Monofocal IOLs set for distance or micro-monovision, and progressive contacts?

Eye care
1

Hello everyone,

I'm in my early 30s with rapidly progressing PSC cataracts and am going under the knife soon. Been doing lots of research as the lenses will have to last me a long time under all kinds of conditions. Before the cataracts I've been myopic and wore either glasses or contacts for my vision with correction for astigmatism. Did not have inconvenience dealing with contacts. Only drawback was that if I was in the water, I wouldn't wear any vision correction, and beach or water parks were really not my favorite.

Now that I have the possibility of correcting my vision, I'm trying to get the best of all worlds. I do want night vision, I do want computer work and reading. I'm really not sold on the multifocal lenses given their side effects and rate of explantations. I am open to wearing progressive glasses or contacts to correct for near and intermediate. I'm not finding many reviews on wearing progressive contact lenses in eyes with bilateral monofocal IOLs set for distance. Does this option offer good intermediate and near vision without the need to take out the contacts during the day?

What about having micro-monovision with dominant eye set for distance and non-dominant eye set for intermediate? This would necessitate wearing very different contact lenses, with dominant one trying to correct for intermediate and near, and the other one for near only? I wonder if that is even possible for some optic reason.

It seemed like the ideal option would be Panoptix Toric done in Europe or Mexico,but would rather go the most natural way I can without side effects and much neuroadaptation. I know micro-mono would necessitate some but probably would not have to deal with "sweet spots" and acuity fall-offs. Crystalens seemed good but having them done at my age, I am certain to have them fibrose at some point and turn into monofocals.

Frankly, I don't have much knowledge on progressive glasses or contacts. I know there's that "sweet spot" for head tilt with the glasses, but how does it work with contacts?

Thank you in advance.

2

Being used to monovision, initially with the contact lenses and then with the IOLs, I am partial to going with the monovision route with the monofocal lenses. I will suggest aiming the dominant eye for about -0.25D and the non-dominant eye for either -1.25D or -1.50D. This should provide you good vision at the intermediate distances as well as far distance, needing glasses only for reading fine print. This will be essentially mini-monovision, which is easier to adjust to than monovision for people (although it took me less than 5 minutes to adjust to monovision)

3

Thank you. Is it possible to wear progressives on top to be completely spectacle free?

And what's exactly fine print? 12pt printed document or ingredients label on a candy bar?

4

I tried progressive contact lenses many years back , but did not like them. Am sure the technology has got better over the years. So, may be, the newer ones are easier to work with.

I was thinking of fine print like point 6 (commonly used in newspapers or books) at about 16 to 18 inches from the eyes, when I mentioned that you may need glasses for reading that. If one has good vision at arms length (about 2 feet away) , one can easily read 12 point material by holding it 2 feet away.

5

Are you considering a toric IOL to correct the astigmatism?  If your plan is to do mini monovision which would eliminate glasses for most of the time it might be something to consider toric lenses.  They do come in monofocals as well as EDOF lenses.

6

Sorry that you are going through this. I am early 40s and have PSC. Left eye is very poor vision. It is converting exterior lights into circles.   Right eye vision is okay but night time light have begun to distort.