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When Is Intraocular Cataract Lense Best Suited For The Eye?
Question: Hi, I am a 64 year. Last August I had an epiretinal membrane operation on my right eye. As a result, I needed a cataract op on the same eye, which was done mid April this year. I was told that because I was very short-sighted, the long distance alone would be corrected. The model used was PCFB00 Diopter +11.5D
My present prescription for glasses is now+0.50 (sphere) for right eye and – 4.25 for the left with -0.50 cylinder, 105 axis. +2.75 Add for both right and left eyes
I was told at the follow up appointment with the surgeon that because of the imbalance between the two eyes now, I now need a cataract operation on my second eye. This was not told to me before the first operation. (In itself, the cataract in the left is yet needing an operation)
My present long distance vision in the right eye is very good but I cannot read at all with my right eye without glasses unless it is huge print.
I am now wondering what IOL would best suit me for the left eye
I do a lot of reading and computer work both for work and hobby.
I read without glasses before sleeping while lying in bed, and then fall asleep. ( I wake up if I get up to take glasses off).
After the cataract operation, I can no longer read without glasses with my right eye. My concern is that if I have the same IOL put into my left eye, I will not be able to read without glasses at all in bed which would affect my sleeping very badly.
Having not been told about the resulting imbalance and how ‘blind’ I am now with my right eye for any form of reading words without glasses, I am now apprehensive and very concerned that if the left eye cataract op is the only way to go, that I get the most suitable type of IOL for my lifestyle. Please advise as I find my specialist not easy to understand or to discuss with.
My present prescription for glasses is now+0.50 (sphere) for right eye and – 4.25 for the left with -0.50 cylinder, 105 axis. +2.75 Add for both right and left eyes
I was told at the follow up appointment with the surgeon that because of the imbalance between the two eyes now, I now need a cataract operation on my second eye. This was not told to me before the first operation. (In itself, the cataract in the left is yet needing an operation)
My present long distance vision in the right eye is very good but I cannot read at all with my right eye without glasses unless it is huge print.
I am now wondering what IOL would best suit me for the left eye
I do a lot of reading and computer work both for work and hobby.
I read without glasses before sleeping while lying in bed, and then fall asleep. ( I wake up if I get up to take glasses off).
After the cataract operation, I can no longer read without glasses with my right eye. My concern is that if I have the same IOL put into my left eye, I will not be able to read without glasses at all in bed which would affect my sleeping very badly.
Having not been told about the resulting imbalance and how ‘blind’ I am now with my right eye for any form of reading words without glasses, I am now apprehensive and very concerned that if the left eye cataract op is the only way to go, that I get the most suitable type of IOL for my lifestyle. Please advise as I find my specialist not easy to understand or to discuss with.
Brief Answer:
You need to go for monofocal intraocular lens similar to that of right eye
Detailed Answer:
Hello Madam
Welcome to Health care Magic
I am Dr. Dadapeer K, an ophthalmologist and I will be answering your question.
I reviewed your history.
I can understand your concerns.
After cataract surgery the near vision will be affected as the natural lens is replaced with intraocular lens and accommodation which is responsible for near vision is also lost.
Hence after cataract surgery for near vision glasses need to be used.
Coming to your problem of imbalance, whenever the refractive power between the two eyes varies by more than 2.5 dioptres this problem will occur. Since in your case the refractive power difference is more than this you will be having this problem.
Cataract surgery in left eye will solve this problem.
But after surgery you require spectacles for near vision as I had explained earlier.
The only way to avoid the use of spectacles is to use multifocal intraocular lens. But ideally it needs to be used in both the eyes. In your case because of pre existing problems of epiretinal membrane and short sightedness only monofocal intraocular lens is used.
Hence we need to go for monofocal intraocular lens similar to that of right eye.
If you want to avoid spectacles for near vision after cataract surgery the options available are
Laser refractive surgeries after cataract to correct near vision.
Do discuss with your eye doctor regarding this option and do write back to me with his opinion so that I can advice you accordingly.
Hope this information is helpful to you.
Thank you
With regards
You need to go for monofocal intraocular lens similar to that of right eye
Detailed Answer:
Hello Madam
Welcome to Health care Magic
I am Dr. Dadapeer K, an ophthalmologist and I will be answering your question.
I reviewed your history.
I can understand your concerns.
After cataract surgery the near vision will be affected as the natural lens is replaced with intraocular lens and accommodation which is responsible for near vision is also lost.
Hence after cataract surgery for near vision glasses need to be used.
Coming to your problem of imbalance, whenever the refractive power between the two eyes varies by more than 2.5 dioptres this problem will occur. Since in your case the refractive power difference is more than this you will be having this problem.
Cataract surgery in left eye will solve this problem.
But after surgery you require spectacles for near vision as I had explained earlier.
The only way to avoid the use of spectacles is to use multifocal intraocular lens. But ideally it needs to be used in both the eyes. In your case because of pre existing problems of epiretinal membrane and short sightedness only monofocal intraocular lens is used.
Hence we need to go for monofocal intraocular lens similar to that of right eye.
If you want to avoid spectacles for near vision after cataract surgery the options available are
Laser refractive surgeries after cataract to correct near vision.
Do discuss with your eye doctor regarding this option and do write back to me with his opinion so that I can advice you accordingly.
Hope this information is helpful to you.
Thank you
With regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Dadapeer,
Thank you for your advice and clear explanation.
I read about XXXXXXX monovision on a site referred to by a friend - www.kutrybeye.com in which Dr Kutryb mentioned it. What I understand is that the second eye can be operated on to provide -1.25 of myopia, just enough to support a small to medium amount of imtermediate and near vision. (20/20 distant reading in dominant eye and 20/50 in the non dominant eye)
I have 2 questions:
Is XXXXXXX monovision feasible in my case?
Also, how do I know which is my dominant eye?
Thank you
Thank you for your advice and clear explanation.
I read about XXXXXXX monovision on a site referred to by a friend - www.kutrybeye.com in which Dr Kutryb mentioned it. What I understand is that the second eye can be operated on to provide -1.25 of myopia, just enough to support a small to medium amount of imtermediate and near vision. (20/20 distant reading in dominant eye and 20/50 in the non dominant eye)
I have 2 questions:
Is XXXXXXX monovision feasible in my case?
Also, how do I know which is my dominant eye?
Thank you
Brief Answer:
Monovision can be considered if there is no imbalance.
Detailed Answer:
Hello
Thank you for the follow up question.
Monovision is an option by making the eye slightly myopic.
But the problem with monovision is imbalance between the two eyes because of difference in the refractive error between two eyes.
Since you are already experiencing the problem of this imbalance I did not suggested that for you.
You can see by simple testing of wearing of glasses for near vision in one eye and XXXXXXX glasses for other eye for one week or so and if you does not experience any problem you can consider that.
The eye with better vision will be your dominant eye.
Hope this information is helpful to you.
Thank you
With regards
Monovision can be considered if there is no imbalance.
Detailed Answer:
Hello
Thank you for the follow up question.
Monovision is an option by making the eye slightly myopic.
But the problem with monovision is imbalance between the two eyes because of difference in the refractive error between two eyes.
Since you are already experiencing the problem of this imbalance I did not suggested that for you.
You can see by simple testing of wearing of glasses for near vision in one eye and XXXXXXX glasses for other eye for one week or so and if you does not experience any problem you can consider that.
The eye with better vision will be your dominant eye.
Hope this information is helpful to you.
Thank you
With regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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