Monofocal(Monovision) or Multifocal for tennis/badminton

Eye care
1

Hi, I have cataract in my dominate eye and would probably need surgery in a few months.  My other eye has myopia about -6D but no cataract so far.  I could not decided if Monofocal or Multifocal is best for me. 

One big question for me is that I would like to keep playing racket sports after the surgery.  The ball will be coming from the opposite court (far distance) to within a few feet very quickly and I need to sight the ball clearly to time my swing.  Any double or fuzzy vision is a definitely no-no.  I don't play professionally but I still wanted to play good (not playing with grand kids just yet, I am 47).  

My questions are

1) Will monovision with monofocal IOL provide enough depth of view in the intermediate range for me to judge distance and time my shots?

2) Will multifocal IOLs distort the ball too much?  I need more than seeing a "clear" image of the ball, I will need to see if it is spinning, wobbling and gauge its incoming speed in split seconds.

Thank you very much.

2

Hi, I feel bad for your situation. There is no winning in this game. Regardless of what doctors and other people tell you about ‘normal’ life style, post cataract surgery life is one of compromises. If you will play under the lights at night or late evenings, I would definitely advise staying away from multifocals. If you will play in bright day light AND playing tennis is more important to you than night driving, a Symfony/multifocal may be a good option. If both of these are not a resounding yes, I’d say stick to a monofocal set to distance. 

Another serious suggestion is to postpone the surgery until the cataract is too bad for you to see with that eye. I don’t know if that is the case already, but at this you age, if it’s less than 50%, let it be and let it worsen before you touch it. 

Would be interesting to see what others say. 

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I agree with Sunny - cataract surgery is hardest on those that are younger.  If you can wait that’s your better option.

I had my surgeries this past July and August at 53.  My cataracts were affecting my vision so that I could not read road signs. Couldn’t read TV online guide with my glasses on and my optometrist couldn’t correct my eyes and better than that due to advancement of cataracts.  If your eyes can still be corrected - if I were you I would wait as sometimes it can take years for them to develop to the stage you need surgery.

My surgeon spent more time discussing and ensuring I knew there was a compromise to make.  He said for younger patients this is a choice of what you lose.  For older patients at normal cataract age their eyesight has already deteriorated so that they are pleased to gain something.

Sounds like you have time - so as much as you are researching lens options my suggestion is to find a good surgeon.  That person is often the difference in a good or poor outcome.   If you live in USA be even more wary as many are motivated by money.  In Canada where I live our surgeons are paid the same no matter which lens you select and you pay the hospital for the upgraded lens if that is what you selected.   My surgeon didn’t push me one way or another.

That being said I chose the Symfony lenses for both eyes.  I knew about the nighttime halos etc.  I have great daytime vision and see really well from 11 inches beyond.  Have not worn glasses since the surgeries.  I was told to expect that near vision to be at 16 inches out and to expect readers for fine print.  In my case I can read at J1 and so fine print is not an issue.

The compromise I made was night vision.  First 6 weeks I did not like night driving - thankfully it was summer so sundown was much later than it is now. I had strong glare and starbursts.

Thankfully those have subsided greatly to the point where night driving is not an issue anymore and I don’t think twice about driving at night.  The glare I experienced with cataracts was worse. The other nighttime artifact with Symfony due to lens design is seeing multiple concentric circles around certain light sources (outside).  I don’t expect those will ever go away.  Inside lights are fine.  These concentric circles are noticeable starting at dusk - see them around traffic lights or when a car brakes (not normal brake lights when car is in front) also around certain porch lights.  These are odd to look at but are like a spider web and I can see through them.  Sometimes they are lighter and I really have to look to see them other times like when a car brakes they are more vibrant. I think they were always there but in the beginning with strong glare that hid them.

In regards to tennis and night lighting.  I don’t t play tennis but I have a daughter that plays in the premier soccer league.  Sometimes after season we have parents vs players match.  I like to participate in that as I played soccer for years up till I was 30.  Strangely I am not affected by those floodlights at all.  No concentric circles.  I see the pitch and ball well.  

