Upcoming Cataract Surgery

Hi, I'm 42 years old and am in the process of getting cataract surgery on only my right eye.

My background (sorry for the length):  I am slightly nearsighted and have a slight astigmatism.  I don't think the astigmatism is so bad as to need correction surgically.  No prior eye surgeries, but when I was a teenager, I did have a small spring seriously impact my right eye.  There was some bleeding inside the right eye and I could not see.  That subsided after several days with medication (no surgery).  Afterwards, the pupil in my right eye didn't dilate as much as my left eye but apparently now, it is close to normal.

At work, I do a lot of fine print reading and typing on the computer.  However, I'm also very active and drive a lot as well.

So here are my initial questions:
1.  Should I be concerned that my prior eye injury will result in greater risk of complications during or after cataract surgery?

2.  I am leaning towards getting an IOL for distance.  I was told that some IOLs also do well for intermediate distance vision.  What exactly is intermediate distance?  If my computer screen is about 1.5 to 2 feet from my face, is this intermediate distance?

3.  Will a monofocal IOL give good intermediate distance vision?  Or is that possible only with a multifocal IOL?

4.  What is the difference between a mutifocal IOL and a toric IOL?

5.  I was told that accommodating IOLs, like the crystalens, are good in theory but they often have unpredictable results - true?

6.  I've read a lot of posts to get a consensus on silicone versus acrylic but am confused.  What is the current view on which is better for vision?

7.  What are the preferred multifocal IOLs on the market today (I only know of ReSTOR and ReZOOM)?

I probably will have more questions but thanks for any assistance and insight.

[Ray T Oyakawa, MD]

Every one has a different opinion regards these question.  Use the search function.  These questions have been address.  The ReZoom is hardly used anymore.  Besides the ReStor there is the Tecnis multifocal.

Your previous injury may affect your surgery. However, the surgeon should look at the eye carefully before surgery to avoid potential problems.

Dr. O.

[900fe]

Thanks
As for multifocal IOLs, are they all of made of concentric rings similar to the ReZoom?  I think the issue with that are refractions causing halos and glare.  Are there multifocal IOLs that are not made in this way (other than crystalens)?

[DrHossamBakir]

Don't worry about your previous trauma it was probably a hyphoema and has no effect on the coming surgery, as a consultant surgeon I would recommend you to go for an acrylic monofocal lens for far (driving) and if needed, u will use glasses for your computer , toric IOLs are those that correct astigmatism ( if significant )

[cwatt1]

Multifocal lenses all have the concentric ring configuration, which does tend to cause halos and ghosting in some people.  Note that astigmatism is usually more of an issue with these lenses than it is with the monofocals.

Intermediate distance is usually arms length to about 4-5 feet or so.  With a monofocal lens you will get excellent distance viewing but may need glasses for both intermediate and near, as DrHossamBakir stated.

[900fe]

Is there any way to know if you will or will not need glasses for the computer after cataract surgery?

[900fe]

To clarify, will I need a pair of glasses for intermediate distance and another pair of glasses for near distance?

[cwatt1]

The majority of people will require reading glasses or progressive lenses for both intermediate (computer) vision and near vision (reading).  You did not mention the degree of your nearsightedness, but since you are only slightly nearsighted you may be able to get by without glasses by using your unoperated eye -- a type of mini-monovision.  Talk to your surgeon regarding the amount of difference between your two eyes after the lens implantation.  If you have plans in the future to have the other eye done, you can opt for slight myopia in that eye to give you good intermediate vision, and you would probably only need glasses for very small print.

There are lots of posts in this forum's archives about lens choices, monovision, mini-monovision, etc.  Use the search feature (top center of the page).

[900fe]

Thanks.

I'll inquire about the mono-vision, as that may be a possibility.  My left eye doesn't need cataract surgery yet.

I'll continue to check the prior posts but it appears many are from months to years old based on search results.

[LynneAV]

For what it is worth, I had a similar starting situation:  Cataract surgery on one eye only, minor nearsightedness in the other, non-operated eye. My cataract eye was given an acrylic IOL set for distance (this eye is my dominant eye and prior to surgery it was considerably more nearsighted than the non-operated eye and I had worn glasses since age 18 months).  After the surgery, I no longer wear glasses at all for either distance or intermediate (computer, writing, most reading).  For fine print and threading needles, I need drugstore reading glasses, but I don't like putting them on and I usually find it easier to pick up a magnifying glass (which makes my husband laugh).  

[baggyrinkle]

One year ago I had cataract surgery and chose Alcon Acrysoft mono focal IOLs set for distance. My eyesight was similar to yours with only slight astig in one eye. My results have been fantastic. Distance is perfect. Intermediate is perfect. I only need low power readers, +1.00 for reading small print. I use a 24 inch monitor and can read it perfectly at about  24 inches.

Since then my wife had hers done with Toric IOL's with the same outcome. Also two other friends of mine have since had theirs done with the same results. The most important factor here is the skill and experience of your surgeon. If you live near Houston, we have one of the best in the business at Berkley.  IMHO avoid multi focal IOL's .
Hal..