My wife did not want me to post this thread as we have taken too much of your bandwidth. Anyway last 2 days my wife has been saying that she is worried that Dr Zeiss's 1.4 diopter difference between the two eyes might be too much and if 0.5 diopter error happens, she might end up needing glasses for near and far, a situation she does not want. With that in the air, Rockstar ends up emailing us today and wife is kind of leaning towards Dr Rockstar's safer options! So two excellent surgeons, both with 10,000 operations etc. Both recommended Mini-Monovision over multifocals, but both recommend different directions. Current status- Left eye cataract: Very dense. Right eye cataract: Semi dense but changing. Dominant eye- No one knows truly. Currently Right eye is dominant but that could be because left eye has bad visibility. Patient is right handed and writes and throws with right hand. SURGEON-Dr Rockstar - Will operate left eye first (dense cataract eye) and set it for plano or -0.20 if we prefer. - Right eye 1 month later or more and set it for -1.0 or -1.20 - So a difference of 1 diopter - IOL: He prefers in order- Hoya Vivinex > Alcon Clareon > Zeiss CT Lucia > Kowa. He said that they are all premium lenses and have the same features (aspherical, blue light block, UV A and UV B filter, hydrophobic). SURGEON- Dr Zeiss - Will operate both eyes together or if we prefer, left eye only first. He will set left for -1.60 - Right eye for -0.2 a month later - Difference of 1.40 diopter, with Right eye set for far unlike Left eye for far with Dr Rockstar. - IOL: Zeiss Asphina (pco loving) ____________________________________ Worst outcome for wife: Needing glasses for near and far!!!! Ideal outcome for wife: Needing glasses for near only! Thanks for listening if you made it here :-)
I think you and your wife have done the best research possible, and sharing it in this group has been (and still will be) helpful to many others. Let us know when the surgery date is and how it all goes!
Well - now that I ended up with one of each type of lens to be able to compare, why don´t your wife have one eye done at each surgeon? 
I would not worry about far vision, or the surgery in itself, both surgeons knows what they are doing. But I would worry a lot about near/close-midrange vision.
If worst case scenario strikes, and it hits a lot under the target, so correction is needed, then as long as it is under the target, it can be corrected with ReLEx Smile laser (Zeiss), that are the least intrusive type of laser surgery, where they only make a very small cut in the outer cornea, and the stability of the cornea is maintained.
If it hits over the target, Smile is not an option, then you would need Lasik, that I personally would not like, and also the reason I leave my Lara eye where it is, even that it shot a little bit over the target.
When I got the Lara, that covers about the same range close up as a monofocal set for -1, I was kind of shocked to realize how many things I am used to do close up, beside reading.
A lot of things became slightly blurry that I have never thought about, like food on the plate in front of me, keys on the keyboard, mobilephone, and stuff like that, you don´t really think about would be affected as well.
I think the difference between -1 and -1.6 could make all the difference between something you can live with and something you enjoy, personally I would find it really annoying if I had to bring reading glasses with me, to use my mobilephone, when I am not at home.
But that is just me, I know I went for premium lenses, so I probably think different
Hi worried - on my way back from Ottawa U. I wear glasses so infrequently even forgot to being them on this trip. I always wore glasses distance only and in the end leaned towards premium because of wanting to keep intermediate and near vision. Had BellaD shared her choice prior to my surgeries I would have considered monofocals for that range and gone with wearing glasses for distance which is what I was used to. I think like Danish and we use near and intermediate vision far more than Distance.
That being said given good amount of time between surgeries either surgeon will make adjustments to 2nd surgery based on where first eye settles.
Why are your surgeons doing the opposite of each other on targets? Is one assuming RE dominant and the other assuming LE dominant? Both seem to be assuming readers for the rest of her life.
The potential 1.4 diopter difference could be difficult to adjust to. Might consider 1 diopter or less.
Like Viking and SueAn, I suggest that your wide do a thorough walk thru of how much she uses near vision, How many times would she need to put on glasses per day if she aimed for best intermediate & distance with the IOL’s? vs. how often does she need best distance vision? If she goes with Rockstar, then she will have a month or more to experience the loss of near vision and make any adjustments
Too bad you feel limited regarding premium lenses, but only your wife can know how she truly feels about it all. No matter how much research you do on her behalf, it is her vision, her life.
Wishing her the best possible outcome!
Why are your surgeons doing the opposite of each other on targets? Is one assuming RE dominant and the other assuming LE dominant?
One is assuming that wife could be RE dominant based on her being right handed.
The other says we can’t truly know which eye is dominant anymore and thinks if she had good vision in both eyes before cataract then it should not be an issue and brain will adapt.
No matter how much research you do on her behalf, it is her vision, her life.
Agreed, which is why I am typing her thoughts and questions and not purely mine. She reads all the posts here. Ultimately she will choose.
keep in mind that -1.5 may not give enough near.
keep in mind that -1.5 may not give enough near.
