IOLs for near-focus vision?

[flageyes]

I am scheduled to have lens replacements in both eyes and have decided on monofocus lenses.  My surgeon mentioned two options: (1) distant-focus lenses in both eyes (plus reading glasses) or (2) distant-focus in my dominant eye and near-focus in my other eye.  My question is whether having near-focus lenses in both eyes (plus glasses for distance vision) is another viable option?  I have been near-sighted for 56 years and am very used to wearing glasses.  Initially, I needed glasses only for distance vision, but now I have graduated lenses in my glasses for distance, mid, and near vision).  Therefore, it would seem that having near-focus lenses in both eyes and wearing glasses for distance and mid-distance vision would be less of an adjustment than either of the two options mentioned by my surgeon.  What are the disadvantages of having near-focus lenses placed in both my eyes?

[flageyes]

Thank you very much for your comments.  Using contact lenses, I experimented with all three options listed in my original post (i.e., distant-focus in both eyes, distant-focus in one eye and near-focus in the other, and near-focus in both eyes).  I learned that getting the correct focus for reading was indeed a bit tricky and that small differences prevented me from reading well (londonbridge, thank you for raising this issue).  I also learned that my near vision wasn't as bad as expected with two distant-focus contacts (and vice-versa), because I could read the dashboard when driving, select most grocery store items off shelves, etc.  Recently, I chose to have a distant-focus lens implanted in my dominant eye (and will experiment again with monovision and mini-monovision before deciding on my second implant).  I am happy with my decision not to have two near-focus implants and strongly suggest others use contacts when deciding among these choices for implants.

[bbuzz]

My brother just had cataract surgery with near IOL vision in both eyes..  He had hoped by having two near vision lenses implanted, all he would have to have would be distance glasses and would be able to read without glasses.  This has not been the case.  He can't see to read with the new IOL lenses and of course, he can't see distance at all.  He has not been fitted for distant glasses yet because his eyes have not settled down from the surgery.  He is miserable at this point because after 3 months he is not able to drive or read.  Personally I would rather be able to see at a distance and then wear glasses to read or have monovision IOL.  Be sure to give this a lot of thought.  Good luck.  bbuzz

[londonbridge]

I am a fellow myope. -8.0 in both eyes with slight astigmatism. I had been wearing progressive bifocals for about 10 years successfully. Here is what I did. At the present time the cataract in my dominant eye is mild. I wear a distance contact in that eye. When I need surgery I will choose an IOL set for distance. When I take the lens out, I have great up close vision. I chose a monofocal ACrySof torric lens in my nondominant eye set for intermediate vision. This is essentially blended vision. It gives me a good range of vision for most tasks driving, using the computer, cooking, seeing items on grocery shelfs. I do need glasses for reading. I do not have trouble with my eyes being slightly different in focal length. It is not the same as true monovision with one eye set for close up and one for distance.
Many people who are myopic and go with straight distance vision find they are not used to loosing their up close vision. Going with lenses set at about -.25 for distance and -1.25 for intermediate gives you a lot of freedom. Keep in mind that cataract surgery is not an exact science and your result may vary by .50 to 1.00 diopters but should come close to your target with an experienced surgeon. Good luck.

[flageyes]

I just received confirmation that an IOL Master was used.

[Ray T Oyakawa, MD]

It should be close to target.  Is your doctor using an IOL Master.

[ace399]

I've also been myopic all my life (and it is a joy to read close up without glasses at all).  I could not get used to bi-focals, so I opted for two pairs of glasses - one far and one near/computer.  I'm 62 and have lived with this for ~7 years.  I feel that with the newer technologies available today, it seems reasonable to see if you can have something better.  Why not try and find a combination that will minimize the use of eyeglasses?

Sure it's a risk, but there are also many people who are very very happy.

[flageyes]

Thank you Dr. Oyakawa, but are there any disadvantages to having both eyes set for near?  My surgeon mentioned that the lenses selected for my eyes could turn out to be slightly off and that any error would be more impactive if I had two near-focus lenses and less impactive if I had two distant-focus lenses.  Your thoughts on this?

[Ray T Oyakawa, MD]

Yes, you can have both eyes set for near.

Dr. O.