Power selection for multifocal vs. monofocal

[ddtla]

I had ghosting problem with the Rezoom so I decided to explant it(4/9/07) and replace it with monofocal. I was seeing 20/20 distant with my rezoom and the power for the rezoom lens was set at 14 Diopter.
I told the doctor that I wanted plano for the monofocal lens and after the surgery I noticed on the patient's card that the diopter for my monofocal lens was set at 15 diopter.
I thought that the power should be the same regardless whether the lens in monofocal or multifocal.
Could this be a mistake/error in the lens selection?

I was seeing 20/20 at 14 diopter and now the new lens is set at 15 diopter. So with a 1 diopter increase in power, does this mean that now I am more nearsighted or farsighted?

[Forum-OD-MP]

it doesnt mean either.  its more complicated than that (way more complicated).  your lens implant power is only ONE of the many, many, many factors involved in predicting your post-op rx.  no, its not nearly as simple as 1 eye being 14D so if the other eye is 15D then you're 1 D nearsighted or whatever.

i have no idea if you are farsighted or nearsighted or plano or have astigmatism or what.  the power of the IOL is not near enough info.  also need manifest refraction, corneal curvature, possibly ultrasound, etc etc etc

[aimee37]

I don't have any agstigmatism or any other problems.
My left eye was implanted with a rezoom set at 14D and I was seeing 20/20 but with ghosting vision.
Could not stand the ghosting so decided to have it explanted 2 days ago and replace it with a monofocal. Prior to the replacement, had a talk with my doctor regarding whether to go  plano or bring in the vision a little closer(slight nearsighted). I decided to go with plano.
I don't know if he wrote down the wrong power or not.
All I can think of is that there was a clerical error in prescribing or picking out the lens. Because why would you increase the the diopter from 14D to 15D if the pt was seeing 20/20 distant with the 14D and that the patient told you that he wanted plano.?
Again, if the pt is seeing 20/20 with 14D multifocal lens and has no other visual problems, why would you increase it to a 15D with a monofocal? How common is this? What could be the rational behind this beside clerical error?
By increasing 1 diopter(14D to 15D) does that mean I am now slightly nearsightedness given that I was seeing 20/20 at 14D.
Yesterday at my day 1 follow-up, my distant vision was between 20/30 and 20/40. Again I am thinking that this has to be a clerical error.

[aimee37]

I don't think there's a clerical error involved.  The same eye might require a different power in a different model IOL.  Actually, the same eye might even require a different power for the same model IOL, depending on which surgeon implants it.  (I assume this relates to the way the surgeon positions the lens.)  Did your doctor use an IOL Master?  My IOL Master output indicates different powers for plano vision for different lens models, with some variation in the predicted power for plano depending on which of the clinic's surgeons would be implanting the lens.

I know how anxiety-provoking it is waiting for the inflammation to resolve.  Your vision one-day post-op vision is about what mine was, and I ended up with 20/20 acuity for distance.  I predict that you'll be pleased with your results.      

[aimee37]

I don't think it is due to the different lens because he used the same power for my right eye. I had the rezoom explanted from my right eye 3 weeks ago. The power for the right rezoom lens and the replacement monofocal lens was the same both set at 14D and I am seeing 20/25 with the monofocal in my right eye the same as before the explant with the rezoom.

The rezoom in my left eye was removed 3 days ago. I was seeing 20/20 with the rezoom at 14D and the doctor knew that I wanted plano and he used the same type of monofocal lens as for my righ eye.
If he didn't change the power for my right eye when it was pretty close to being plano then it does not make any sense to change the power on my left eye when infact what I am seeing is 20/20 at 14D.
Again I am thiking this has to be a clerical error.

[aimee37]

If indeed a 14 implant would give you plano, then a 15 would leave you a little nearsighted.  But I still think that your vision one day post-surgery was very good, especially considering that your eye had to endure the extra trauma of an explant.  Have you spoken to your surgeon about your concerns?  Please keep me posted on how much your vision improves.