Cataract surgery: If you've had the eyes done different ways...

[GoodbyeYellow]

Would you recommend that, or same in both eyes?

Me, so far: 63M, right eye done for long distance 2.5 weeks ago, now test at 20/20. Original thinking was to correct left eye the same (coming up next week), but new info revealed this thing called mini-mono correction, where one eye is corrected for distance and the other for mid-range (eg computer), leaving slight myopia in the second eye but sharpness in the mid-field and the brain adjusts for a pretty good (but not perfect) outcome at all ranges. This is what I am considering.

If you've had it done this way, would you recommend it?

 

[Katsmeow]

Yes, I have done this. Mine is a bit more complex.

Note - I had prior LASIK surgery in both eyes so that gave me certain limitations. Also in my left eye I had a macular pucker and have some distorted vision that is not correctible (this is mild - basically what I see with my left eye is slightly wavy and slants down a bit).

Anyway --

Right eye - I had the Vivity Extended Depth of Focus lens prioritizing distance. This lens gives me excellent vision all the way for distance to about 36" away. I can read most things without glasses but it is a strain so do need reading glasses.

Left eye - I had the Light Adjustable Lens. This is a monofocal lens where you can adjust the prescription after surgery (usually up to about 3 times) to fine tune the prescription. This lens was optimized for computer distance.

My combined vision usually tests at 20/20 occasionally 20/25. I do not have to use glasses for anything other than reading. My computer distance is a little bit of strain but this is due to the uncorrectable macular pucker distortion which makes it harder for the 2 eyes to work together. Most people wouldn't have that problem.

I don't have any difficultly adjusting to the 2 eyes being different. I have about a 2 diopter difference in the 2 eyes IIRC. I am happy with my choice.

Some people can't adjust to this. My husband once tried to use monovision contacts and couldn't adjust. I had no problem with this. If you have never had any kind of monovision I recommend these 2 options.

(1) Get a light adjustable lens where you can adjust the prescription after surgery. This will allow you to try it out and fine tune exactly as you want. However, this is a premium lens and will cost extra money that may not be worth it to you.

(2) Try a contact lens in your left eye to simulate monovision. However, whether you can effectively do this will depend on how bad your cataract is in that eye. One of my eyes was much worse than the other and I would not have been able to do that with that eye. But on the other eye it was not as bad and I could have tried this.

Actually there is a third choice. I was told that in a worst case scenario they can take out the new lens and replace it with a different lens within about 3 months after surgery. Of course, this is a big undertaking so not lightly done.

 

[braumeister]

As I posted in another thread, my ophthalmologist only recommended this for people who had already done it successfully with contacts. IOW their brain was already trained to deal with it.
For those, it was a great idea, but for someone coming at it new it was a crapshoot.

 

[donheff]

I tried it with a Vivity lens. It ended up performing good at midrange (PC) and pretty good close for reading books, eBooks, newspapers, etc., but not fine print. It is a little blurry at distance. I went with the standard distance lens on the other eye and I am happy with the overall results. BUT I am happy because the Vivity got the range wrong, so I can read without glasses.

What I should have done was just go with a standard reading lens and a standard distance lens, which DW did. We both used mono contacts for years and liked them. She can read fine print and the PC as well as distances. I would recommend that anyone considering this, first try mono contacts for a couple of weeks. DW and I adjusted to them instantly. Some people do not.

 

[GoodbyeYellow]

Thanks. Some more info on my situation:

I do not (at this point) have the option for different lenses such as adjustable or multifocal. Am with an HMO that I like, and this is what they do; they do offer a choice of distance correction, so what I am considering for my left eye (right is already corrected for distance), is a mid-range, which for distance is a slight compromise in the left (-1.5) but overall the brain should adjust.

I like the idea of the contact lens but it was not offered to me and by the time I found out about it it was too late to ask. But I did get 15-20 minutes with lab specs for that correction and I liked it pretty well. Not perfect of course but this whole thing is built around compromise as far as I can tell. Maybe with lots of money and custom consultation there could be better outcomes. But as noted, I am at this point a day late and a dollar short.

From your responses and general reading on the web I see that for most people this is a good solution. I really don't like the idea of using glasses for everything but distance (eg kitchen work or assorted tool usage), and mini-mono seems to offer a way out from that. For just reading (and perhaps 2% of distance usage) I'd need glasses. I can live with that.