Monovision or not?

I'm 62 and have used glasses for myopia since I was 15. It started with about -.75 left and -.25 right and progressed to -2.0 left to -1.75 right last year plus astigmatism -.50 (right only) and a +2.50 presbiopia ( both eyes ).
I was also diagnosed with a very mild cataract on the left eye about 3 years ago, which progressed to a "mild+" four months ago on the left and very mild on the right. I've been experiencing difficulties for driving at night ( blurred "starred" lights, refractions ) for at least one year now. After a thorough series of exams, I've decided with my oftalmologist surgeon to have IOL's implanted.
I had my "dominant" eye ( right) surgery done wednesday last week ( Feb/02 ) with an AMO Tecnis Foldable Acrylic Aspheric IOL implanted, adjusted for far-sight ( beyond ~ 5 feet ).
The surgeon is suggesting me to go for the "monovision" correction with a near-sight lOL ( up to 3.5 feet ) on the left eye in about 4 weeks.
I'm in doubt now if I should go that way or just have the left eye IOL also adjusted for far-sight like the right eye and wear glasses for near sight - reading, computer, etc. I'm really worried about not getting used in using one eye for near and the other for far focusing, it seems quite weird - I know the brain is supposed to adapt to that "automatically" - but what if....?!?!
I'd lappreciate to hear comments from MD's as well as other patients who have gone through that or knows more about it.
Thankyou.

[JodieJ]

The formulas used to make IOL power predictions are based on averages, and they usually get you within .50 diopters of your refractive target.  It is advantageous to be minus (myopic) side of plano, because this gives you better near/intermediate vision.  It seems to me that you have an excellent outcome.  You can wear glasses to correct residual refractive error if needed.

[luke48]

I forgot to say that the right eye surgery went well and I was able to identify details very far. It was a bit "foggy" and dark on the first two days, but that disappeared. On the last three days that eye's vision has become a bit blurry beyond maybe 35 feet, more like a double vision, I went to the Oftalmologist yesterday and he detected a residual -.25 myopia. He said it could go away within the next two weeks.....or not!

[JodieJ]

You have probably enjoyed good uncorrected near vision for most of your adult life.  If you go with a distance correction in your second eye, you will lose your good uncorrected near/intermediate vision.  Many formerly nearsighted people have difficulty adjusting to this loss.  Mini-monovision (intermediate vision in your second eye) might be a good compromise for you.  It would allow you to perform tasks such as shaving without glasses.

[luke48]

Thanks for your comment! I haven't thought of that and you're right, my near vision was perfect until maybe 12 years ago. Today I can still read small prints with my left eye uncorrected at about 10 inches away. I'll really look ( no pun... )into that.

[luke48]

As I said before, after the IOL implant in my right eye, it has now a "residual" .25D myopia. Is that common? I'm asking this because I thought that with the implant of a far sight lens the eye would be free of any myopia. I guess that's a very low number, but before the surgery I had a perfect far vision acuity ( on daylight ) with glasses and now the slight "double vision" bothers a bit, mainly when driving ( am I asking too much? ).

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

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[JodieJ]

The formulas used to make IOL power predictions are based on averages, and they usually get you within .50 diopters of your refractive target.  It is advantageous to be minus (myopic) side of plano, because this gives you better near/intermediate vision.  It seems to me that you have an excellent outcome.  You can wear glasses to correct residual refractive error if needed.

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

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