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Which monofocal lens is best (after multi explant)
Can any of the doctors on this forum recommend any particular monofocal lens over another? I am looking at a bilateral explant of the hideous Restor.
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
Your refractive error relates to how nearsighted/farsighted you are. If you want good distance vision, you want to be close to plano (i.e., zero). Something around -1.25 would give you good intermediate vision. Good near vision might be around -2.50.
Hi Thanks for the reply. I have no idea what a refraction error is. I'm thinking that it is just where my distance vision stops. I really do not know much . I assume once I know what the refraction error is in the left eye I will know what to do with the right eye. I will schedule a consultation appointment.
Thanks Jodie.
L
Thanks Jodie.
L
Be sure to get your concerns addressed before your second surgery. Schedule a consultation with your surgeon if you need to. What is your refractive error for your left eye? Make sure that your surgeon is aware of your goals for your post-surgery vision. It's very important that you both are in agreement about the targeted refraction for your right eye.
Hi
Restor I am so happy to hear of the improvement to your vision. I am scheduled for Nov 9th for my right eye. I have the distance technis monofocal in the left eye. (Thank goodness that dreaded Restor is out). I do not think I have the full distance vision. It is more like an intermediate. My surgeon plans on putting another distance in the right eye. I am a little confused. I will have to consult with him on what vision I actually have in the left eye and what he hopes will be accomplished with the right eye done. I am happy with what I have with the left eye. I do not know or understand any of the technical terms and measurements. I never knew there was so much involved. It all stems back to the first surgeon who just jumped on the bandwagon for Restor and did not inform me of any other choices or anything else. Now I am quite apprehensive.I originally started to wear glasses for presbiopia and then needed help with distance. I have been wearing multifocal eyeglasses for years. I also wore monvision contacts. I did okay with them but couldn't keep them in too long. After the left eye surgery I had the lens taken out of my glasses. I need the right eye glass to see full distance and small print reading. I am confused, but at this point seeing everything with the Tecnis left eye and half of glasses on the right eye.I am confused and not as excited about having the other eye done as I was at first. I want crisp clear vision at all distance with or with out glasses. Am I being overly concerned?
Restor I am so happy to hear of the improvement to your vision. I am scheduled for Nov 9th for my right eye. I have the distance technis monofocal in the left eye. (Thank goodness that dreaded Restor is out). I do not think I have the full distance vision. It is more like an intermediate. My surgeon plans on putting another distance in the right eye. I am a little confused. I will have to consult with him on what vision I actually have in the left eye and what he hopes will be accomplished with the right eye done. I am happy with what I have with the left eye. I do not know or understand any of the technical terms and measurements. I never knew there was so much involved. It all stems back to the first surgeon who just jumped on the bandwagon for Restor and did not inform me of any other choices or anything else. Now I am quite apprehensive.I originally started to wear glasses for presbiopia and then needed help with distance. I have been wearing multifocal eyeglasses for years. I also wore monvision contacts. I did okay with them but couldn't keep them in too long. After the left eye surgery I had the lens taken out of my glasses. I need the right eye glass to see full distance and small print reading. I am confused, but at this point seeing everything with the Tecnis left eye and half of glasses on the right eye.I am confused and not as excited about having the other eye done as I was at first. I want crisp clear vision at all distance with or with out glasses. Am I being overly concerned?
Dear All,
I'll make what is probably a concluding post on this thread, for the sake of anyone who comes along and follows it.
It is now nearly three weeks since I had a Tecnis aspheric mono in my left eye, and five weeks since having an AcrysofIQ in my right eye. The Tecnis-eye had complications from earlier Restor surgery whereby vitreous fluid leaked and the eye depressurised, and stitches were required. It was not a happy eye.
All stitches are out of both eyes, and five days after Tecnis-eye has settled down and lost the awful and worrying ghosting, though a small but irritating blur from astigmatism remains right across the whole visual spectrum. This may or may not improve, as apparently I did have a bit of pre-all-surgery astigmatism with the cataract. An earlier mild distance prescription over Tecnis-eye brought acuity almost up to perfection!
Was the bilateral explant worth doing?
Most emphatically yes, given these results. My life and sanity have been returned to me, and my quality of vision is far better than I had dared to hope for. In my opinion, the aspheric monofocals *in skilled hands* represent the best current technology can offer. There is no tommyrot about long periods of "adaption" that may never occur, just (potentially) good clear distortion-free vision from the time of surgery. Night-time abberations are negligible compared with the dreadful multifocals. Quality of life (ability to return to work and normal pursuits) is wonderful. Most importantly, clarity and crispness of vision is as unimpaired as it could possibly be - at the expense of some glasses dependency which most people experience anyway! Why anyone would want a multifocal lens in their heads is quite beyond me.
However, things could have turned out much worse, and I think it is awful the way patients who fall prey to lens-touting are placed in this quandary to begin with.
