Before I contact Doc again I wanted to clarify my understanding. In the context of Mini Monovision... Q1- For the eye set to far, am I correct in understanding that in general it is better to be under corrected than over corrected. So for example -.2 is better than +.2? Q2- If Plano in the far eye means perfect sharp vision to infinity. Like mountains and moon? What will -.2 or -.5 mean? Your sharp point moves from infinity to bit closer? How much closer? Moon and mountains will appear slightly blurry, completely blurry? I can't wrap my head around this fully. I have +1 reading glasses that I rarely use, so if I look far wearing them then something like that is what my wife will see if it overshoots to +.5 (ok half that blurriness as my reader are +1 and not +.5)? Q3- Dr Zeiss's recommendation of -.2 with -1.4 for example is superior to Dr Rockstars Plano and -1 recommendation, as it wins you more near and intermediated vision sacrificing really far vision. Correct? Specially if Dr. Rockstar plano ends up overshooting in the + direction after healing. That is wasted range, correct? Let us say if it overshoots by .5 after healing, then in Dr Zeiss's case it will still end up being +.3! However in Dr Rockstar's case it will end up being +.5!!!!!! Q4- What about if for far eye we aim for -.5 and it undershoots by .5, then it ends up being .-1 in the far eye!!!!! What does one see in distance if they have -1? Basically what I see with +1 readers? Q5- If I remember correctly. Dr Zeiss said the Zeiss lense's come is steps of .5. I think Sok's mentioned in one thread IOLs' come in steps of .3? Dr Rockstar did not mention the steps but he said that he can use Zeiss or Hoya. He said though that the Hoya's steps brings it more closer to plano than Zeiss's one. I assume their starting number are different even if they are both in .5 or whatever increments. Q6- If Dr Zeiss's recommendation of -.2 and -1.4 is taken (difference of 1.2 Diopter between the 2 eyes). Then if it overshoots .5 in opposite direction in each eye, then it could end up being a difference of 2.4 Diopter!!!! Although that will be taken into account when operating on the 2nd eye. Although Dr Zeiss even wanted to operate on both eyes together! As Sue said that shows why never to operate on both eyes at the same time. Jeez!!! :-)
Heading out for a walk but off top of my head:
Q1 in my opinion yes undershoot plano target better than overshoot (wasted distance vision and sacrificed intermediate near vision) IOLs come in .50 diopters (wush they came in .25 like glasses or contact lenses) so take that into account along with healing and settling of IOL which can put you +|- .25.
Ask Dr Rockstar what his def of targeting plano - many tell you that is the target but they take into account the above in their calculations (complicated calculations that are often above patient’s understanding). Except patients like us who dig deeper before surgery - lol.
Q2 plano is seeing 20/20. Yes some may think seeing better than that is terrific but again it’s not as useful in everyday life and with IOLs you sacrifice more useful intermediate/near vision depending on IOL chosen.
Off for my evening walk. Will check in later
I think surgeons do things a little bit different, because they learn what works for them.
Lenses works a little bit different, some will have higher risk of shooting to high, some have higher risk of shooting too low, some will tolerate a specific refractive error better than others, this is something the surgeon knows, and he will choose lens and targets according to this and his experience.
Also, different eyes will move the power slightly up or down with the surgery, it depends on different factors, one of them how deep the iol settles in the eye.
Again the surgeon will take this into account, and make his best estimation based on his experience.
So I really think when it comes to lens calculation, you need to tell the surgeon your wishes for the outcome, and let him decide the rest, he have done it thousands of times before.
Even the most experienced surgeons with the best equipment gets refractive surprises from time to time, but he will have the experience to minimize the risk accordingly, we amateurs would only be doing wild guessing based on help from google.
You can not compare the diopters and outcome of vision to your own vision with glasses.
Iol diopters and glasses diopters are not quite the same, and your eyes still have accommodation, maybe not as much as it have had before, but it still have a lot.
When you have lens implant, you will have 100% presbyopia as part of the surgery, there is no accommodation left in the eye at all.
But some have a more adaptive brains than others, so some have still a little bit accommodation in the brain, and they will have a wider vision range than others with the same lens, that is why the eye doctor can/will not tell you much about the outcome in advance.
Off course all this is only my opinion, I wish your wife the best of luck.
- correct. with +correction you are wasting the near.
- google “billauer blur” and use the simulator to simulate -0.2 and -0.5. infinity to how much closer is difficult to predict. can be 4feet to 3 feet for monofocal or some people get great near with the monofocal like seeherenow.
- use a +1 on a normal eye and what you see will be what you end up with -1 for distance. it is difficult to simulate where you will end up with for near vision.
- the lens model come in 0.5D but the correction they provide is for approximately 0.35 diopter. see my iol master readings in the pictures to understand. it will be different for different people. for me for technis zcb00 for right eye plano is 16D which gives me -0.25. for left eye plano is 16.5D which is the Symfony i got and gives me -0.20. if i want -0.55 in the left eye i will need 17D lens.
