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How is your vision after Cataract Surgery?

How is your vision after Cataract Surgery?
Please specify whether you got a monofocal or multifocal/accommodative IOL.

I would like to know what distances you are able to see clearly. What distances are slightly blurry, but acceptable, and what distances are just unbearably blurry.

I am particularly interested in those who have received Monofocal IOL set to Distance but I would also really appreciate hearing those experiences with different IOLs. I have heard from several people that with a IOL Set to Distance, they are still able to use the Computer at about 18 inches. This has confused me since I had thought IOL set to distance makes intermediate distance blurry.

Thanks!
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1136705 tn?1260648194
This past January, I had both eyes done with Acrysoft monofocal IOL's set for distance. I now have 20/20 vision and only need readers for close up reading. Depth of field is excellent from about 20 inches to infinity. I have a large monitor 24" and can sit back in my chair and read it perfectly without glasses. My wife also had hers done last month and needed the Acrosoft toric lens, she had minor astigmatism, set for distance as well. She's a waitress and was concerned about reading the menus and working their computer, but she has no trouble at all without glasses. Like me, she only needs cheap readers for close up work. You can search my previous posting about my experiences. Let me know if you are in Houston. I had mine done at Berkley Eye Center. Good luck.
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Avatar universal
I had cataract surgery in 2013, both eyes.  I was REALLY nearsighted for 50 years!  As I had had success with monovision with contact lenses....right eye for distance and left eye for reading....doc and I decided to do the same with the IOLs.  It was a miracle surgery for me.  I could see near and far PERFECTLY!  A real gift.  I do have to have a little help with mid-range (computer) but I can deal with that fine.  Sadly, 6 years after the cataract surgery, I developed a tiny, full thickness macular hole in my right (distance) eye, which I am having surgery for tomorrow.  I had my eye doc prescribe me a multi focal contact lens for my left eye so I can see all distances with that while my right eye heals.  I did not even realize I had any big issue with my right eye (the hole) until my annual check up with my ophthalmologist, when he found the hole during the routine exam.  I though I just needed glasses or contacts for the slight blurriness in that eye.  I have no regrets over how my cataract surgery turned out and I love monovision!
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Avatar universal
I am 61-year-old female. Very independent. I was highly nearsighted having worn glasses most of my life. In my left eye I had a symphony extended vision IOL about 6 wks ago. I can see far clearly I cannot see anything within arms length my focal point is probably a foot past my fingertips. Very disappointed even though surgery went well. So for my right eye the surgeon chose for me a Tecnis multifocal IOL with a 3.25 adjustment for nearsighted. After this surgery although I have   somewhat clear vision it is sort of blurry and all distances.   I feel that my eyes are always struggling    I am only three weeks out on this eye. I am praying that all this clears up. Because at this point I was better before and I’m $11,000 out-of-pocket. I paid for laser cataract surgery also plus high deductible.    It really wasn’t discussed with me about neuroadaptation after.   I know I cannot live like this the rest of my life. I am an avid outdoorsman and do everything myself in my yard    So right now I’m living disappointed and frustrated   Reading glasses on and off all the time it’s constant.  
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7 Comments
I've been saying this since I started this forum in 2007 do your research BEFORE the surgery. You should consider getting an independent 2nd and 3rd opinion from cataract/IOL/refractive surgeons that specialize in post operative problems.  I see see these problems in Kansas City from several practices that relentlessly push patient to 'up sell' into high cost 'extras".  
I am so grateful to my opthamologist as he did NOT push any upgraded IOL's or expensive, fancy ones when I had my cataract surgery in 2013.  I went with the basic lenses and chose monovision because monovision had worked so well for me when I wore contact lenses. I could not be more pleased with the outcome of my cataract surgery...and I was severely myopic...blind as a bat without glasses or contacts!  
Thanks for your comments
My cataract surgeon did likewise, recommending a monofocal IOL once I informed him I was only having my LE addressed. His practice offers the upgrades, but he in no way pushed them. I never adapted very well to monovision with contacts years back, so I stayed with my usual distance correction for both eyes with contacts. I put on readers for close up work when I’m wearing the contacts, if I’m wearing glasses I can see fine close up by taking them off.
Thanks
I am the original poster.  I had cataract surgery in the left eye in Jan 2019 and right eye Feb 2019.  Left eye has Symfony Extended Range lens 8.0, right eye has Tenus Multifocal with a 3.25 near vision correction.  I know I'm not listing the multifocal exactly correct.  It is end of July.  My right eye has never adapted well and the lens is being replaced on August 1st to a Symfony lens like my left eye.  It is being doing by a specialist and I am so hoping it all goes well.  I will try to remember to post here again before long.
Thanks for the follow up.  Hopefully after the IOL exchange you will be 100% happy not use 50%
Avatar universal
I also underwent cataract surgery in both eyes in year 2014 within span of two months. Lens Abott ZCB00, single focus. Distance vision is much better than I had in my entire life before that. But needs reading glasses for near vision to read new paper and small texts. I have 20/20 vision for distance without glasses and same for reading with glasses. It took about three months for vision to stabilise.  (Though overall I am better after surgery, it is important to remind ourselves that with surgery one loses auto focus  capability of natural eyes; so I am not very comfortable for distance less than one meter and have to switch between naked eyes & reading glasses or adjust distance. So surgery should be last option)
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Avatar universal
I had cataract surgery on both eyes in may of this year on both eyes set for distance with the standard iols and can read my computer up close but it depends on the size of the text im reading I can also read store price tags, but the tiny small print is what I need reading glasses for, I also have a astigmatism that keeps me from seeing 20/20 but I have better distance vision than I have had in my entire life with out glasses than I had when I had to wear glasses, now I only hav to wear glasses for reading small text. but I still do not have 20/20 but im hoping when my eyes fully heal that my vision will be 20/20 or close to it.
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3 Comments
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From what my ophtho said, astigmatism results in better near vision even with both monofocal lenses set for distance. So count your blessings on that astigmatism!
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Avatar universal
I had the lenses replaced in both eyes ten days ago
My distance is great I can also read a news paper and the very small print on the back of my eye drop bottles
My vision is better than it was when I was a teenager

