Lisa is great, off course it would be even better with two eyes with Lisa.

If I put on +1.5 readers on Lara, Lisa without glasses is still slightly better near than Lara eye.

If I put on +2,5 readers on Lara, Lara eye is slightly better than Lisa eye near without glasses.

I don´t have a set of +2.0 readers, but I guess +2.0 on Lara eye would make similar near as Lisa without glasses.

Lara and Symfony are very similar, I think you can use this as inspiration for comparison.

But I can also put on +2,5 readers on Lisa eye, the I move distance vision into near vision, it makes it slightly better, so here you can see that a little more light is allocated to the distance vision.

But that means, that I can use +2,5 readers on both eyes, if I have to see really small stuff, or lighting is really bad.

About lighting and contrast, I think the trifocal is better than it sounds, many places they are talking about contrast loss and it sounds terrible, but actually contrast feels slightly better on the trifocal than Lara.

When Panoptix hits the US marked, all other multifocals becomes useless antiques, I would surely wait, if I was looking for multifocals right now.

Symfony will still be useful for some, but bifocals will be gone, the Panoptix is just that much better.

+2.5 glasses make my head hurt. am i at that risk with a trifocal?

a test for contrast is the stars. do the stars look brighter with the lisa?

edof's claim to fame was no halos. it's interesting that lisa would have lesser halos than lara.

No, I am sure you will not get a headache from the trifocal, I have never heard of that, you brain will adapt.

In my case, I had great vision with the trifocal day after surgery, it does not feel the same way as wearing glasses, it feels likes continuous vision from near to far.

And yes, I was surprised with the halo part as well, I don´t feel that edof really lives up to their promises, but the trifocal exceeded my expectations.

Combined the two lenses I have gives good vision, but I would choose trifocal over edof any day.

I think different manufactorers iols have different colors, so it might be a little strange to combine the Panoptix with Symfony, but I guess you could get used to it.

i think edof and trifocal combination may be the best combination for premium lenses at this time. the edof would fill-in for the gaps in intermediate if any and there would be the advantage of binocular summation for all distances albeit a little lesser on the near range.

zeiss is the only manufacturer with both edof and trifocal. technis does not have a trifocal while alcon does not have an edof so zeiss would be the only option for same color.

Yes, I agree.

I don´t really feel any soft spots with the trifocal, I don´t have the feeling of different zones, it feels continuous.

The Panoptix have slightly different power adds, with 2.2 and 3.2 for midrange and near, so near could be slightly stronger than Lisa, and combined with the Symfony to fill in midrange, I think you would have a really good combo.

Another thing about the mix - because they don´t make the same type of visual side effects, they somewhat equals out each other, it feels like the brain choose the best it can get.

yes it would be good enough to drive at 0.50. Even between natural eyes people have variances. My husband's far vision always been better than mine. Great if with natural eye to see better than 20/20 but then there is no sacrifice to near vision. IOLs have a range so it would not give anyone any benefit to see 20/15 and sacrifice intermediate.

Hi Soks,

I haven't checked this forum in a day, and was reading WH's interesting updates, and saw your question for me regarding adjustment of near and intermediate vision with PanOptix.

I suspect it will be a different for everyone. I knew before surgery that it can take one week to 3 months to adjust but didn't really know what that meant.For me, the day after surgery, my distance vision was outstanding. But my computer distance and reading distance vision was very fuzzy; this is not something I was used to as I have been near-sighted, so it was a strange having great distance vision, and not being able to see near. But in day after exam, doctor said my pupils were still dilated, and it was pretty common for distance vision to improve first. (Perhaps other people will have near or intermediate improve first).

In the week between my first eye and second eye, the near vision was still fuzzy, so I got a pair of +1.00 readers on the day after my second eye was done.

Intermediate vision got better first, and then near vision got was the last to improve. After a couple of more weeks, I could read documents and newspapers, but in poor light, I needed readers to read newspapers. Somewhere before one month, I could read newspapers on the subway.