Double-distance rig starring Tecnis and AcrysofIQ:
This may be a minority opinion and I'm not knocking the shades of mono/modified-mono vision often used - but I do find my double-distance focal points extremely satisfactory. Distance vision is by far the bulk of our visual spectrum, and I'm a very active person so I find it very intellectually satisfying to have this entire range of vision correct and balanced across both eyes, with the same power of glasses prescription needed in each eye for close/intermediate. (It may also be that I have had particularly good results, so take what follows as an observation, not a promise!). I see perfectly well "across a room", and can distinguish without stress all items on a table, on my desk, people's faces across a table etc. I absolutely need glasses for all print and computer, buttons on remote control, mobile phone, price tags - I needed them for this purpose from my mid forties prior to cataracts, so no surprises there. I can see "the hand in front of my face" quite satisfactorily for practical purposes without glasses - to see every vein and wrinkle clearly, on with the glasses, ditto for "fine" close up distinctions, such as different weaves on cotton fabrics, esp if light is a bit dim. I can read the digital clock upon awakening without glasses. I can see a kitchen benchtop to peel an apple - to see the hairs on the grub in the apple, glasses. I suppose my point is that "one" distance focal point is giving me a much better range of unassisted vision than I had been led to believe possible - surely any decent surgeon should be able to advise what a patient's eyes would most likely support based on their measurements!
My "zone" of glasses dependency is about a foot further than it used to be, and in special situations such as standing in bookshops or DVD shops, I can't quite comfortably make out all the print on spines without standing a bit far back - new glasses not yet prescribed. I have glasses permantly slung around my neck, just as I used to and regard pulling them on and off as required as a small price to pay for the beautiful clarity and quality of my vision. Wearing glasses while stationary - eg reading, or at the computer is a trifle - why sacrifice acuity across the spectrum and night vision for that?
Walking both by day and night has returned to being the pleasure it used to be. The finest outline of leaves on distant trees can be seen without the inherent blur and ghosting of multifocal technology. Strongly contrasting colours no longer have penumbral smudging and bleeding, and as for the absence of nasty halos everywhere, well, don't start me! I used to have mental competions - what annoys me most - is it the halos, the ghosting, or the bleeding of contrast?
My Restor lenses were nearsighted for distance, but even with a distance correction that improved the sharpness, all the other "special effects" continued unabated.
Tecnis/AcrysofIQ
There is a noticeable difference in the colour spectrum between these two lenses as described above. It doesn't make a huge difference to night vision, though I think a slight edge to the Tecnis. I vote for Tecnis-world, though not by a huge margin. Am quite happy to have one of each, and am not sure at this stage which set of visual input dominates with both eyes in use.
Night Vision:
I had been concerned all along about the "dimmer/darker" world of the Restor - well that's about the only thing that hasn't greatly improved. Post-cataract night vision (and dim-light acuity in general) is very definitely worse with *any* of the lenses than it was pre-cataracts just a few years ago. I used to be driven so nuts by moonlight and street lights streaming though my bedroom window that ordinary curtains were inadequate. This is no longer the case, and contrast sensitivity at night has definitely declined. I suspect I had very good night vision without knowing it & can't account for this. Dr thinks the natural lens does a lot that has not been replicated, though results are still very good (not complaining).
It is still early days with a lot of healing and settling down to do - left eye still quite sore, right one less so but not yet there. I hope my saga is of help to others - I'm very happy with my vision now and think aspheric monos are the way to go, especially for people who are very exacting and like things just right. For the technically minded here are my latest measurements - just *look* at those spheres, lol.
Right Left
Sphere -0.12 +0.12
Cylinder -1.25
Axis 157
Add +2.25 +2.25
Regards to all other helpful posters,
Restornomore
I'll make what is probably a concluding post on this thread, for the sake of anyone who comes along and follows it.
It is now nearly three weeks since I had a Tecnis aspheric mono in my left eye, and five weeks since having an AcrysofIQ in my right eye. The Tecnis-eye had complications from earlier Restor surgery whereby vitreous fluid leaked and the eye depressurised, and stitches were required. It was not a happy eye.
All stitches are out of both eyes, and five days after Tecnis-eye has settled down and lost the awful and worrying ghosting, though a small but irritating blur from astigmatism remains right across the whole visual spectrum. This may or may not improve, as apparently I did have a bit of pre-all-surgery astigmatism with the cataract. An earlier mild distance prescription over Tecnis-eye brought acuity almost up to perfection!
Was the bilateral explant worth doing?
Most emphatically yes, given these results. My life and sanity have been returned to me, and my quality of vision is far better than I had dared to hope for. In my opinion, the aspheric monofocals *in skilled hands* represent the best current technology can offer. There is no tommyrot about long periods of "adaption" that may never occur, just (potentially) good clear distortion-free vision from the time of surgery. Night-time abberations are negligible compared with the dreadful multifocals. Quality of life (ability to return to work and normal pursuits) is wonderful. Most importantly, clarity and crispness of vision is as unimpaired as it could possibly be - at the expense of some glasses dependency which most people experience anyway! Why anyone would want a multifocal lens in their heads is quite beyond me.
