Monofocal for Distance in Non Dominant eye

[Readynow16]

I have been nearsighted entire life with a big split.  Left eye is -3.25 and right eye -13.  Left eye dominant.  Very successful correcting both to 20/20 with glasses and conacts and did mono vision with left set for far and right set for near.  I now have cataract in right eye (age 54) that restricts my best vision to 20/50.   I have been to several doctors who have recommended two options:  Insert Monofocal IOL in right eye set for distance and leave left eye alone as it is ok for intermediate/near without glasses.  Stick to monovision since I was very happy with mono vision with contacts.  QUESTION.  This would mean using non-dominant eye for distance and dominant eye for near, which would be a switch from what I currently have.   Does it matter which eye is set for distance?  Any thoughts on switching which eye is set for distance?    I have no astigmitishm and small pupils (2mm)

Another doctor recommended going with Crystalens in my right eye vice monofocal.  Appreciate any thoughts on monfocal vs crystalens for my situation.  

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

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[artforartsake]

I just had surgery on both eyes in the last two weeks, Crystalens Five-O, with my non-dominant right eye set for plano and my dominant left eye set for about -1.0.  It appears my surgeon hit target in both eyes.  HD was unavailable in my power for either eye (before surgery, I was -12 in right and -10 in left); you may have the same situation.  I had not done monovision or contacts before (except for a brief trial before surgery, which didn't tell me much because my vision was so far gone in my right eye due to the cataract), but I'm not having any difficulty with the "reverse monovision."  I'm getting excellent distance and intermediate vision, and suspect that I'll be reading without glasses pretty soon.  I think the key is to have an excellent surgeon implanting the CL.  Good luck!

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

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[peakhope]

It might be too late with your cataract, but you could try getting contact lenses with the near/far reversed and see if you like it. Spending even a couple hundred dollars to find even a partial answer might be better than having a permanent surgery that leaves you unhappy.

Based on my wife's unpleasant experience with contacts that attempted to reverse her uncorrected natural monovision, I would be very nervous about swapping what has worked well for you.

I like my Crystalens HD's, but before you choose them you have to understand that you might not get perfect distance vision, and quite possibly might not have "near" (<2 feet) vision in that eye. Plus the added costs and risks, of course. If you get Crystalens, be sure to get the new HD model, and be sure to choose a doctor who has implanted quite a few Crystalenses successfully.

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

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[ace399]

I have also been left eye dominant, but my recent experience leads me to believe it may not matter.  approx. 6 weeks ago I implanted the Cyrstalens HD in my right eye and ~2 weeks ago, the latest Restor lens in my left.  The Restor lens is tinted whereas the HD is clear.

I noticed that in binocular vision, the two eyes work together to give the best vision as follows:
- 1 ft to 2 ft - Restor is best (HD is not as clear)
- 2 ft to ~6 ft - HD is best (Restor is not as clear)
- >6 ft both are equal
(cannot read small print yet like a newspaper without readers, but can see the dash board and monitor)

It seems to me that the better vision will be selected by the brain.  So if you can achieve good vision in your previously non-dominant eye, I think your brain will adjust.  I am not a Dr., so this is only my personal opinion.

[JodieJ]

Based on everything I've read, it's better to stick to what you're used to, as long as it has worked well for you.  Some people doing monovision can switch their distance eye; for others, this causes lots of problems.  My (nonprofessional) advice would be to set your non-dominant right eye for whatever near vision target you're used to and wear a contact in your right eye.

There have been several recent threads about the new Crystalens HD.  Some people have been very happy with their results, others not so happy.  If you go for this option, you could set your right eye for (mini) monovision and continue wearing the distance contact in your left eye.  (Since you've had good results with monovision contacts, you might be happier with monofocal IOLs set for full monovision.)