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IOL Refraction Result vs Target Refraction

I had Alcon IOL implants, both eyes, last year, different surgeons for Left and Right eyes due to first surgeon breaking his arm.  It was to be mini-monovision, 50D Right eye for Distance, 1.50 Left Eye for computer and reading except for tiny print. The surgeon refused to use higher than 1.50 and since many folks have been mostly glasses-free with 1.50, I agreed.  I was informed immediately that the result for the  Right eye was referred to as  a .25D refraction or Plano. But it took almost a year of follow visits with both surgeons, phone messages, 2 letters, and finally a "second opinion" consult with a third surgeon before I got the Refraction Result for the Left eye, which was .50 -- a much greater a difference than the 1.50 hoped for, and so, of course I need reading glasses for normal print, even beyond arm's length.  My QUESTION, which I neglected to ask any of the surgeons, is whether it is common for a 1.50 IOL to result in only .50?  Or is it more likely that I received less than a 1.50 IOL?  Thank you.
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Avatar universal
I looked again (with reading glasses) at both sides of the page by the "second opinion" surgeon
and one side of the page indicates:
OD plano sph
OS -0.50 sph (DRKS)

and on the other side of the page states:

"discussed at length post-cataract surgery. pt felt she was getting mild monovision

OS -0.50 sph distance
       +1.50 near  [yes, that's a plus (+) ]
===============================
Put another way (rather than guess if it's a typo), is that the result to be expected with even "mini-monovision" using a "1.50" IOL for near,
where I now can see the entire Snellin Chart clearly with my Right (plano) eye IOL, while my  Left (1.50 IOL) clearly sees all but the last line on the chart?  If I had opted for both IOLs set for near, would more lines of the Snelling chart likely be blurred, or would the blur likely begin a bit further away?
Thanx again for any sight insight  (-:



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2 Comments
The +1.50 refers to the 'reading add' ie the extra power that needs to be added to you distance correction to enable you to see clearly for near.
There are several contexts this information might be listed and i can't tell which you are reading. One would be present glasses  second would be today glasses test  3rd would be targeted post operative refractive error.    OD plano and OS -0.50 if that was target is entirely a distance RX and not even distance mini-mono bias (the OS would need to be -1 or -1.25)   If the OS as target Rx was written -0.50 +1.50 then that is a call for a multifocal IOL like ReStor not a monofocal IOL.
177275 tn?1511755244
Look again I'm sure he didn't write +1.50   it should be -1.50    Almost never will a surgeon leave a eye farsighted (+ number)
Helpful - 0
177275 tn?1511755244
So the target post op refraction was RE -0.50 and the LE was -1.50 and the LE ended up -0.50  (you have to have a sign plus + or minus - before the number)  It's never planned to leave an eye farsighted (+ lens) so that is what I'm putting minus number.

Your target was -1.50 and you ended up -0.50 so the target was off by one full diopter.  That is not good. The standard range is plus/minus 0.50 diopter and many practices are plus/minus 0.25 diopter.  It's likely there was some error in measurement (a scan and corneal curviture readings)    The IOL power is checked twice before its put in so its likely the surgeon put in the IOL power he/she planned but the calculations were incorrect.

The IOL should have been stronger to leave you more myopic in the planned reading eye.

There is no good way to fix that and its doubtful that an IOL exchange is warranted if your vision is good with glasses.

JCH MD
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Thank you, Dr. Hagen. I just received the record of my visit with the "second opinion" surgeon -- He  wrote -0,50 distance, +1,50 near.  Using 22" as the distance from my eyes to my laptop, which he didn't measure, and using the formula for converting inches to cm to Diopters, I think it should have been 1.75 target instead of 1.50. In any case, I decided not to risk PRK in my LE that they advised to gain near vision, due to reading about the risk of scarring and blindness.
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177275 tn?1511755244
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