Thursday, May 19, 2011

Near Vision Monofocal Lens Implant

Question: I recently had left eye cataract surgery with a near vision monofocal lens and LRI for my astigmatism. The surgery was uneventful and at my 2nd post-op visit today my surgeon said that everything looked just great. I discussed with my surgeon my having some regrets having the near lens rather than the distance lens. When he asked which lens I wanted, I said I really didn't know and asked him what most others do when they are nearsighted. He said they usually choose the near vision lens, so I went with that.
I now know that the plan to use the near vision lens was made with me not totally understanding the differences. I am now not able to watch television (8 ft) or just to be able to walk around in the house without my glasses, which I was able to do before the surgery. I can no longer watch the beautiful birds on the bird feeders on my deck with out blurriness without my glasses. He said that he could extract the near lens and replace it with a distance lens and then do the other eye with a distance lens but it was up to me. My near vision without glasses in the surgery eye is clear and best at around 14", but this is much closer than I was used to reading at before my cataracts developed, so it is a bit uncomfortable, but I assume I would get used to that.

Even after talking with my cataract surgeon, I am still in a frenzy over this, trying to determine if I should stay with the near for both eyes or extract the current near lens and have both distance lenses. If I do the extraction and go with distance, at what range does the distance start and what kind of vision would I have in between? Will I need to wear my glasses for watching TV if I go distance? Do most nearsighted patients go with close vision lenses? Are nearsighted patients who go with distance correction happier. It is such a hard scary choice for me to make!!...and I know I have to decide in a week.It is not the end of the world if I do have to wear glasses pretty much full time, but not having to would be nicer, of course. Monofocals are the only choice I can make. I cannot afford multifocal's. Any info you can give me that would help me make the decision, would be appreciated.

Answer: The decision to correct your vision after Cataract Surgery primarily for distance or primarily for near is entirely an individual decision and not dependent on what other people do. It depends only on how you spend your day and whether the bulk of the activities you participate in require better vision for near or for far. The fact that you have not chosen a presbyopia correcting near vision lens implants and chosen a monofocal lens implant means that you will have to wear eyeglasses for one or more distances in order to see clearly. Since you were nearsighted before the surgery and thus had to wear glasses at lease to see at a distance, the choice of providing you with a near vision correction in the lens implant was not inappropriate. But, based on your comments it sounds like perhaps you have achieved too much near focusing ability with the lens implant. The best solution is to carefully measure and list the distances that you wish to see clearly at and provide them to your Cataract Surgeon. By giving him or her a list of distances at which you desire to see clearly, he or she will be able to approximate the lens implant power to be used in order to set clear vision for you for most distances. However, vision correction with a monofocal lens after cataract Surgery necessitates that you will need eyeglasses for one or more distances-you just need to choose which one or ones and tell your Cataract Surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

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