Dominant v. non-dominant

[Occupant]

I had cataract surgery on my right (non-dominant) eye two days ago and it came out (first day after surgery) 20/25. I had discussed the possibility of making the non-dominant somewhat myopic and the other one plano to get better intermediate vision without glasses. The result is, it didn't happen. My Ophthamologist said, that he was aiming for it, but it came out the way it did. Would it be advisable to try again to get the same effect on the dominant eye four weeks from now?
I opted not to take the multifocal route and had a aspherical Alcon lens implanted. The reason for me was that my optometrist said: "You'll have to wear glasses no matter what due to your astigmatism (~-1)". And the ophthamoligst told me:" I don't do Wavefront Lasik and it would be about $4500.- for both eyes". Adding to that the cost for the multifocals ~$3000.-, it didn't seem to be a worthwhile investment for me - I am 70 years old.
Thanks

[aimee37]

Are you a gambling man?  IMO (and after further consideration), I think the odds are greatly in your favor that you would not experience any problems if you targeted your dominant eye to -.5D to -.75D.  As opposed to a plano correction, this focus would significantly improve your intermediate vision.  (A full monovision correction is about -2D for the near-vision eye.)  You might consider consulting your optometrist or other eye care professionals about this.  (My sense is that optometrists may be better able to address this issue than ophthalmologists.)  What is your refractive error in your nondominant eye with the implant?  With a little astigmatism, you could easily be a little farsighted and seeing 20/20.  In that case, you may want to avoid a situation where one eye is farsighted and the other is nearsighted.  The degree of your eye dominance may also be a consideration.  All this is well beyond my expertise; definitely discuss your situation with someone more knowledgeable.

With cataract surgery, you pay your money and you take your chances.  The target for my first eye was -.5D, and I ended up with +.125.  The target for my second eye was plano, and I got +.125 in that eye, too.  (I needed to have both eyes about the same because of problems that you don't have.) As a former high myope, it was thrilling to be able to drive for the first time without corrective lenses, even though I didn't end up with exactly the vision I had wanted.
    

[aimee37]

Yes, I hear you. However, when you had your monovision contacts, you still had an "accomodating" lens behind it. Does that make a difference if you would then switch to a monofocal IOL? My left, dominant eye still has the cataract and my vision from that eye, if I am lucky, with glasses is 20/70 (I printed my own Snellen chart and I don't know how good that is). However, it allows me to watch TV and do much of everything else and the dashboard on the car is in focus and this is quite tolerable to me. Other than reading, which is difficult unless I close my right eye, I could probably live with it.

[aimee37]

If your vision is 20/25 two days post-surgery, it may be 20/20 ten days from now.  I know it's not what you targeted, but many people would envy your outcome.

I agree with Dr. Prince about using your dominant eye for intermediate vision.  I'm slightly right-eye dominant, and I was equally comfortable using either eye for near vision when I did monovision.  But not everyone is comfortable doing this.

Best wishes for your second surgery!

  

[Forum-OD-MP]

dont know.  tough choice.  *most* people do better in monovision when their dominant eye is for distance and their non-dominant eye is for near.  now thats not a possibility for you.  you may or may not be able to adapt to having your dominant eye be for near.  i dont know.  nobody does.  difficult to predict.