advice on eyeglasses after cataract surgery/IOL implants

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fchsia1@gmail.com - 17 May 2007 00:45 GMT

I had cataract surgery in both eyes over a month ago, and with the new
IOLs, have gone from O.D.-12.75 and O.S.-14.00 sph / 0.50 cyl / 068
axis to O.D.-3.00 sph / -0.75 cyl / 170 axis and O.S. -0.50 sph /
-1.25 cyl / 010 axis. Needless to say this is a miraculous change,
but not without complications. I can now see the alarm clock, even
read both print and computer pretty well (right eye must be
dominating), but I do need glasses for distance (reading headlines on
the TV, road signs). The only suggestions my optometrist has made are
for polycarb lens.

Having looked at the many informative exchanges on this group, I now
wonder if I should be considering other issues, such as abbe values of
lens materials, aspheric vs. spheric, etc. From previous discussions,
I gather that anything higher than 1.60 index is probably not going to
benefit my current Rx (I have had my fill with high-index lenses,
colored halos, and peripheral distortion); also that a good anti-
reflective coating and no polished edges are vital. I've picked
Flexon 717 frames with a 47 eye size, so light, small, and also
sitting close to the eyes. The optician is primarily hooked up with
Essilor and was very unsure about being able to get Trilex, but
thought that they could probably get Spectralite, possibly Sola and
Hoya 1.60s, I didn't ask about others.

Lastly I should add that I do experience noticeable glare and haloes
with the IOLs, and that I already know that I will have to have follow-
up surgery in a few months to zap the posterior capsular haze already
developing in both eyes (vision has certainly begun to deteriorate
post surgery). Hopefully the second set of surgeries will improve
matters again, but I'll certainly still need glasses afterwards for
distance.

Being able to read, write, and work on the computer without strain is
my most important consideration. I understand that many factors are
at issue in "without strain" - thickness, distortion, weight, shifting
from near to far viewing distances (should I be thinking about
progressives?) - but I would be most grateful for any and all
suggestions/comments.

Florence

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Robert Martellaro - 21 May 2007 17:56 GMT

>I had cataract surgery in both eyes over a month ago, and with the new
>IOLs, have gone from O.D.-12.75 and O.S.-14.00 sph / 0.50 cyl / 068
[quoted text clipped - 5 lines]
>the TV, road signs). The only suggestions my optometrist has made are
>for polycarb lens.

Well, that wasn't very helpful. See an experienced optician.

>Having looked at the many informative exchanges on this group, I now
>wonder if I should be considering other issues, such as abbe values of
>lens materials, aspheric vs. spheric, etc. From previous discussions,
>I gather that anything higher than 1.60 index is probably not going to
>benefit my current Rx (I have had my fill with high-index lenses,
>colored halos, and peripheral distortion);

That won't be an issue with the decrease in lens power.

>also that a good anti-
>reflective coating and no polished edges are vital. I've picked
>Flexon 717 frames with a 47 eye size, so light, small, and also
>sitting close to the eyes.

As close as possible. It's the major factor in decreasing the minification
disparity due to the difference in lens powers. The optician might want to trial
frame the Rx to get a rough idea how it feels with an Rx/lenses that introduce
about 2.5% difference in image size.

> The optician is primarily hooked up with
>Essilor and was very unsure about being able to get Trilex, but
>thought that they could probably get Spectralite, possibly Sola and
>Hoya 1.60s, I didn't ask about others.

Trivex is the lightest but is thicker than higher index lenses, although in some
frames the top, bottom, and nasal edge of the lens needs to be a minimum
thickness, especially with rimless. You might end up paying a lot more for high
index only to have the lab grind the lens thicker, resulting in a lens that's as
thick as less expensive low index materials!

>Lastly I should add that I do experience noticeable glare and haloes
>with the IOLs, and that I already know that I will have to have follow-
[quoted text clipped - 10 lines]
>progressives?) - but I would be most grateful for any and all
>suggestions/comments.

One possible solution is multifocals for general use, and a separate pair of
multifocals for the computer. Start with the general purpose pair and evaluate
the near vision comfort. There are a multitude of variations, some to eliminate
vertical prism imbalance (if necessary), others that will more appropriately
address your lifestyle and personal preferences. Again, a really good optician
will help you sort this out and make recommendations based on your needs.

>Florence

Hope this helps,

Robert Martellaro
~~~~~~~~~~~~~~~~~~
Optician/Owner
Roberts Optical
Wauwatosa Wi.
~~~~~~~~~~~~~~~~~~
"Science is a way of trying not to fool yourself."
- Richard Feynman

Reply to this Message

Florence H - 24 May 2007 17:02 GMT

Thanks so much for your input. While waiting for my (single-vision
distance) glasses I'm starting to think that your suggestion for
multifocals may be right. For about a week now I've been trying to
read + do computer work as I would normally - the first time I've
tried doing so since my surgeries - and am getting pretty consistent
eyestrain and headaches. The optometrist thought that it was due to
the strain of trying to focus at distance without correction, but
perhaps it's because I also really need correction for near vision as
well (I guess this is what an earlier poster meant about an "add").
When I asked whether I needed near vision correction they said, well,
can you read? and after I said, well, sort of, they seemed satisfied.
I just called the clinic today to report on the eyestrain and was told
to wait for the glasses and to see how those worked out.

>From a patient's/consumer's perspective, it's hard to strike a balance

between giving the professional enough feedback about one's vision and
just being a difficult patient.

Many thanks again.

> One possible solution is multifocals for general use, and a separate pair of
> multifocals for the computer. Start with the general purpose pair and evaluate
[quoted text clipped - 15 lines]
> "Science is a way of trying not to fool yourself."
> - Richard Feynman

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