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Honest question about monofocal IOL set at plano
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Honest question about monofocal IOL set at plano

Hello all,

I have lurked on this site for a long time and this is my first post. First off, I would like to express my gratitude to all the MDs who take time out of what must be ridiculously hectic schedules to educate us noobs here. I have a question below based on many many hours of Internet research, a good bit of it coming from MedHelp.

Note: The below question contains a lot of background information; so respect to all who just do not have time to go over all the information, thanks to anyone who even takes a glance.

Question: I am considering cataract surgery for both eyes using monofocals (Tecnis 1-piece) both set at or around plano. For reading I don't mind (and expect) glasses; however I have a desk job that requires long hours in front of a computer. In your experience, could working at a computer for long hours without glasses be accomplished (with larger font sizes) if set at plano, or is this unrealistic in your experience?

(background information to follow on next post)

SP
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This is a difficult decision, with no one right answer. If you are implanted with monofocal IOLs for both eyes to correct your distance vision to plano, then of course you will need reading glasses and possibly computer glasses. It is possible that you would be able to work at a computer without glasses, but that cannot be promised. Using IOLs which will give you -1.25 or -1.50 post-op refraction would allow computer vision without glasses, but you would need glasses to drive. Since you have already tried monovision and did not like it, you don't want to do this with implanted lenses, or you might need an IOL exchange. Also I would not recommend multifocal implants due to your history of retinal problems.
6 Comments
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Supporting information (long):
Location: Japan
Age: 41
Sex: Male
Height: 180cm (5' 11")
Weight: 82kg (180lbs)
Vision: Myopia Left -9.00 Right -8.00
Dominant Eye: Left
Astigmatism: 1 diopter each eye
Health issues: antianxiety meds, occasional migraines other than that OK, lifting weights and taking vitamins for about 25 years, physically fit
Amount of computer use: High, desk work requires long hours of computer work

Background information:
I have read tons and tons of other posts here and on other sites and have seen varying information and was hoping for a doctor's view.
I have just had my second vitrectomy (one each eye) this month, one for retinal tears and one for partial detachment, both due to vitreous friction/long eyes (around 28mm long each as told by MD).
Family history of myopia. Out of my family I have the worst (including parents and older family members).
Slight cataracts due to vitrectomy surgery (as heard from my doctor, and I think I have experienced them when moving from a light room to a dark room).
Slight presbyopia, need to read food labels more than 1 foot from my face depending on how small the print.
Need to drive at times due to working for a car company.
Why not monovision or mini-monovision? -I already have uncorrected monovision as each eye's myopia is different and am uncomfortable with it. I would not expect I would all of a sudden be comfortable with mini-monovision IOLs.
Why not contact lenses? I wore contact lenses for almost 30 years but was told due to thin corneas (around 2000 cells density each) that contact lenses cannot be worn anymore so this year had to switch back to glasses.
Why not multifocal IOLs? Upon reading lots of data, my decision not to use.
Why plano (20/20)? I tried under-powered glasses for intermediate-near (set about 2 diopters less than 20/20). They were a nightmare when outdoors as anything outside of a 6-foot radius was blurry and very disorienting, nausea. Finding streets or even navigating stairs were a challenge. I had the lenses reset to 20/20 quickly.
I am grateful for my doctor, the best in Japan according to rating books (and if I remember right an AAO member) for restoring my sight (I recovered to pre-op vision in the left which had the partial detachment, waiting to see what happens on the right which was not detached), however if I do have options to improve my eyesight I will definitely try them since I am not comfortable at all with glasses at this power (my personal experience).

My apologies for the long post, I wanted to make sure I read what I think is enough information before asking, as well as give plenty of information to help answer the question (rather than a fly-by "HELP!" post).

Unfortunately I can't do much in return unless you would like something translated to English or tips if you are coming to Japan or tips on new cars.

Much obliged to anyone who can offer any advice based on experience.

SP
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I just had one ye done with plano, was in similar situation and was able to work at PC with large fonts and one eye
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5613890_tn?1370957942
aps, many thanks for your time. I work with large fonts anyway even at 20/20 since smaller fonts make my eyes tire quickly (no brainer due to long hours in front of the screen). I also zoom Word documents to full screen regularly. I would expect to have to stretch my arms out or use a seperate keyboard(we use laptops) to create more distance with the computer.

SP
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probably not   its not that bad

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5613890_tn?1370957942
Dr. Fazio, much appreciation for your advice. I figured that would be the case. My old glasses prescription that was set for near was horrible yet I still somehow passed the drivers test to renew my license. In Japan they have a rating system of 0.0 (blindness) and 1.0 (20/20). To pass the driving test you need 0.7 and my guess is I was barely
around there. Perhaps 0.9 might be acceptable. Tough choice but even if I do need computerr glasses they will be a lot smaller than the big ones I have now.

SP
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