I know I got a very good outcome with Symfony lenses.  I had my optometrist visit 3 weeks ago and distance is plano (OD).  One eye sees better at 20/15 and other sees 20/20.  Reading was tested at J1 at 14 inches (distance optometrist measures reading at).  

I came to these forums like you looking for lens reviews prior to surgery.  I would say most here came after surgery due to complications/ not seeing well etc.   Most who don’t research in advance and are pleased with their results likely would not post on forums.   So perhaps I am more the norm as success rate for cataract surgery is 95+%.  I really don’t know.  Can only tell my story.  

There are no guarantees with cataract surgery.  My only advice again would be to wait if you can and get a few consults from opthamologists. Good luck to you.

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I'm a life long tennis player. I played tennis for the first time just this past Saturday since my right eye was operated on three weeks ago. I wore contact on my left eye which will be under the knife in two weeks. Overall, my left eye is plano but with cataract and my right eye after monofocal implant is -1.00D. So I stepped on the court as a tennis player w/ a mini-monovision. Well, the first time I served(first serve in, no practice) I totally missed the ball, lol. Moment later, I'm not sure if that was my first volley, I again totally missed the volley, ball just flew by me...lol. 

I didn't really answer your question. But I can say this, the embarraments I described above is more of the vision change than the inherent sharpness and depth of the field that concern you. The vision change will be considerable regardless of the IOL lens you choose. Even with such a big vision change, I was able to adjust on the fly as I don't remember I double fault during the rest of the three sets(double match). I resorted to kick serve which is less likely to miss the sweet spot. You just adopt and I was doing okay. The effect on ground stoke was less obvious.

 

5

Am sorry to learn that you have a cataract in your dominant eye. That is always tough, although with today's technology, it is easier to deal with than it was a few years back.

1. You say that your non-dominant eye is myopic at -6D. Are you using a monofocal contact lens in that eye (and in the dominant eye) right now? Is that set to achieve best distance focus? Are you starting to have trouble reading fine print with that eye when wearing that contact lens?

2 Assuming that you can live with the vision in the non-dominant eye using a contact lense right now, my first strong suggestion is to do nothing to your non-dominant eye right now. In spite of the sales pitches by many lens manufacturers and surgeons, who should know better, you may have new issues which you don't have right now. Keep on enjoying what you have with the contact lens in the no-dominant eye.

3. I will rule out multifocal lenses right away. The lenses offer good focus at couple of distances, but the goodness of the vision falls off dramatically between those distances. In addition, they will cause too many night vision issues to consider seriously.

4. I have used monovision with contact lenses and then later with monofocal lenses (after cataract surgeries) for the last 30 years and never felt any loss of depth perception at any time. However, depending on the best focus distances of the lenses in the 2 eyes and the remaining adaptability of the natural lenses, one may not have good vision at all distances. Thus, if you want to be able to see the tennis ball well as it is coming towards to you, you may need to emphasize having good vision at the intermediate and far distances, using glasses if needed for reading fine print at close distances.

5. A Symfony lens will provide you better day-time vision and a better capability to play tennis during day, compared with a monofocal lens, but may result in night vision issues such as multiple circles around lights (making playing tennis or doing driving etc more difficult) at night.

6

One other thing I thought of is perhaps you’ll want to inquire about eye protection.  Usually one wears a shield at night for a week however if playing tennis perhaps your surgeon will suggest something to protect your eye just while playing to prevent any injury to the eye.

7

My dad has actually had a similar problem, he has got cataract in one of his eyes, however I do not really remember which one. So, he has actually taken the surgery(which went successfully, thankfully) however he has been playing table tennis and tennis and badminton for his entire life, and he really wanted to keep on playing.

8

I played tennis before cataract surgery and afterwards. I have the Tecnis MF low add 2.75 IOL. I currently have problems because my 2nd eye also needs cataract surgery and does not see well causing me deepth perception issues.

In general these sports are not close vision and I think distance vision is the most important. I think something people get confused on what close vision is. In general, most of the time the ball is at distance vision except when you are hitting the ball at intermediate vision (maybe ping pong a bit closer). So I would think if one got the Vivity IOL that would work out for all those sports. And even with a monofocal I think you would be mostly OK, but the closer the ball the worse the vision would be, so you might be a step off your game, but you can surely still play.