However, things could have turned out much worse, and I think it is awful the way patients who fall prey to lens-touting are placed in this quandary to begin with.
Double-distance rig starring Tecnis and AcrysofIQ:
This may be a minority opinion and I'm not knocking the shades of mono/modified-mono vision often used - but I do find my double-distance focal points extremely satisfactory. Distance vision is by far the bulk of our visual spectrum, and I'm a very active person so I find it very intellectually satisfying to have this entire range of vision correct and balanced across both eyes, with the same power of glasses prescription needed in each eye for close/intermediate. (It may also be that I have had particularly good results, so take what follows as an observation, not a promise!). I see perfectly well "across a room", and can distinguish without stress all items on a table, on my desk, people's faces across a table etc. I absolutely need glasses for all print and computer, buttons on remote control, mobile phone, price tags - I needed them for this purpose from my mid forties prior to cataracts, so no surprises there. I can see "the hand in front of my face" quite satisfactorily for practical purposes without glasses - to see every vein and wrinkle clearly, on with the glasses, ditto for "fine" close up distinctions, such as different weaves on cotton fabrics, esp if light is a bit dim. I can read the digital clock upon awakening without glasses. I can see a kitchen benchtop to peel an apple - to see the hairs on the grub in the apple, glasses. I suppose my point is that "one" distance focal point is giving me a much better range of unassisted vision than I had been led to believe possible - surely any decent surgeon should be able to advise what a patient's eyes would most likely support based on their measurements!
My "zone" of glasses dependency is about a foot further than it used to be, and in special situations such as standing in bookshops or DVD shops, I can't quite comfortably make out all the print on spines without standing a bit far back - new glasses not yet prescribed. I have glasses permantly slung around my neck, just as I used to and regard pulling them on and off as required as a small price to pay for the beautiful clarity and quality of my vision. Wearing glasses while stationary - eg reading, or at the computer is a trifle - why sacrifice acuity across the spectrum and night vision for that?
Walking both by day and night has returned to being the pleasure it used to be. The finest outline of leaves on distant trees can be seen without the inherent blur and ghosting of multifocal technology. Strongly contrasting colours no longer have penumbral smudging and bleeding, and as for the absence of nasty halos everywhere, well, don't start me! I used to have mental competions - what annoys me most - is it the halos, the ghosting, or the bleeding of contrast?
My Restor lenses were nearsighted for distance, but even with a distance correction that improved the sharpness, all the other "special effects" continued unabated.
Tecnis/AcrysofIQ
There is a noticeable difference in the colour spectrum between these two lenses as described above. It doesn't make a huge difference to night vision, though I think a slight edge to the Tecnis. I vote for Tecnis-world, though not by a huge margin. Am quite happy to have one of each, and am not sure at this stage which set of visual input dominates with both eyes in use.
Night Vision:
I had been concerned all along about the "dimmer/darker" world of the Restor - well that's about the only thing that hasn't greatly improved. Post-cataract night vision (and dim-light acuity in general) is very definitely worse with *any* of the lenses than it was pre-cataracts just a few years ago. I used to be driven so nuts by moonlight and street lights streaming though my bedroom window that ordinary curtains were inadequate. This is no longer the case, and contrast sensitivity at night has definitely declined. I suspect I had very good night vision without knowing it & can't account for this. Dr thinks the natural lens does a lot that has not been replicated, though results are still very good (not complaining).
It is still early days with a lot of healing and settling down to do - left eye still quite sore, right one less so but not yet there. I hope my saga is of help to others - I'm very happy with my vision now and think aspheric monos are the way to go, especially for people who are very exacting and like things just right. For the technically minded here are my latest measurements - just *look* at those spheres, lol.
Right Left
Sphere -0.12 +0.12
Cylinder -1.25
Axis 157
Add +2.25 +2.25
Regards to all other helpful posters,
Restornomore
Dear Restornomore
Again that dreaded Restor is out!. It will probabaly take a while for the vision to clear up. It took me a week. I went to dr. this week. My left techis lens eye is doing well, I can see at 20/30I but eye is still not fully healed and it has been a month. The cornea is swollen and there is an inflamation on the spot where the incision was made The doc said it will heal in time. The good part with me is that it is not in my field of vision
I"m sure yoou tecnics eye will imrove You are on your way without the Restor!.
Keep in touch.
Again that dreaded Restor is out!. It will probabaly take a while for the vision to clear up. It took me a week. I went to dr. this week. My left techis lens eye is doing well, I can see at 20/30I but eye is still not fully healed and it has been a month. The cornea is swollen and there is an inflamation on the spot where the incision was made The doc said it will heal in time. The good part with me is that it is not in my field of vision
I"m sure yoou tecnics eye will imrove You are on your way without the Restor!.
Keep in touch.
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