Not sure if you noticed an interesting presentation i found, but search for:

"panoptix presyboia correcting iol thad demong" for a presentation on the PanOptix from Nov 2017 given by a doctor in Canada (materials prepared by Alcon). In particular, it has "bench bad images" -- ie illustrative eye chart images at different distances (for PanOptix, ATLisa, and FineVision).Trifocals do a pretty good job at giving you good vision at all ranges, but as you can see in the sample images, there will be a range beyond the normal computer monitor range where the vision is not quite as clear with a Tri-focal.That is consistent with an article I found where a European surgeon says the only patients he would not recommend a tri-focal to are orchestra conductors who must see well in low-light at a distance of 120 cm.

But I'm not an orchestra conductor, and in my every day life, I do not notice any gaps in vision.

Thanks for sharing. Vision getting better with time scares me because the best vision I had 8 hours after the surgery and for five days after. If at all anything the vision has gotten worse since then.

what lens do you have in the other eye?

I have PanOptix lens in both eyes. Binocular summation is an added benefit with same lens.

I think the adjustment period with PanOptix and other tri-focals is that lens is essentially using as much available light as possible but is sending a signal to the brain with one focused image and two slightly out-of-focus images.The brain adapts to combine these into one image and that can take time. So really the time thing is all about neuro adaptation.

I would also note that in the bench Badal images from that "panoptix presyboia correcting iol thad demong" presentation I found, they do note in the footnotes that the sample images are mono-ocular images that do not take into account binocular summation that improves overall vision at all distance. So the actual result is quite a bit better than what is implied by the sample images.

Although -.50 might not give 20/20 I would be concerned about being left over corrected. Max I would target is -.25 to allow for movement when settling.

I too was LE dominant when cataracts were bad but RE cataract was worse than LE. Now after surgeries I am RE dominant.

Yes, I understand, but at the same time I would be worried to have both insufficient far and near at the same time, kind of like leaving 1 pin standing alone both sides when bowling, then what do you do 😃

Anyway, we both went for premium lenses, so we might not be the best help for someone getting monofocals 😃

Funny with the dominant switch eye thing, I guess the concern about this is a bit overrated.

Yes really hard to imagine what I would choose if I'd gone for monofocals. My early posts prior to surgery I remember thinking it's like the game would you rather where neither option was ideal. In the end that pushed me towards Symfony as that was the best option in premium lenses at the time. Think it still is here in NB.

with monofocal i would still go -0.5 and -1.0. objective being glasses free functional vision indoors. i would wear glasses to sharpen vision outdoors while driving and reading and to address astigmatism.

with monofocal i would still go -0.5 and -1.0. objective being glasses free functional vision indoors. i would wear glasses to sharpen vision outdoors while driving

Would -0.5 give enough far vision to allow you to do non driving tasks? Like walking around town?

Is the A-Constant difference between the two relevant?

Zeiss CT Lucia: C-Shaped Haptic

Incision Size 2.2 – 2.6 mm (depending on diopter)

Company Labeled A-Constant 119.9

Zeiss CT Asphina: Plate Haptic

Incision Size 1.8 mm

Company Labeled A-Constant 118.3

I am just like you soks in that I like crystal clear vision and will wear glasses to get it. As soon as my near vision went in my late 40s, I went with progressive lenses.

Zeiss aT Lisa

Incision Size 1.8 mm

Company Labeled A-Constant 117.8

"Would -0.5 give enough far vision to allow you to do non driving tasks? Like walking around town?"

i am plano 20/15 in the symfony eye. the surgery induced -0.5 astigmatism in that eye and i wear glasses for it if i want to walk around town / drive. it just sharpens things up to my liking. keep in mind that those astigmatism glasses will make near vision a little worse. for example when i wear those glasses the sidewalk becomes a little blurrier.

i am a proponent of -0.5 because when i was 12 in 1987 i did not wear glasses and did not experience any visual issues. then we traveled for my mother's eye surgery. since we had a lot of time on our hands waiting for her surgery my dad got our eyes checked on the autorefractor which was a big deal then. it said i needed -0.5 for left and -0.75 for right. i remember the optometrist telling me welcome to our world. it was only because of that test that i started wearing the glasses not because of visual issues. it was the same for my sister and she didn't bother with the glasses and has no glasses even today at 47.

