correcting for "plano" versus "modified-mono" vision

[rsdixon]

To: Ray T Oyakawa, MD and Michael J Kutryb, MD and any other MD who wishes to advise,

I appreciate the wealth of knowledge shared by the professionals and the patients on this site.

A few questions I have:
Is it possible to have good distance vision with the Alcon toric lens when one has modified or mini-monovision -- i.e. if surgical eye is corrected to "plano" and the second eye is corrected to the mini-vision.  Or can one only get good long distance vision (15-20 feet, reading street signs, watching a play) if one has both eyes corrected to "plano" or if a different lens is used -- e.g. one chooses a non-aspheric lens or a more standard lens?

In your experience with the Alcon toric lens (versus other lens options), is achieving a desired target of “plano” for good long distance vision difficult to attain?   If a target of 2 meters is chosen is that close enough to “plano” to give good long distance vision and avoid the risk of “overcorrecting”?   Could a person end up with "good computer vision" when the goal was "good long distance vision" and that patients can end up with varying results as on a bell curve.

If one is considering a IOL explant/exchange on the surgical eye, is it advisable to “redo” the biometric measurements (especially if there was a difference between the 2 eyes).

Would Lasik be more advisable than "lens exchange" to correct the vision to "plano" in the surgical eye?  Assuming the person is a good Lasik candidate.

Thank you for your time and consideration.      Sincerely,   rsdixon      

[rsdixon]

Dr.  Oyakawa,

thank you for the response you left on 9/7/10.  It appears you have erased the response above and left simply the comment, "answered".  Unfortunately, I hadn't fully digested the information -- could you please respond again?  
From what I remember of your response:
You had stated, that you didn't understand my question:  "If a target of 2 meters is chosen is that close enough to “plano” to give good long distance vision and avoid the risk of “overcorrecting”?" By 2 meters I meant approximately 6 feet + some inches -- would the diopter chosen to achieve that distance be the same diopter if one were going for "plano" (which I interpret to be good long distance vision - 15-20 feet out)

And in regards to the the Alcon toric lens specifically, whether it is a more difficult  to achieve a target of "plano" or 0.5 than if one chose to use a standard lens (that doesn't correct for astigmatism).

I did understand your statement about how a surgeon might set a target at 0.25-0.5 (instead of plano 0.0) in order to avoid overcorrection.  And if one were to choose that target what expected range of good sharp vision might be expected.   6 feet, 3 feet, 10 feet?  By sharp vision I mean clear, not blurry -- as if one were corrected to 20/20 with eyeglasses.    

[Ray T Oyakawa, MD]

Answered.