- it is possible but highly unlikely.
u r asking very good questions.
Reply waiting to be moderated - I don´t understand this forum…
There are many factors involved in choosing targets, i really don´t think any of us is qualified to do this.
Different lenses, different eyes, different expectations.
I really think you need to tell the surgeon what outcome you wish for, and let him decide the rest, he have done this thousands of times before.
A monofocal lens can cover one of the three zones, far, intermediate and near.
You have two eyes, you can only cover two zones fully with monofocals in both eyes.
Most people choose to cover far and intermediate, and use readers for near, because this is the setup that makes you able to go out and do stuff without wearing glasses for either far or midrange.
But you can sacrifice a little far to get a little more near, you take some from one zone and move a little into another zone, in all cases I think it is matter of telling the surgeon what is most important, what hobbies/job is important to you, how you live your life.
No matter where the focal points ends up, you can always move the focal points to where you want them, with glasses or contact lenses.
As an example you can move both focal points to near, and have optimal reading vision with both eyes at the same time, if you wish.
And how vision turns out, how well you can see, is very different from person to person, the surgeon can only try to hit the targets, and time will tell how much each individual person can see.
I think all big players in the field makes good monofocals, the surgeon will choose the one he feels comfortable with in the given situation for the specific surgery, which I think always will be better, than us amateurs guessing 
Even though I would also stay away from the 3 piece stuff…
I wish your wife the best of luck!
my #4=5
and
#5=6
On ur #4: for distance use the simulator and see how -1 will show for distance. how much near -1 will get you is difficult to predict. settings iol’s for near is a bit tricky.
my #4=5
and
#5=6
On ur #4: for distance use the simulator and see how -1 will show for distance. how much near -1 will get you is difficult to predict. settings iol’s for near is a bit tricky.
more explanation: for my right eye for technis ZCB00 IOL:
+16.5 IOL would give me -0.60D vision which mean I will need -0.6D glasses for distance. But my near will be a little better.
+16 IOL would give me -0.25D vision which mean I will need -0.25D glasses for distance. The doctor will choose this for plano as my next reading is +0.09 which will waste diopter. At this reading with 0.25 overshoot or undershoot I will end up with 0 (plano) or -0.5D.
+15.5 IOL would give me +0.09D vision which mean I will need no “sphere” glasses for distance. But my near will be worse than if I went with +16. I may still need distance glasses for any astigmatism (also called cylinder).
See at the end in the picture that Emmetropia which means plano is +15.63 which means I need a +15.63 IOL to give me plano but there is no such IOL made by Technis so I go with the closest option.
(wish they came in .25 like glasses or contact lenses)
I think it has to do with current manufacturing limitations.
technis ZCB00 IOL
Your IOL-
“360° square edge for uninterrupted contact at the haptic-optic junction
Frosted edge designed to minimize unwanted edge glare”
In your case, did not help though,correct?
my iol is symfony NON- toric which is zxr00. my exact iol in left eye is zxr00 16.5D. if you are using tecnis iols they will use the zeiss iol master readings for zcb00. but yes zxr00 is frosted edge and does not help with the glare.
the iol comes with the card which is given to the patient by the doctor’s office. if medical records were unavailable, you still know what went in.
if that 6mm was 7mm, i would be a happy camper.
One would think this issue would have been addressed and 7mm ones would be available.
I am not going for mini/mono but maybe you could call it micro-mono. Dr is targeting -.4 in nondominant eye. If I end up closer to plano then I will target dominant eye slightly myopic. I think my first surgeon targeted plano and I ended up .5 farsighted. In his defense, I did not request that I’d rather he err on the myopic side. I just assumed he would. I would not want to operate on both eyes at the same time. You can adjust the second one if necessary.
if that 6mm was 7mm, i would be a happy camper.
I got copy of all the readings from Dr Zeiss visit. Hard to understand all these numbers. Anyway I see…
Right pupil size- 5.94mm
Left pupil size- 6.26mm!!!
The normal pupil size in adults varies from 2 to 4 mm in diameter in bright light to 4 to 8 mm in the dark.
my very first report says pupil size 5mm in dim light. it also says artificial pupil size 7mm. i dont know what artificial pupil size means. are your numbers from zeiss machines?
i went and checked after you mentioned this. second report has no mention of pupil size. i will check report 3 and 4 too.
we may be a smaller population to invest in. i am shocked they wont do anything for the kids. this is what my surgeon said about 7mm iol.
“There is no large optic foldable IOL - that has always been my wish. I would use a different material IOL if we used monofocal - such as the B&L LI61A0 - this lens has the least edge or other glare for a monofocal - but not zero..”
so it seems inserting a foldable 7mm iol could be the deterrant. the BL LI61A0 is the one that Dr. Safran is prefering. also 3 doctors said just wait it out till pupil getting smaller.
janus did mention one iol that is 7mm though.
Are your numbers from zeiss machines?
No, it says TOMEY CORPORATION on that particular sheet.