What other option do we have?
I think you might have suggested something like -.62 combined with -2.00 or -1,65
That would mean no far vision? Also needing 2 set of glasses? Or you think -2.00 would definitely secure near vision?
That Dr Hagan on other forum suggests plano and -1.5! He says he would never operate with a surgeon who even offers to do both eyes at the same time (Dr Zeiss).
Dr Zeiss I think said, he is doing some clinical study to demonstrate that operating 2 eyes at same time does not lead to worse results than operating separately. Either way we won’t be doing both at the same time.
I think you and your wife have done the best research possible
Have we? Feels like we are chasing our tails
and sharing it in this group has been (and still will be) helpful to many others.
Thanks. Yes if they can go through tons of garbage that I have typed
Well - now that I ended up with one of each type of lens to be able to compare, why don´t your wife have one eye done at each surgeon?
You think we did not think about that already too? Although don’t forget that you still have to get both your IOLs replaced for Mini-Monovision to give us the full true comparison
I think the difference between -1 and -1.6 could make all the difference between something you can live with and something you enjoy,
So you prefer something like -.2 and -1.6 (depending on selected IOL /biometry)
Dr Rockstar might do that too if I ask him. Plus he is open to using Zeiss CT Lucia.
Yes, I you are right, I will get monosion next month then
Personally I would be worried that -1 might not gave me enough midrange in the near eye, -1.6 is clearly better.
I think many surgeons tend to think that near vision does not matter, and they don´t see glasses as a problem. But personally I would hate having to bring reading glasses with me all the time.
So I think that -1.6 or -1.5 is better than -1.
Even that the difference does not sound like much, it can be the difference that make or break if your arms are long enough to see stuff without glasses.
near is very tricky and the span it covers is very limited. for example +2 glasses only give me 10 inches to 14 inches. (only 4 inches of good close up vision). at -1.5 you risk not having good near or good far and be a bit disappointed. u may need glasses for both near and far. can you reconsider LISA?
is -1.50 the same as -1.5?
If it is, that is my left eye iol. i can see , but not crystal clear my ipad print (11-12 font ) That is with my right eye closed ( un corrected eye) i can see intermediate distance.
I had to understand, which was very difficult that monofocal lens is a comprise. I couldn’t get multifocal iol due to a cornea problem.
near is very tricky and the span it covers is very limited. for example +2 glasses only give me 10 inches to 14 inches. (only 4 inches of good close up vision). at -1.5 you risk not having good near or good far
Ok but far and intermediate can be secured, no? So close to plano in left dense cataract eye like Rockstar recommended and then say -1.50 or -1.25 in the right eye. Exact numbers obviously depending on lens/biometry.
Dr Zeiss approach of doing -1.6 on the left eye instead of plano seems more risky. Say it ends up being -2.10 in the left eye? Then what the hell do you do in the right? Can’t do more that 1.5 diopter difference anyway. Probably would have to aim for 1.0 or 1.25 diopter differences to take possibility of error into account.
can you reconsider LISA?
If it was my eye, I might. Although I panic when it comes to eyes so not sure in reality what I would do. Wife is the one who is normally calm and she is 100% against Trifocals, she feels the risks are too high!
Also not knowing which eye is dominant is also a mind twister.
True, with monofocals you don´t have any other options, you don´t want to go too short with the lens set for far, then you far vision would suffer.
And even -2.0 will not secure near vision so you are guaranteed glasses free, you can not “secure” near vision with monofocals, if you also want to cover far and intermediate.
You only have two eyes and there are three distances to cover(far, intermediate and near), but you can get great far/intermediate and “enough” near so you can do driving, shopping, sports and socializing without glasses, which is what most people aim for with monofocals, and then use reading glasses for close up work.
Some few have a rare good outcome, and are practically glasses free with monofocals, but most need glasses for near.
Bifocals often have 3.25 for near, earlier 4.0 was common, later years a 2.75 have made it into the scene, because people don´t have enough intermediate with the higher adds.
Trifocals have powers in the range 3.2-3.5 for near depending on manufacturer.
So even 1.5 is far from what is considered near vision, and 1.0 is even further away, both powers are in focus at intermediate distance.
But all that said, I know a guy with monofocals, that are almost glasses free, he only use glasses for extended reading or seeing really small stuff, so monofocals can give goods results, and often have much less side effects. There is no right or wrong, it is a matter of opinion.
yes -1.5 is same as -1.50.
if i went with monofocals i would shoot for -0.5 and -1.25. i would only have -0.75D difference between the two eye. i would plan on wearing glasses as i like crystal vision from both eyes and being glasses free is probably not an option for me with what i expect from my vision.
You only have two eyes and there are three distances to cover(far, intermediate and near),
Can the cosmic third eye be brought into play?
I find having far and intermediate in the bag most appealing.
if i went with monofocals i would shoot for -0.5 and -1.25. i would only have -0.75D
So you then carry two different glasses? One for near and one for far? Correct?