How is your vision after Cataract Surgery?

[orbitnw]

How is your vision after Cataract Surgery?
Please specify whether you got a monofocal or multifocal/accommodative IOL.

I would like to know what distances you are able to see clearly. What distances are slightly blurry, but acceptable, and what distances are just unbearably blurry.

I am particularly interested in those who have received Monofocal IOL set to Distance but I would also really appreciate hearing those experiences with different IOLs. I have heard from several people that with a IOL Set to Distance, they are still able to use the Computer at about 18 inches. This has confused me since I had thought IOL set to distance makes intermediate distance blurry.

Thanks!

[JodieJ]

Both my eyes are at plano with monofocal IOLs.  My distance vision is excellent.  It would be a strain for me to see my monitor without glasses.  Prolonged computer use without glasses would probably give me a headache.  If you set your dominant eye for distance and non-dominant eye for intermediate vision, you would probably be comfortable using the computer without glasses.

I had a cataract in one eye only but I chose to have cataract surgery in both my eyes.  My post-surgery distance vision in the eye without the cataract is at least as good as my best-correct vision was before surgery.  I've never had a problem with my IOLs.

[baggyrinkle]

This past January, I had both eyes done with Acrysoft monofocal IOL's set for distance. I now have 20/20 vision and only need readers for close up reading. Depth of field is excellent from about 20 inches to infinity. I have a large monitor 24" and can sit back in my chair and read it perfectly without glasses. My wife also had hers done last month and needed the Acrosoft toric lens, she had minor astigmatism, set for distance as well. She's a waitress and was concerned about reading the menus and working their computer, but she has no trouble at all without glasses. Like me, she only needs cheap readers for close up work. You can search my previous posting about my experiences. Let me know if you are in Houston. I had mine done at Berkley Eye Center. Good luck.

[LynneAV]

I had only one cataract, received same IOL set for distance as baggyrinkle, I now do not wear glasses at all for the first time since age 18 mos.  Can see to drive better than I ever could with glasses, and do not need glasses to use the computer or read normal sized print.  I use a magnifying glass for extremely small print, same as when I wore prescription progressive lens glasses.

[John C Hagan III, MD, FACS, FAAO]

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[disappointed66]

There are many factors that have to be considered with each individual's eyes. I have both eyes done with Tecnis monofocal lens after having the Restor multifocal explanted from the left eye . I have both eyes set for distance . I was astonished at how good my intermediate and close vision turned out. My vision is excellent.  I can use  the computer and sit back in my chair and read the  15" screen and do just about everything glasses free.  I need glasses for small print.  Like baggyrinkle I use the cheap readers.  I have no problem with driving and my night driving vision is terrific. No starbursts or glare as with the Restor.  I am so pleased with the outcome with these Tecnis lenses.  After having had both, I recommend the monofocal lens.  Tecnis has an informative web site you may want to check out. This site was recommended to me by JodieJ.   Good luck :)
  

[allmymarbles]

I had tentatively planned on getting the Tecnis monofocal set for distance. Your post is much appreciated because it answers my question about how closely one can see clearly. I presume you have the aspheric acetate 1-piece lens. Is that correct? Thanks again.

[JodieJ]

It's not the brand of aspheric monofocal IOL that lets you see up close (or not) when your IOL is set for distance vision--it's your eyes.  Your pupil size can make a difference.  Smaller pupils are supposed to have more depth of focus than larger pupils (like mine).  On the other hand, larger pupils are better able to utilize the benefits of having an aspheric IOL.  (These benefits are explained in the patient education video at www tecnisiol com, and they don't apply to only Tecnis IOLs.)  Another point--conventional IOLs provide better depth of focus (i.e., better near vision when the IOL is set for distance) than aspheric IOLs.  But an aspheric IOL provides better distance vision than a conventional IOL.  (Whether or not these differences are truly meaningful is another question.)  There's a lot of marketing hype put out by the IOL manufacturers.  It's probably best to let your surgeon choose the brand of monofocal IOL.  If s/he has a lot of experience with a particular IOL brand/model, that experience can be factored into the power calculations to get you closer to your targeted refraction.  This will make a meaningful difference.  Having an experienced surgeon is a real advantage.  

[Gowrie]

My Acrysoft monofocal left me at plano for one month. During the next month it went to +1.0. Vision is blurry at all distances. Lenses mostly correct this but also have glare, halos, etc.
Since this is my "good" eye my two doctors say I should live with it. So not a happy camper.

