Monovision and Cataracts

Hi Doc;
I am 68 years old and was severely nearsighted, first corrected with glasses and then with contact lenses.
About 20 years ago I opted for monovision contacts with the left eye for distance and the right for near vision. Nine years ago I opted for Lasik surgery, retaining the monovision.
I am now developing cataracts, with the left eye (distance) more advanced and am scheduled for cataract surgery on that eye. I have no problem retaining the monovision capability but wonder if their would be any benefit to getting a Crytsalens instead of the standard IOL?
Thanks

[Michael J Kutryb, MD]

In this situation, I personally would use a standard aspheric monofocal implant shooting for monovision.  It is extremely important that your surgeon have excellent corneal topography capabilities such as pentacam or Zeiss Atlat (my favorite) and is able to measure corneal spherical aberration.  A tecnis or acrysof IQ lens will have negative spherical aberration to cancel out some of the high levels of positive spherial aberration created by myopic lasik. Also surgeon needs to be comfortable with IOL master or Lenstar system and Holladay 2 lens calculations. Old records are usually not available so newer predictive calculations are needed and are available online for the surgeon. With the Atlas, IOLMaster, and post-refractive IOL predictive formulas, I can usually get the patients quite close to the desired outcome but there is still some definite margin of error, much greater than non lasik patients.  Make sure surgeon has ability to custom pick the type of implant depending on your spherical aberration.

[AntonReiser]

With Lasic eyes it can be a problem to calculate the power of the IOL.
There are videos about measuring the eye at:
http://doctor-hill.com/iol-master/iolmaster_tutorial.htm

What I read about IOLs in Lasic eyes was that there might be "interference" with multifocal lenses. So I think it would be safer to choose a high quality monofocal aspherical IOL.

[AntonReiser]

Highly myopic eyec are also difficult to measure/calculate.
So you need a very experienced surgeon to do measurement and calculation.
(There are five different formulas to calculate the power of the IOL. It is even difficult to choose the adequate formula.)

[gperzel]

Thanks-appreciate your help
GM Perzel