shall I remain shortsighted after cataract surgery?

[timmie]

I am shortsighted but have a very bad cataract in my left  eye so I can no longer read with the it and can only see poorly for distance. My right eye also has a mild catract but I can see well with it. I am going for surgery soon and wonder if I should go for near perfect vision in my cataract eye? But this will mean I will need to have an operation on my good, right  eye. My vision in both eyes is  - 5.5. and no astimatism. I am scared of having the operation and feel I should leave the relatively good eye alone for the time being. I tried contact lens in my good eye and found that reading glasses (+3) when wearing the contact lens were not all that wonderful compared to my naked eye. Please can you tell me what shortsighted lens I should go for in my left eye so I can still read without glasses and also do not need to get my right eye operated on for sometime. Also when I finally do need to get my right eye operated on, can I then have it done to near perfect vision so I can have mono vision?

[timmie]

Many thanks for your very helpful reply. I was told that getting the right lens is not an exact science and I may end up with a replacement lens that is quite far out from what I want.  To allow for this possibility, shall I still go for a target of -2.00 so that I can still cope without an operation on my relatively good eye and yet have monovision when the time comes for my good eye to be operated on. My good eye (which is -5.5) is my dominant eye. I understand that very mature catracts are harder to operate and also I have unusually small eyes. Will these (and my shortsightedness) increase the risk of the operation? Thanks again.

[Michael J Kutryb, MD]

Ok so  you are minus 5.5 in each eye but only need cataract surgery in one eye for now.  This is not unuusal at all.  If you were my patient I would consider making the first cataract surgery eye around -2.00 and leave the other eye at -5.5 until it needs cataract surgery.  Then with second eye cataract surgery go for about plano as close as possible to try to get excellent distance vision.  In the end would have one eye about -2.00 and other about plano (zero prescription for distance but blurred up close.)  There is one thing to note - I usually like the non-dominant eye to be the near vision eye (about -2.00) and the dominant eye to be the better distance eye.  SO - talk about this with your surgeon.  This is just one example one result to shoot for.  You could also make first eye near plano and then you would have to get cataract surgery on second eye because of the imbalance (anisometropia) and you could make second eye near plano also or anywhere from -0.75 to -2.50.  Again your personal surgeon is your best source here to help you make decisions.

MJK MD