I was awake throughout the op which lasted just over an hour
I could see everything that was going on but no pain
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2 Comments
Avatar universal
It's been a little over a week since cataract surgery on my left eye. The target distance was less than I had figured which I would classify as more near than intermediate. I guess I was figuring more on my "arm's length" vs normal. :) They were targeting 18" and nearly got that. Last week's follow-up had me seeing 20/25-20/30 with correction which is better than this eye has  ever been my entire life with a best correction of 20/70. I'm pretty happy with the results as are the doctors involved. I can sit much further back than 4-6" away from the monitor. I can also see the dashboard & center console in my car again.

The right eye is scheduled in another two weeks and they're going to try and target a little further out.  I could tell the wheels were turning in the doc's mind when he mentioned my right eye had a bit of a cone shape to it so the capsulorhexis will be a little more challenging.

The only complications were from anesthesia. I was put fully under and coming out of it had me groggy for a bit. Other than that, I don't know why I was worrying so much about and I'm REALLY looking forward to the right eye getting done!
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Avatar universal
I'm having cataract surgery this coming Thursday with Toric implant in my right eye and will have the left eye done probably within one month.  I'd like to hear more experiences with toric lenses.  I work in accounting and have been very near-sighted all my life.  I'm having my vision set to distance, so I'm hoping my vision with reading glasses will be good. Otherwise, I guess there could be trouble.

