Mini-monovision cataract surgery for RK patient

I am a 61 year old man, who had 8-cut RK 20 years ago (to correct -5 myopia). Now I am developing cataracts. I frequently have some annoying symptoms with ghosting images, glare, blurriness, and scattered light (esp at night) My Rx now is approximately +1.5 in both eyes with some negligible astigmatism in one eye.

I am still able to drive at night, and play tennis, but I would really like to improve my vision to get rid of these annoying symptoms. So, I have been thinking about mini-mono cataract surgery. (which I can tolerate, since my RK was done as mini mono)

Ideally, I would desire a visual result which would provide me with a “compromise” between near and far: For example, a) good distance vision -- perhaps one (1) diopter off plano,  b) good intermediate vision -- so there is good intermediate vision), and c) good near vision -- so I would could read my cell phone, and at least the larger print in a newspaper).

In other words, I would like to shoot for good "all-round functional vision", ---  so I would only need to wear glasses if: a) I needed really sharp distance (such as driving or tennis) -- or b) I was doing close point work with smaller print.

My question: Could mini-monovision achieve the visual result I'm shooting for?  Would the dominant eye be set for about -1, and the other eye, about -2.25 to get this result?

Thank you for your kind advice.

[Timothy D McGarity, M.D.]

Hi,
RK makes it more difficult to achieve those results. RK eyes (8 cuts or more), tend to have daily vision fluctuations and a drift toward farsigthedness. In general, I do mini-monovision with cataract surgery, but set the dominant eye for distance (as close to plano or zero as possible), then set the nondominant eye to intermediate vision (-1 to -1.25). This allows clear distance, good intermediate and some near (for large print). I don't have experience with the -1 and -2.25 combo you described, but I believe it could be done (just haven't purposefully induced this on a patient). You should accept the notion that glasses will be needed for some tasks. If you can accept that notion, then you will do much better. Best wishes