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cataract surgery: nearsighted to farsighted?
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cataract surgery: nearsighted to farsighted?

I've been myopic since about age 8, and now need cataract surgery in both eyes. If I have monofocal lenses implanted, I'll suddenly become farsighted, right? This prospect feels quite weird to me. Has anyone else here experienced this change? Could you tell me what it felt like to suddenly become farsighted? Unable to see something clearly no matter how close you hold it?

(I realize glasses can enable near and intermediate vision -- but it still seems like a huge change.)
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233488_tn?1310696703
CathyJM   You are way off in your understanding of what monofocal IOL vision will be like after surgery. Eye MD surgeons NEVER try to leave their patients farsighted after surgery since then no distance is clear without glasses. We try and leave someone either "plano" (not needing any glasses for distances greater than 20 feet) or slightly or moderately nearsighted so that without glasses they will have good reading vision or intermediate vision (computer/shop).

You can discuss with your surgeon whether you would rather your distant or near vision to be clear without glasses. With glasses generally both eyes see well at all distances (progressive bifocals).

Not to worry. Discuss this with your surgeon WELL before the day before the surgery.

JCH III MD
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Avatar_f_tn
It was really quite a thrill for me to be able to drive without glasses or contacts for the first time.  Before surgery, I was so nearsighted that I could not easily find my car without corrective lenses.
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233488_tn?1310696703
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Avatar_n_tn
So -- you can drive without glasses now, after cataract surgery with monofocal lenses set at "plano" for distance vision at 20 feet and further? I was thinking I'd still need progressive lenses to drive, so as to see the dashboard dials.
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233488_tn?1310696703
What some people and surgeons do is set one eye "plano" for distances of > 20 ft and the other eye at -1.50  The near sighted eye can see nicely for shopping, dashboard, computer and in bright light can usually read high contrast printing.

OR if someone wishes to emphasize their near vision they can leave one eye -2.50 to -2.75 and that eye will read beautifully even small print and the other eye -1.00 to -1.25 for intermediate vision. Glasses are worn for distance.

Since I have been near-sighted all my life and greatly enjoy reading and doing computer without glasses, if I were having cataract surgery this latter is what I would ask my surgery  to shoot for with aspheric monofocal IOLs.

JCH III MD
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Avatar_f_tn
Cathy, I don't want you to be misled into thinking that correcting myopia with cataract surgery yields exact results.  IOL power is determined by plugging your eye measurements into complex formulas.  It is not an exact science, and no doctor can guarantee that your outcome will be exactly the same as your target (although it will probably be very close.).  If you are having limbal relaxing incisions at the time of surgery to correct astigmatism (like I did), that further complicates the calculations.  My surgical target was very mild myopia, and my eyes ended up plano with minimal astigmatism (and 20/20).  Maybe my Corolla has big dashboard dials, but I can see them fine without correction.  I do need correction for comfortable near and computer vision.  I wanted both my eyes to have the same vision, but if you targeted the type of "blended" vision described above, chances are very good that you wouldn't need readers for the computer, most menus, etc.  (You'd would probably need them, though, for reading small print in the newspaper, magazines, or books.)  
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978323_tn?1248350845
I am having much difficulty seeing close or far. I had two lasik procedures done about six yrs ago for extreme myopic. Apparently it is difficult to calculate for IOL after cataract removal? I am now scheduled for Yag on both eyes next week; the week after I am scheduled for Epi Lasek on both eyes. My IOLs are Restor HD. Several months ago I had a bleeding optic nerve the specialist monitored it and when ready gave go ahead for the cataract surgery. Also, I am in the very early stages of macular degeneration (dry). I am 56 year old female. Should I seek another opinion? Surgeon said I am not 'normal' but I am definitely 'fixable'. thanks for any advice, jackie
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Avatar_m_tn
I was a near sighted individual for 79 years.  I had cataract surgery about one year ago and I found that I was now farsighted which I did not and do not like but I have become accustomed to it.  The doctor who did the surgery did not tell me I would become far sighted.  I have since been told that I had a choicd which was not offered to me.  I'm stuck with it now.
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Avatar_f_tn
Your comment here is that the -1.50 eye is good for shopping, dashboard, computer and reading in good lighting.  I am happy to report that this is now true for me after but only after a vitrectomy (4 weeks ago) --- before that I needed readers for all of that because of distortion and blur.  Now the white spots that obliterated parts of letters and words are gone, as well as the vaseline like floaters, and I only need my readers for tiny print.  Although the
-1.50 was a not the intended target for the crystalens, I am happy as a clam! All the steps I have taken are due to the good advice seen here.  I am so thankful for you and the other doctors who contribute their time and are willing to make suggestions without an examination and without cost. Many thanks to you and all of the good people here who contribute to helping one another!

To CathyJM - I am sorry to hear that things were not explained to you as far as your options. You are definitely not alone in this. I certainly did not understand fully before I made my own decision; then I found this website, after the fact. Hope you can get some answers here.  All the best!
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Avatar_f_tn
What distance will the -1.00 to -1.25 intermediate (suggested above) give one in feet to see clearly?
I would like to clearly see atleast 10 feet out.  Would I need -.5 or -1.00 or what?
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Avatar_f_tn
I am farsighted now after cataract surgery.  I guess the surgeon missed the mark.  I am +1.75    and trying to decide if the same Dr should do my other eye.  I am so upset about this.  I went from being able to at least see up close, to being able to see nothing in focus.
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1932338_tn?1349223998
In my opinion, your Dr. missed the mark pretty far.  I would ask if there were extenuating circumstances or just how that happened.  From what I've read, the average amount a Cataract surgeon misses is about .25 Dioptor.
Personally, I would get at least one other opinion before making this huge decision .
Best of luck.
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Avatar_f_tn
He says it is due to my previous lasik and prk touch up.  What do you think?
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Avatar_m_tn
Can't you get that eye corrected with glasses?
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Avatar_f_tn
I don't know why the eye ended up at +2.  That's my concern.  How could that happen?  I had a piggyback lens implant and all is well now. However....why??? did the first lens end up at +2   The day after surgery it was close to 20/20  and then the next day it was far sighted.  Which is a miserable thing. I wonder if the lens shifted a bit.  Is that possible?
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Avatar_m_tn
Did you end up having a procedure to correct this? I've had both eyes done - with multifocal lens - and I started out barely nearsighted - but wanted to be able to read and see up close work more clearly - I can read (slightly fuzzy) but if anything is 3' away, it;s blurry! I can see distance about the same as before surgery - which was okay.
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