Thx,

Nancy
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Avatar universal
re: "and only need readers for near"

The older multifocals were bifocals with  adds that targeted near and had lower quality intermediate vision. Just this year the US has approved lower add multifocals from both Tecnis and Alcon that do a better job of intermediate vision, while still leaving decent near with just a small chance of needing readers.  The Symfony (if you go outside the US) is a better bet for excellent distance&intermediate with a slight chance of needing readers for near. Trifocals (not available in the US)  give good vision at all three ranges, with perhaps not quite as good intermediate as the Symfony but very near might be better. There are a few models of trifocal, the Zeiss AT Lisa Tri and the Finevision trifocal are the most common (generally rated as being comparable, with some sources giving one or the other a slight edge in different ways depending on the patient), with major vendor Alcon just having gotten approval a few weeks ago for the Panoptix trifocal that I haven't seen any data on yet to see how it compares.


re: "Please tell us about your Symfony experience?"

I've already posted about that in perhaps too much detail in a thread here:

http://www.medhelp.org/posts/Eye-Care/my-Symfony-IOL-results-after-cataract-surgery/show/2425258

Your profile indicates you are in the US (which hasn't yet approved the Symfony). If you aren't going to go outside the US, there is a thread here by someone who received the new Tecnis +2.75D lens:

http://www.medhelp.org/posts/Eye-Care/Tecnis-275D-MF-IOL-Experience/show/2597910

He is one  of the rare people bothered by halos with the low add lens (which can happen even with a monofocal) but they may go away with time, often they disappear in the first few months for those who have them initially. Although the Tecnis lenses seem to be better in certain ways than the AcrySof Restor lenses (less chromatic aberration for instance) I just recently saw a video indicating that the new Acrysof +2.5D low add lens has a different design than the Acrysof +3D lens and isn't merely a different lens power:

http://www.healio.com/ophthalmology/refractive-surgery/news/online/%7B543dce4e-252f-4ad9-821d-30961b045e35%7D/video-speaker-discusses-acrysof-iq-restor-25-iol
" VIDEO: Speaker discusses AcrySof IQ ReSTOR 2.5 IOL"

Halos may be less of an issue with that design than with the +3. That video shows   simulated halos, but unfortunately the only Tecnis lens they show   is the +4 and not the low add Tecnis lenses. That is the only simulation of halos I recall seeing comparing the Restor and Tecnis showing the sort of difference I see there (though it may be I hadn't paid enough attention to the halo descriptions of those lenses  in the past, I think its more that they usually aren't shown).
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Avatar universal
ty, I will be discussing this with my surgeon on Thursday
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Avatar universal
I highly encourage you to experiment with trial lenses and then contact lenses that simulate your proposed outcome.  That way you will be able to determine your tolerance for monovision or mini monovision. Best wishes.
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Avatar universal
A little background, I enjoyed good vision all my life without glasses until my 40's when presbyopia set in...went to progressively stronger readers to the point where I was wearing +1.25 for driving, +2.25 for intermediate, and doubling them up for near. In the past 6 mos the left eye developed cataracts so I met with the surgeon today. I have healthy eyes and negligible astigmatism, so from my research, I thought the crystalens might be right for me. When it came to q&a, I quickly learned  he no longer implants CL, says he doesn't think they work, and all he does is monofocal or Restor, in fact he ran a clinical trial for restor in the past. I hadn't researched restor and was ill prepared to discuss them.

My objective is good far vision (driving w/out glasses), and good intermediate (computer, smart phone), I'd be ecstatic if I could accomplish this and only need readers for near...not sure how best to accomplish this yet, a second opinion will be next. Problem is, most of the forum discussion on iol's seems to be from myop's, Would love to learn more from some hyperop's experience....? With readers, I'm more comfortable undercorrected, as soon as I approach overcorrection, it gets uncomfortable.

Thanks for all the great info shared here.
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Avatar universal
Lots of excellent information here, I will be copying for reference. Please tell us about your Symfony experience?
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Avatar universal
Best wishes!
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Avatar universal
re: "But I wonder if targeting distance and wearing glasses for computing/near is a better option."

Its all personal choice, what is best varies for each person. It  depends on how much you'd like to get rid of correction and when (and since you are a high myope, the risk that they may be slightly off in the lens power since it isn't an exact thing, even with ORA which some are skeptical will do better, so you may need to rethink the 2nd eye after the first is done).

