Couldn't decide on the distance option

HI,

I'm a 30-year old male going to get my cataract removed in left eye sometime next month.  I had a retinal detachment back in early 2009, that's what causing the cataract.

I have spoken to my surgeon and regular eye doctor several times, but I still couldn't decide if I want to be able to focus near or far.

Currently I'm a -9.00 on my right eye, and -10.5 on my left.  My surgeon suggests that I should aim for a -3.00 or -2.50 since so it'd be easier for my brian to adopt than correcting it all the way to 0.00.  He said that I can still wear contacts in my left eye if I want to avoid using glasses.  However, my regular eye doctor thinks that if I can correct it all the way, I don't have to worry about it if and when I need a cataract surgery in my right eye.

What do you suggest?  I'm an Accountant/Information System Specialist so I spend a fair amount of time in front of the computer.  On my days off, I like to hike, take photos, travel, gym, and movies.  Should I leave it at about -2.5 to -3 as the surgeon suggests, or have it correct it all the way?  What's the focus distance (how many inches away from my eye) if it's a -2.5 vs 0.00?  Will I be able to achieve good "balanced" vision wearing contact in my right eye and correct my left eye to either a -2.5 or 0.0?  Thank you very much for your help.

[John C Hagan III, MD, FACS, FAAO]

You need to start doing your homework. use the search feature and archives to read about monovision and your options.

You are not fully understanding the problems you're going to have either way.

If you do "plano" post op you are 0.00  (assuming that you hit the nail on the head for post op desired refration and you cannot always guarentee that especially with high myopia and RD surgery both of which intruduce errors in the IOL forumula) in the LE and -9.00 in the RE.

The other way you are -2.50 in the LE and  -9.00 in the RE.


Either way your eyes will likely not work together due to difference in refractive error and image size. (aneisometropia and aneisokonia)  read the excellent posts by Jodie J on this subject.

Even with a contact lens on the RE you will likely need glasses over the contacts and high posibility that the eyes will not work togehter.

If your RE does NOT have a cataract one way I've handled this that has worked well is shoot for about -1.00 in the LE and have lasik on the RE. That should get you to about -1.00 to .2.00 in the other (likely you will need PRK rather than flap lasik).

If your RE DOES have a cataract then if they don't work together post op you may need to consider cataract surgery to help balance eyes BUT that will increase the risk of a RD in the RE significantly.

There is no easy answer to your problem.

Be sure you understand the option.

JCH MD