Cataract Surgery/Lens Choices

[coachglove]

All,

I have read many of the posts about people getting cataract surgery and trying to pick a lens.  I am a 37 yo male who has had a cataract in my R eye since birth.  I'm not well versed in the various distances in terms of #'s (ie-1.75, etc), so I am looking for some plain English help on deciding what lens to go with for my surgery.  My Dr recommended the Crytalens Multifocal, but I'm not sure if I should trust that recommendation considering the extra cost.  My insurance will cover the standard monofocal lens.  I have seen a number of terms on here that I am not familiar with, so again I ask for replies to be in plain English when possible.  If the Crystalens is truly the best option, I don't mind paying the $ since this is my eye I'm talking about.  I also don't mind wearing glasses for reading/computer work, but don't want to wear them all the time, so I want my distance & intermediate vision to be crystal clear.  I have seen some recommendations of telling the Dr specific settings for mono lenses.  How do I know what to tell the Dr for that #?  What do those #'s mean?

Any help would be appreciated.

[Houman Vosoghi, MD]

0 or plano means focus at distance.  -1.75 usually is for intermediate or computer.  Tough decision and no one can tell you what is best for you.  With regular monofocal lenses you can see perfect at distance (assuming all else is OK with your eyes) but will need reading and computer/intermediate glasses.  The crystalens gives you a chance at seeing far and near without glasses but is not guaranteed to do so and may sacrifice some contrast as well as clarity to make that happen (20/25 vision instead of 20/20 for example in some people) and it may also cause halos around lights at night time etc in some people.  It also would not take care of any astigmatism if you have a significant amount.  If you want truly perfect vision, the best chance is with monofocal for distance plus glasses for reading and intermediate work.

HV

[ledbrv]

My 2 cents of contribution.
I had cataract from my RE removed last friday and a IOL implanted.
In my case, except for a rare condition known as a "anisometrophia/aniseiconia", everything else is worderful.
This "anisometrophia" things happens when you have a big power difference from on eye to another.
But don`t worry, you probably don`t have it, but talk to your doctor just in case.
About IOL choice I decided to go with a monofocal IOL AcrySoft IQ and I am very happy with it.
But there are other great monofocal IOLs. Ask you doctor which IOLs he has experience with. Ask second opinion if in doubt, as you said it`s your eye.
I my case my RE is 20/20, so my RE is plano (0 power).
For distance viewing I can see things I couldn`t see before, even before cataract.
Beware though that, with monofocal IOL, you will lost your near distance view and, as Dr. Houman said, you will need reading glasses.
This is not a big deal, it`s similar to presbyopia, and sooner or later you will have presbyopia, so you would need reading glasses anyway.
I didn`t choose a multifocal IOL because of the risks Dr. Houman pointed at his post.
I would be very unhappy to see halos and glares at night, and that could happen with multifocal.
Some people say you can get used to it, but I think its not worth the risk.
You said you want intermediate and distance view crystal clear and don`t mind wear glasses for reading/computer work, so I would say you should choose monofocal.
If you choose a monofocal IOL, other topics you should discuss with your doctor are monovision and dominant eye.
If your RE is your dominant eye, you should try to get it as close to plano as possible.
This is my case, my RE is the dominant one, so even without glasses, and with -3.75 power on LE (big myopia), I can do many ativities, even drive.
As I learned, the dominant eye is the one the brains prefers for far distance viewing.
Monovision is a technique that allows you to do some fast near reading, like tag prices at supermarket, even without reading glasses.
It does sacrifice far distance viewing a little, but if well done you will not notice.
At least that is the idea, I did`t do it yet, but based on my case (something like a HUGE monovison) it should work pretty good.
Just don`t expect the best solution on all circumstances, It may not be possible.
The best you can do is educate yourself, so ask your for opinions here at medhelp, discuss all your doubts with your doctor, talk to people.
Almost everyone I talked to know I a person who had cataract surgery: a father, mother, uncle, brother, him/herself...
Cataract treatment for young people like us that do many activities can be a little trick sometimes, but if you have the patience to make the right questions and do the right choices, the result can be great.
Regards.