What IOL should I use for my cataract surgery

[squareone6164]

I am having cataract surgery.  I am extremely nearsighted, my contacts are -10.5 in right dominant eye and -9.0 in left eye.  I am set for monovision with my contacts because with both set for distance I couldn't read my watch.  This has worked pretty well for me for years but I do wear a +1 reading glass for really small work at my desk.  I have worn glasses since first grad and am in my fifties now.  I work on a computer and at home also use computer and watch alot of TV.  

The cataract surgeon wants to set my monofocal iols for monovision, with my dominate eye for distance and my left eye for close up (he is saying probably arms length).  My optometrist thinks I should have both eyes done for distance and then modify with glasses or contacts.  Obviously, I am going to need glasses or contacts after the surgery regardless of what I choose.  

I am really concerned about my intermediate vision.  With distance, will everything from reading to about 9 feet out be blurry? Everything I am reading seems to indicate that.  I don't mind wearing glasses for my computer work but would like to be able to see the TV and peoples faces that I am talking to from my desk without using glasses.  What should I do?  

I have been reading about mini monovision and it seems like that might be the way to go.  Any info would be appreciated. This is very confusing and scary.  I only get one shot at it.  Thanks.

[Ray T Oyakawa, MD]

You are already testing it out with your current monovision contacts. If that works set your eyes the same.

Another consideration is mini-monovision with Crystalens.  This would allow you to see all distances most of the time.

Dr. O.

[squareone6164]

I have read alot of the forums and can't find where anyone has given the distances you will be able to see.  Given my heavy prescription, if I get my eyes set as you described, will I see clearly for the computer and distance and only need glasses for reading.  Will I see the TV clearly and a persons face across the table clearly?  Any information would be greatly appreciated.  This is a very complicated decision since you only get one shot and can't "test" it out first like with contact lenses.

[Ray T Oyakawa, MD]

Use the search function.  This has been discussed in detail.  I would set you IOL the same as the contact lens you used.  I would set you non-dominant eye for the same amount of decrease in distance power that you have in the contact lens.  If you distance correction for the left eye was -10.5 and you are wearing a -9.0 CL, I would set the left eye for -1.50.

Dr. O.