Regarding eye dominance - I tend to think it is overrated. I am left eye dominant (right handed). My RE was first to have cataract surgery and my RE would gain dominance when I wasn't wearing my glasses for my LE.

i could never get used to progressives. i wish they allowed me to design the progressive glasses. i would start the reading power a little lower than where they have it by default.

my near vision went the year following my 40th birthday and i started removing my glasses to read.

Have you seen the diopter to distance conversion charts? How far away is your wife usually from her computer, phone, etc? -1.5 Diopters is equivalent to 26.2 inches (.67 meters). -1 Diopter is equivalent to 39.4 inches (1 meter).

So I now have 2 pairs of glasses - office lenses which are great from about 6 feet in. That's what I wear around the house. I also have full progressives where the center point is lower than the center of my pupil. These work best when I am out and about. I can still read, but the bulk of the lens sees into the distance. Perhaps you could try that.

I am doing an IOL exchange for positive dysphotopsia.

Deb in the other thread you wrote the above. My question is how will lens exchange help if the size of the new lens will probably be 6mm like the old one?

did u ask for that arrangement with the progressive lenses?

I am 57 and don't believe the problem is my pupils dilating beyond the edge of the IOL. It could be the combination of the acrylic and high refractive index. It could also PCO, although I only have trace PCO in one eye. Most doctors will say don't have a YAG laser if there is a chance you will need a lens exchange. Your wife is much younger so her pupils will probably dilate more.

Yes I have asked for that since I began wearing progressives. I think they typically mark it a the bottom of my pupil. If it doesn't end up right, I can do a one time lens replacement at no charge.

Hi Deb at 57 your pupils likely still dilate same as if you were in your 30s and 40s. Night Hawk shared a chart and pupils only start to dilate less in your 60s. Here's a graph I found.

I also came across the following info regarding medications (prescription and non prescription) that cause pupils to dilate

The following prescription and non-prescription medicines can cause your pupils to dilate and affect their ability to react to light:

Antihistamines

Decongestants

Tricyclic antidepressants

Motion sickness medicines

Anti-nausea medicines

Anti-seizure drugs

Medications for Parkinson's disease

Botox and other medications containing botulinum toxin

Atropine (used for myopia control and other medical purposes)

Deb - that's great to know. I never knew.

"Yes I have asked for that since I began wearing progressives. I think they typically mark it a the bottom of my pupil. If it doesn't end up right, I can do a one time lens replacement at no charge."

i think the PCO makes the eye dilate more than normal to allow for more light. is that the reason i had no dysphotopsia for 5 days??? i think by 3rd week i definitely had PCO because the concentric circle on traffic light and car tail light became a little smudgy. will they become clear circles after YAG?

This is very interesting, because I had no dyphotopsia in my RE from the outset. It didn't start (or I didn't notice) until after I had my second eye done. So I'd guess 6 weeks out maybe. Looking back I think I had it from the start in my left eye and it has gotten progressively worse.

Thank you for the information about dilation SueAn. I looked up my 2 meds I take regularly and one can cause constriction and one can cause dilation. Maybe they cancel each other out!! I don't understand the graph though. It looks like my eyes don't dilate as much at my age. Can you please explain it?

Soks, this agrees with what you experienced when you were a child. I think many of us who have worn glasses since we were young have similar experiences, and it's good to know that we weren't imaging it.