[JodieJ]

"Live with it" translates to: "There is nothing that I know how to do to fix this."  You need to see another doctor--preferably someone with special skills at fixing problems.  You might try calling the ophthalmology department of a major medical center to set up an appointment with a senior faculty member who specializes in cataract surgery.  It might be worth traveling to see a doctor with special skills.

[allmymarbles]

Your comments are very helpful. (By the way I meant to say "acrylic" not "acetate.") I have small pupils and, before presbyopia set in, had no eye problems, not even astigmatism. Both my sister and brother have had excellent results with monofocals set for distance, and my brother mentioned that he does not need glasses for reading. Perhaps, since he had his surgery a few years ago, his lenses are not aspheric.

I certainly will take the advice of the surgeon, but it helps to be a knowledgeable patient. Otherwise I might become enamored of the ReZoom.

[disappointed66]

I have the Tecnis Acrylic IOL. I was at a point where I would have gone back to progressive glasses again as long as the Restor was out!  After discussing with my surgeon just what I wanted achieve with my vision, he recommended the Tecnis for distance. As I stated before, the results were excellent.  I too had healthy eyes and needed glasses because of presbyopia until the cataracts.  Good luck to you.

[sally987]

I have the alcon acrylic toric iols, implanted in both eyes one year ago (August 2009).  They are set for distance w/ slightly different powers.  I can see the tv clearly at 6' away with one eye, yet the other eye is set for about 10'.  I can see great outside, but for most things inside I wear progressive bifocals (clear at the top, 1.25 middle, and 2.50 bottom); this is sooo much easier than having different powered readers all over the house.  I have no problems with night vision or halos or astigmatism and all-in-all am very pleased.  I have tons of floaters (had these before) that I try to ignore.  Have not needed a yag (I'm keeping my fingers crossed on that one).

[taurus1203]

Hi all,
I have the same question as orbitnw has - Can a monofocal IOL see distance object and computer at arm length ?

I am planning to have a cataract surgery on my left eye which has a RD surgery last year. My right eye is -1.75 and has quite a good vision (20/15). My doc expect my left eye to recover to 20/25 or better after the cataract surgery.
I am still making decision of alcon-arcysoft as I had some astigmatism or Crystalens. I just found baggyrinkle mentioned that has both eyes done for plano but his vision can cover from 20" to infinity. This makes me feel that I don't need to take the risk for Crystalens. I wear glass anyway and I have a big monitor as well.
One doc suggested me to have the left eye set at -1.5 to match my right eye. He thinks that if I put a glass near-sighted lens (-1.0), then I can see distance quite well and still have a fair intermediate vision.

Sally: Can you share with me your is the prescription of your IOL ? thanks

[GaryFx]

I think the caveat with all these experiences is YMMV - your mileage may vary.  It's more important to understand the factors that affect depth of field, and to distinguish typical results from best case results.  

[allmymarbles]

Yes, I have decided to go with the Tecnis acrylic monofocal, set for distance. The only thing I have to decide if whether I want the aspheric. From what I have read you get better near vision from the non-aspheric, but better constrast from the aspheric. Which did you chose and why?

[taurus1203]

Hi all,
I am in a similar situation as allmymarbles.
I also read an article mentioned that aspheric lens will have better contrast and quality with some sacrifice of the depth of field. But it also mentioned that a very good quality aspheric lens may have a good balance of both.

As I am going to lose accommodation with the mono-focal, depth of field seems to be important as well.  I just found disappointed66 and baggyrinkle messages that they can drive and read monitor (let say at distance of 25"). It seems mono-focal is not as bad as I thought. I remember both of you are using aspheric lens. Would you mind share some of your comment on the IOL you chose.
Thanks

[sally987]

you know what, my doctor has never done a proper post op refraction, so I do not know exactly what my prescription is (they just gave me the prescription for bifocal readers...I was surprised that you do need a prescription for that even though they are only magnification).  I would like to know my proper prescription so I can make more sense of my vision, depth of field, etc, and when I do find out (perhaps when I go back to my optometrist), I will certainly post the results.  I think what I have is -.75 in one eye and -.50 in the other.  At ball games and outdoor events, I test my eyes by covering one at a time, and the more distant one lets me see more of the fine print on billboards, etc.  But w/ this nice distance vision, I do suppose I am sacrificing the computer range, because I am definitely unable to read the computer w/o my glasses.  No one has ever told me if I have large, medium, or small pupils (I will ask), but if I were to guess, I would say large.  Let us know what you decide and how it turns, because I think all of us find this fascinating and educational (even those of us who have already had our surgeries).  I wish that I had understood more of this before surgery and my doctor had discussed target prescriptions (many docs just seem to ask the patient what their hobbies are and what they do, and then decide what is best for them w/o getting into details). But having said this, I don't know that I would change a thing.

