Standard implant set to near?

[rhs55]

I am -9.0 in both eyes with a cataract in the right eye. I wear progressive lens to correct far, intermediate and near vision. Do you recommend standard IOL in catarct eye set to -9.0 and continue using progressive lens glasses and thereby avoid imbalance between the corrected and uncorrected eyes?

[rhs55]

I will have monofocal implant distance bias 0.5 and the other eye done two weeks later. What is best way to manage imbalance in the interim in order to read and/or drive? Eye patch, contact lens on non-operative eye. Progressive or distance? Do nothing? Thank you for your answer.

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

I will not make a recommendation for you.  This subject is discussed scores of times and at great length previously. You can access all these discussions with the search feature and archives. Most popular are distance bias Plano OU and plan on wearing progressive bifocals mini-monofocal plano/-1.25 distance bias, -1.00 and -2.50  mini monofocal near bias,  plano and -2.25 monofocal (hard for many to adjust to), and -2.50  near focus.  Everyone will have a different preference. If I were having cataract surgery i would pick mini-monofocal near bias but that's just because for most of my life I'm used to reading and using the computer without glasses. My refractive error spherical equivalent is -2.25

JCH MD

[rhs55]

Thank you. What would you recommend if both eyes were done? Plano for both?

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

No you will not be able to wear progressive bifocals or any other type with 0.00 to -2.25 in the operative eye and a -9.0 in the unoperated. You would need lasik or contact and glasses on non opeated eye (and still likely to have problems).

Again I would never ever leave a person -9.0    Get a couple of opinions from at least one or two more surgeons.  I would plan on leaving the operative eye somewear between 0.0 and -2.50 after surgery and do something to reduce the unoperated eye to nearly the same levels.

JCH MD

[rhs55]

Thank you for your response and referral to archives, which I have perused. I understand your recommendation and most likely will follow it. I have one further question, however, about post operation strategy: I have been satisfactorily been using progressive lens glasses for near, intermediate, and far distances. The cataract hinders only the far vision. If the IOL were set to the existing eye refraction, would I be able to continue wearing the progressive lens glasses satisfactorily on both eyes? If both eyes received IOLs set to far, would I need progressive glasses, line bi-focals, or half glasses? If both eyes were set to near, what glasses would work? Thanks for answering.