You hear this from low myope all the time,” he said. “They say, ‘I don’t want to wear my glasses because after I wear them, when I take them off I see a lot worse than I do if I never wear them at all.’ We thought that that was just a comparison the patient was making. But in fact it turns out that it’s true. Patients who are –1 D who don’t wear glasses have much better unaided visual acuity than a person who wears glasses all the time because the brain deals with that optical blur. It begins to enhance the quality of the image, and people who are –1 D who should be seeing 20/40 are seeing 20/25. And if they wear glasses all the time they can only see 20/40 because their computer is not enhancing the image because it’s not seeing the blur all the time.

This was an old article: "Understanding of neural adaptation may lead to better vision correction"

Presuming your wife is trying to reduce the need for glasses, I like Zeiss's recommendations best. I don't think -1 is enough to give you usable intermediate vision (especially if only one eye is set to that). Danish's comment about the SMILE procedure makes a lot of sense as it's a simpler procedure/less invasive than LASIK if you end up too near sighted and want surgery to correct it. Regarding posting too much, please keep your questions coming. We are all learning here! I have learned a lot from your posts and the comments.

that's interesting janus, i always though that if i had never got the glasses my minor myopia would have stayed the same. i adopted that strategy with daughter and that came back to bite me. but that is a story for another day!

now that the PCO has progressed and I know it has from the light distortions (its getting darker early) i see complete circles more often than just the arcs. i think the YAG will probably help but i am not taking my chances. i will be buying my tickets tonite. did u fly to PHL or EWR?

EWR since it was a little cheaper; they are about the same distance from his office. There is also a TTN airport very close by, but no direct flights from where I live.

Worried - I saw in another thread where you posted pic of lens powers Zeiss was picking for you. You could also select a power one more farsighted which targets -1.25. I personally wouldn't go with anything more farsighted than that if I were shooting for glasses independence for many tasks. Unfortunately - and maybe more so with monofocals, everything is a trade-off.

Worried - I saw in another thread where you posted pic of lens powers Zeiss was picking for you. You could also select a power one more farsighted which targets -1.25. I personally wouldn't go with anything more farsighted than that if I were shooting for glasses independence for many tasks.

You mean you would pick the orange combination?

have a question by looking at the graph. Will-1.26 give enough distance vision? MY left eye is set at -1.50, and i dont have good distance vision. My right eye is not corrected yet.

"Will-1.26 give enough distance vision?" - no not in that eye. but he will have other eye set for closer.

i guess i am confused with the numbers. it reads -.25 right and -1.26 left. Does that mean the right is set for closer vision than left?

I am trying to it makes sense to me. please explain.

i guess i am confused with the numbers. it reads -.25 right and -1.26 left. Does that mean the right is set for closer vision than left?

Irrespective of eye (as we have not decided which eye to target for far).

-0.25 eye = better for far

0.00/plano = perfect for far

-1.26 eye = better for near, relative to - 0.25 eye.

It is confusing.

0.00 would the optimal far vision you can get.

In theory, for seeing at a distance of 32" you need 1.5 difference from the "far 0.0", this is usually called intermediate vision or midrange.

And for seeing at a distance of 16" you need 3.0, this is usually called near vision.

So the left eye with 1.26 to 1.65 is the eye that provides intermediate vision.

And the right eye with the 0.25 (closest to 0.0), is the eye that provides far vision.

In your case, when your one eye done is set for 1.5 this eye provides intermediate vision, so you can watch television and stuff like that.

And when your second eye is done, this will probably be set close to 0.0 and give you good far vision, so you will have both far and intermediate vision with both eyes.

And when both eyes are done they help each other, which gives you a "bonus" so you will feel an improvement in all ranges, even that the iols are different from each other.

For what you are trying to accomplish, I'd definitely pick one of the two. Is refractive surgery an option for you if the target isn't achieved or if your wife isn't happy with it? If so, as Danish said, it's easier to fix myopia with SMILE and that would make -1.65 a better choice.

The -.25 brings you closer to 20/20 distance vision. 0 would be 20/20.