mini-mono vs plano cataract surgery

[flame1234]

I had a multifocal lens implanted in my left eye in August 2011.  While the clarity of vision with it is pretty good, the halos and glares from it make it untenable.  My surgeon assured me at the time that he could remove it up to a year later if it didn't work out, which it hasn't.   He is considered the best surgeon for cataracts in my city of 1 million people.

We are experimenting with mini-mono contacts at +.5 for the left eye and minus 2.0 for the right.  The right eye has an astigmatic lens; the left eye was corrected for astigmatism with limbal relaxing incisions at the time of the cataract surgery, as will be the right eye.  

I find the disparity between the two lenses to be a little offputting, but possibly wouldn't if I could see clearly out of my right eye and didn't have the glare in my left eye.  Every time I'm in the doctor's office, the vision looks clear according to the charts.  But in "real life" experience, my vision is best at about 18" to 2.5 feet, ie computer screen.   I can't read, for example, the "TV guide" station on my 37" flat screen tv which is about 12 feet from where I sit.  I have a very hard time with street signs until I'm pretty much on top of them.   And that's the same if I cover up my left eye, so it's not about the two "working together" but is about the correction.

My doctor says that the contacts will not give me the same vision as post surgery and are just to see if I can deal with mini-mono.  

So, two questions:
~ SHOULD the contacts be giving me an accurate representation of what my vision would be like post-surgery (sans the glare/halos, of course) but with sharp distance vision?
~ How does this differ from plano for distance?   Although I've always been nearsighted, I don't mind readers but would prefer to have intermediate and distance be sharp -- as long as I can read a little with good light.

Thanks in advance!
Kathy

[flame1234]

Thank you for your reply!  I just got more info from my surgeon, so here's where we're at:

In August 2011, I  had limbal relaxing incision done and a multifocal lens implanted in my left eye.

While the clarity of vision with it is pretty good, the halos and glares from it make it truly untenable.  My surgeon assured me at the time that he could remove it up to a year later if it didn't work out, which it hasn't.  

So, his plan is to give me mini-monovision.  I've tried mini-mono with contacts and seem to do okay.  He plans to explant the multfocal lens in my left eye, a Tecnis Multifocal, and exchange it with an Alcon Toric Astigmatism lens to deal with the slight astigmatism remaining in that eye post limbal relaxing incisions.  The left eye prescription will be -1.75 to give me some nearsightedness.

His plan for the right eye is to use an Alcon toric astigmatic lens implant for distance at plano.

My goal is to have as crisp vision as possible with as little glare as possible.  Don't know if it makes a difference, but I'm a red-haired, green-eyed woman whose always had some (not huge) sensitivity to light.  Also, I have moderate-to-very dry eye.  

I don't mind the idea of readers as long as I can read a little with good light if the font's not tiny. My preference would be to have intermediate and distance be sharp.

So, here are my questions:

~ Is this a  true mini-monovision corrective package?
~ Would you say these are the best lens choices to achieve crisp vision with as little glare as possible?
~What do you see as the pros and cons re: having  the astigmatic lens in my right eye or having limbal relaxing incisions in that eye also?
~ Any other thoughts or questions I should be asking would also be much appreciated!

Thanks in advance!
Kathy

[Ray T Oyakawa, MD]

a -2 in the reading eyes is NOT mini-monovision.  This is a full reading correction.

Use the search function and get a second opinion.


Dr. O.