The nice thing about having good intermediate vision is (depending on the exact range you target) that in addition to being on the computer, its useful for most household tasks, social distance at a meal or meeting, and TV (depending on distance). After having been a high myope and needing correction all my life, its nice to not need glasses/contacts around the house. Though I went with the Symfony to get a larger range, most of my vision tasks are in the intermediate range so I appreciate that aspect the most.

However in your case with monofocals to target that,  you may  need both distance glasses, and reading glasses for anything near. If  you do target distance, you can then get one pair of  progressive glasses to help with intermediate&near both, but are going to be wearing them more often.
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Avatar universal
I should probably create another thread vs hijacking this one so to speak.

Another visit with the ophthalmologist this past Friday. Still targeting intermediate/intermediate via monofocal IOLs. When I asked for IOL details, they claimed they won't know for sure until the day of surgery with ORA  used after lens extraction. I know they attempted to use one machine to do some eye measurements that was hampered by the congenital cataracts and go in again this week where another machine will be used.

I'm having doubts on going intermediate vs distance. The decision on intermediate was based on my lifestyle (12+ hours per day computing and low driving working from home). But I wonder if targeting distance and wearing glasses for computing/near is a better option. They discussed mono-vision options as well (like the suggestion w/ the right eye 2 meters out) and they seemed to think that decision could be made after the left eye was done and how I respond/like the corrected eye.  

I also plan on drilling them on IOL details. I still have time. Just want to make sure I'm making the right choices in a land of confusion. :) Can't thank SoftwareDeveloper & CBCT for the info and insights.
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Avatar universal
My current contact prescription is -11 left, -12.50 right. That, at best, gets me 20/40 in the right eye. Due to where the congenital cataract is in the left eye, I don't see anything clear with it regardless of strength. Just got by with what I could.

I may be getting confused with the options, the pros/cons of each and which would be right for me with most activities I do now and the future. I do compute more than anything else so, initially, the thought of seeing that most clearly at arm's length seemed good. But now I think some answers to some questions first so I scheduled some consulting time.

Thanks again for the info.



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Avatar universal
Regarding Crystalens -- I would not recommend them.  I had them implanted in both eyes.  The surgeries were one week apart.   Accommodation was minimal and I had very severe positive dysphotopsia and light sensitivity.  A year later I had both lenses exchanged for monofocal lenses and I am much happier.  Good luck with your decision.
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Avatar universal
re: "It usually takes 3 weeks to get a contact prescription "

Your profile indicates you are in the US, at least in Colorado most optometrists keep a supply of disposable soft lenses for trials in their office. Mine kept trial lenses up through -10, the odds are low you are more myopic than that. If your usual doctor doesn't, perhaps just pick a doctor at a large chain (.e.g one with an office at a Walmart or something) and due to high patient volume they are likely to have trials.  Had you tried multifocal contact lenses?

I'm not sure if I have your preferences right, but it sounds like you wish to have good computer vision, and that close-in reading distance, and driving distance, are less important.  If you are going with a monofocal,  if you are having one eye set at arms length to handle the computer well, you might consider setting the other at perhaps 2 meters out for a slight bit of monovision to give you good vision at social and household distances, in meetings and getting around  home/office, TV, etc. (I'm guessing those would be focused at like 1.25D-1.5D myopic for computer distance, and 0.5D myopic for 2 meters out).  I don't know if reading a smartphone is also a factor for you. I'd posted earlier on this page I think a link to a chart&formula for converting distances to diopters:

https://www.slackbooks.com/excerpts/67956_3.pdf

I would suggest you  consider whether you might want the Crystalens or a multifocal (  in my case I preferred to go abroad to get the Symfony).

