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How much to expect for IOL for highly myopic "lazy eye"

I am scheduled for cataract surgery on Monday (two days from now) and do not have a way to talk my surgeon until Monday morning.  So, here is an attempt to get some more information before then.  
I am 68, in very good health, at the beginning of "retirement" and need to be able to drive and read (a lot) and work at my computer. The cataract in the left eye is pretty bothersome, the right eye might need its cataract removed for years yet.
I have fairly severe myopia with astigmatism and the two eyes are quite different.  I first began wearing glasses about age 12, and was unaware before then that I needed glasses.  For many years, at least 20 years, I have been aware that optometrists were undercorrecting my left eye in glasses prescriptions because of the large difference in image size when the left eye (about -11 something) was (more?) fully corrected. The right eye glasses Rx is about -9 something (maybe -8.75). In the last 10 or 15 years, the term "lazy eye" has been used for the left eye.  I can see to read without glasses with the right eye at about 5.5 - 6 inches from the eye, and about 3.5 inches from the left eye.  The two images differ in size and in line breadth (darker and larger with the left eye.)
The surgeon's choice of IOL for the left eye is monofocal, and he expects only about 20/60 to 20/80 correction after implanation for the left eye.  That seems like very little help to me, and will leave a large difference between the eyes with a contact lens for the right eye, and eventually a toric lense IOL for the right eye that will attempt 20/20 distance vision for that eye.  Does the ability to read with the left eye mean that my optical cortex is capable of supporting a better correction than proposed?
Given that I can read (at all) with left eye, should I be able to get better correction than 20/60 to 20/80 (If so, how)?  What might I expect for reading ability in the left eye after the proposed IOL?
And I was hoping to be able to resolve some of my issues with poor depth perception/uncertainty about how far things are from me (sidewalks, steps, knives, objects I am trying pick up, paper I am trying to cut, etc.)  Seems like those won't get better and might even get worse?  I'm considering delaying the surgery (at the last minute) to give myself some more time to explore the possible results of IOLs with contacts.  How much would I learn from doing that?
Toric lens.  The surgeon says I am a good candidate for a toric lens (both eyes), but he anticipates such a low amount of correction for the left eye that his final chart note says it would not help me in that eye.  Glare has been a problem for me in the complex glasses I have worn for years, so I have always paid for premium anti-glare coatings, as well the thinnest plastic possible multi-focal lenses, and "adds" to help focus for reading and computer use.
To recap: 1. Could the correction for my left eye be better than the surgeon expects, and how? 2. Would a toric lens for the left eye likely help, or maybe even hinder? 3. Is experimentation with contact lenses worth delaying the surgery, or is there nothing more to be gained? 4. I'm thinking I may need both contacts and progressive or bifocal glasses even after IOLs and wondering if resolution between the two eyes will actually be better, or even more difficult than it is now. (One can always put on a pair of glasses and take them off, but contacts are much more fuss and need clean conditions for placement and removal, and cannot come out willy-nilly.)  

I have tried the first attempt with a soft contact for the right eye (-8.25, I believe), intended to be for after surgery on the left eye.  It was too strong and a second, with less correction (-7.5, toric) is on order and will not be available to try until after the surgery (unless I balk and delay the surgery.)
3 Responses
177275 tn?1511758844
This is a generalization. Cataract surgery is elective. It can always be rescheduled or postponed. This forum is full of people that rushed into cataract IOL surgery not understanding things like risks, costs, IOL types.  It is not good to be scheduled for cataract surgery on Monday and be trolling the internet on Saturday night looking for information that you and your surgeon should have discussed in great detail.

The article that I wrote (see link and also its on the bottom of this page under Today's Pulse click on the blue dots) was written to try and help people understand all the variables. The discussion indicates that many people wish they had taken more time to consider their options. Consider postponing your surgery until you have your questions answered and you have a better understanding of the options.

LINK"  http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

Avatar universal
I appreciate the general comment and have cancelled the surgery for today and intend to talk more with the surgeon and the optometrist, and hope that more contact lens trials will help me decide whether the acuity I will have is enough to risk surgery, and whether the then difference  between the eyes will be tolerable.

It seems likely that the IOL Rx will not change after all that, but I may feel more ready to take on the next set of visual challenges, and know more about what they are likely to be.

I would appeciate more answers to the questions I posed, from your breadth of experience. In particular, I am interested in the degree and nature of visual deficit for from the left eye, and how much correction is achievable.  
177275 tn?1511758844
It is very difficult to predict how well an amblyopic eye will see after a cataract is removed and it varies. Sometimes the improvement can be quite striking 4 lines or more. The rest of your questions to the best of my ability to answer are included in my article and in the discussions that follow. You might want to get 2 or 3 opinions from different surgeons.

JCH MD
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177275 tn?1511758844
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