I was really scared about having surgery.  For the toric, an office emplyee was going to be marking my eye in preop.  That made me nervous, and I insisted that the surgeon do it (on the 2nd eye a few weeks later), and he did.  Both turned out fine.

Also, my anesthesia was injected.  Not the drops.  I know that Dr. K. has said that he usually uses the drops.  Again, mine turned out fine.  However, w/ the first, I had a shiner (black eye) the week following surgery.  With the second eye, after I got home and took the patch off 4 hours later as instructed, my eye was pointing off to the side like Marty Feldman, not funny.  It gradually straightened out over the next several hours. I don't think the drops would have this effect.

I have probably said too much here, I don't mean to scare anyone.  I just wish someone had told me about these things, so it wouldn't have been so freaky.  I am totally fine.  Vision is very crisp.  Surgery takes 20 minutes tops.  I highly recommend the toric (my prior astig. prescription was less than -2 for each eye).

[taurus1203]

Sally:
Can you read big or header fonts in the computer with arm length distance like 28" ?
Thanks

[sally987]

I think if both my eyes were the same iol prescription (ie both set at my closer range), then at 28' (that's pretty far from the compu), I would probably being reading the largest font (of the 3 on this forum) okay, not great.

just checked w/ a measuring stick..... I can read it from 34'.  If both eyes were the same, it would be better (because it's better when I cover the eye set to slightly more distance).

allmymarbles:  my contrast sensitivity is great w/ the acrylic aspheric!  I really like this end of the trade-off.  

Bottom Line:  it is so great to be able to make an informed decision.  we know we can't have it all (although it does sound like some of you are coming pretty close!).

  

[taurus1203]

Sally,
Okay that means you can read it at 28' with the eye set to (-.75) and 34' with the eye set to (-0.5).
How big is your monitor ?
Thanks

[sally987]

28 and 34 were supposed to say " inches ( i guess that was obvious~)

when do you think you will have surgery?   I do not want to give any wrong info since I do not know my exact refraction.

Sorry I am very not very clear in my posts.  Actually, the -.75 (or what I think is -.75) was the eye I was using for both 28 and 34 " measurements.  It's just clearer the further back I get.  

Perhaps some of the other posters can weigh in w/ their post surgery refractions.  That would be helpful ~            

My monitor is 15".

[taurus1203]

Sally,
Thanks a lot for your info. I expect to see the surgeon in a month. Hopefully, I can have the surgery in 2 to 3 months.
I think you can read the computer without the glasses if you switch to a 24" monitor.

[enjay59]

I'm having surgery in two days.  Something I never thought to worry about (and trust me, I didn't think I had left anything unpondered) is will my eyes look different to others, aside from the fact I hopefully will not have four eyes post surgery?  In other words, can you see the lens in the eye?  I saw some photos in a cataract flier today and the lens looked creepy.

[baggyrinkle]

While I cant comment on your situation since you had a RD problem. I can testify about my results and later my wife's. She had some astigmatism and went with the Alcon Acrysoft toric IOL set for distance, which corrected her astigmatism perfectly. I have a 24' monitor and can lean back in my chair and read the screen perfectly from about 2'. Close up I use a cheap pair of readers +1.0 power from about 12 inches. Since you are only doing one eye, it may be a problem balancing both eyes. My wife had minor cataract in her right eye and only the beginnings of one in the left eye. She could have waited for the left eye to "ripen", so to speak, but elected to have them both done one week apart.  Since you are only doing one eye, you may need to wear glasses afterwards to match your right eye. How long do you think before the right eye grows a cataract? They all do eventually. Having both eyes done eliminates the need for glasses other than readers. Good results all depend on the experience and skill of your surgeon. Mine does about 40 a week here in Houston.  Based on all the horror stories about premium lenses, ie Crystalens, Restor and Rezoom, I would not take a chance on screwing up my vision. Good luck and keep us posted.