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Medical Forum / General / Vision / January 2009

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cataract surgery question

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kemcc - 10 Jan 2009 03:39 GMT
question: do you think implanting a mono-focal IOL set for distance is
a good or bad idea for the non-dominant eye?  My dominant eye is
already set for reading (set at -1.5), and I'm now ready to have the
other eye done.  I;m trying to decide what focal length to get.  The
eye is currently at
-7, and I've been wearing a contact lens in that eye for the last 5
years.
Dr Judy - 10 Jan 2009 21:59 GMT
> question: do you think implanting a mono-focal IOL set for distance is
> a good or bad idea for the non-dominant eye?  My dominant eye is
[quoted text clipped - 3 lines]
> -7, and I've been wearing a contact lens in that eye for the last 5
> years.

This is really a question of individual preference and tolerance,
there is no unversal best answer.  If your current contact lens for
the eye is set for distance and you are not having any problems, then
it would seem to make sense to have the post surgical refraction set
for distance.

If using a soft lens, you could ask your contact lens fitter for trial
lenses that deliver the various focal lengths you are considering, try
them out and see which you like better.  Then inform your surgeon of
which lens power you liked.

Dr Judy
Jane - 11 Jan 2009 22:54 GMT
> question: do you think implanting a mono-focal IOL set for distance is
> a good or bad idea for the non-dominant eye?  My dominant eye is
[quoted text clipped - 3 lines]
> -7, and I've been wearing a contact lens in that eye for the last 5
> years.

Keep in mind that calculating IOL power predictions is not an exact
science, so your actual post-surgery vision may be a little different
from your target.  If you have never done monovision, your best bet
might be "blended vision" (i.e, distance vision in dominant eye,
intermediate vision in nondominant eye).  If all goes as planned, you
would only need glasses for prolonged reading or seeing small print.
(I believe that the usual target for intermediate vision is about
-1.25.)  It you go for distance vision in your second eye, you will
need glasses for using the computer and all near vision tasks.  (I
have distance vision in both eyes, and everything within arm's length
is blurry without glasses.)  If you are used to myopia, you'll find
that certain grooming tasks such as shaving (men) and applying makeup
(women) become difficult without a magnifying mirror.

The idea of trying out a contact lens correcting your eye to -1.25
makes sense to me.  You might also check out the eye care community at
med help international, where there are many discussions on this topic
(including recommendations from cataract surgeons).  It's a great
resource.
Jane - 12 Jan 2009 02:07 GMT
> > question: do you think implanting a mono-focal IOL set for distance is
> > a good or bad idea for the non-dominant eye?  My dominant eye is
[quoted text clipped - 23 lines]
> (including recommendations from cataract surgeons).  It's a great
> resource.

Oops--I see that your dominant eye is already set for intermediate
vision (-1.5).  Then I'd suggest distance vision in your second eye
(plano or -.25), unless you want a near/intermediate blend (-2.50 in
second eye).

(BTW, -1.50 would give you good vision for the computer, but not for
prolonged reading or looking up a number in phone book.  Are you sure
about the diopter for your vision in your dominant eye?)
kemcc - 12 Jan 2009 17:19 GMT
thanks for your replies.  Yes, my dominant eye is currently at -1.50
which was the expected result. I can work at the computer without
glasses.  I'm a bit
unsure as to whether I should make my non-dominant eye set at
distance, since I haven't really been able to test that out with
contacts, due to the second eye
having a cataract. I'm  leaning towards trying to match the eyes, so
the non-dominant will be the reading eye, and wearing a contact in the
dominant eye when I want to bring it up to distance. of course, I can
always wear glasses again. If I had it to do over, I would make the
dominant eye set at distance, but the doc never talked to me about it,
and I only did the research afterwards (my mistake).
 
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