I will add one additional approach to consider if you do go for a monofocal. There are new techniques for giving presbyopic people more near vision if their eyes are adjusted to distance. They  have also been tested on patients with monofocal IOLs. They have just approved the Kamra corneal  inlay in the US, and the Raindrop corneal  inlay is in wide use outside the US and is working on getting FDA approval (and may have less reduction in contrast sensitivity since they will implant it in 2 eyes if desired, whereas the Kamra usually just goes in 1). Those are lenses inserted in the front of the eye, which can be removed if they don't work well. In that case you would get your eyes set to distance, and use glasses/contacts for closer in, until you got an inlay in the future.
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Avatar universal
In my case, with congenital cataracts, I've been wearing thick glasses all my life and do have a contact prescription I wear when driving. So either way, either near/near or distance/distance, I'm OK with glasses.

I need to call my ophthalmologist and ask some questions as this past Friday was a blur once he mentioned how I'd like to see and between him, another doctor and myself, seemed arms distance focus would be good. A quick check for astigmatism was enough for them to rule out the need for toric so my guess is they're going with monofocal. Wasn't much discussion mostly because I did I know any questions to ask at the time. This visit surprised me.

It usually takes 3 weeks to get a contact prescription filled with my prescription so that rules out trying monovision. But then I feel I sort of have that going on now with my left eye being so bad compared to the right.

I've got time. The pre-op measurements and consulting is in late June and then late July for the left eye. You and CBCT have given me some piece of mind, wonderful advice and this thread has given me a slew of questions I can ask. I feel far more informed, some anxiety lifting and look forward to perhaps seeing better than I have ever seen since birth.
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Avatar universal
re: "I don't know if that means glasses don't help them in that case or just a frustration to have to use different strengths depending on what they're doing."

It is most likely merely a case of frustration since those with an IOL of any kind but with no  other eye problems should be able to use correction to get good vision at whatever distance they need.  I don't know if before the cataract hit you had already needed reading glasses to get a sense of what that is like, or if you managed to avoid it (usually by your age you would have had to deal with that, but not always).

re: "distance vision would be with a post-op prescription vs had I gone distance in the first place"

Overall the corrected distance vision with a near focused IOL should be comparable to vision with an IOL corrected for distance. Obviously if you are a high myope you are used to glasses and perhaps contacts. The corrective lenses don't make that much of a difference in terms of visual quality, its mostly an issue of comfort and convenience (and with glasses the usual tradeoffs you are used to like any anti-reflective coatings, etc).  
    
You don't mention what IOLs you are considering, or whether you are considering monovision (adjusting one eye for near).

It sounds like your vision may be too degraded to get a good sense of what an IOL targeted at a certain distance  is like by using contacts. Otherwise CBCT had a good suggestion to try contact lenses to correct you to whatever target distance you might wish to try out .  If  you can't do even 20/40 in one eye,  I don't know if it would  give you a good enough  idea of what 20/20 vision at that distance would be like (since unless you have other eye issues you should be able to get 20/20 or better with an IOL). Most eye doctors can give you trial soft disposable lenses. If you were going to try that, you might consider going  to an optometrist for that rather than the eye surgeon since they are usually more focused on surgery and medical issues than on trials of different contacts.

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Avatar universal
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Avatar universal
Thank you for the info. I know I'm getting lost and confused. I really don't know what the expectations are post-op with any of the choices compared to how bad I see now or have seen most of my life. I don't now how well I'll see w/ glasses distance wise if I go near/near. Or how well I'd see with readers and close work/computing if I chose distance/distance. Would it be good enough or will I be frustrated with that choice. Or any choice.

I do see it common both here and from an uncle that had one eye done that many miss near when they've gone distance/distance. I don't know if that means glasses don't help them in that case or just a frustration to have to use different strengths depending on what they're doing.

It has been great to see other's experiences as found in this thread. I just hope between my ophthalmologist and I, the right decision is made and I can compute, drive, watch tv and do everything else I normally do and see it all better than what I am now. :)
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Avatar universal
like you, my job requires a lot of reading and computer work.  I chose close and intermediate IOLs.  I also wear progressive glasses which give me clear vision at all distances.  If you opt for distance IOLs, you would need glasses for all close vision, not just when you are at the computer -- think shopping, seeing your phone, etc.  Perhaps you can experiment with contacts before you have to decide.  Best wishes.
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