Adjustment problems for myopes with distance iols

[PJ41NC]

Are there any naturally near sighted people here who had monofocal iols implanted set for distance?
How was the experience of adjustment? It seems that the loss of accommodation would be a problem, and the loss of the ability to read close up by remove glasses would be another. Do progressive glasses solve everything?

[John C Hagan III, MD, FACS, FAAO]

Some of the unhappiest people I've consulted on are myopes, used to reading without glasses, that have IOLs set for distance  (0.00) and have excellent vision at 20 ft (6 meters) but  can't see clearly at any other distance without progressive bifocals.   Leaving one eye myopic is almost always advisable.

[PJ41NC]

Thanks so much for your response.
That's what I feared. I'm near sighted -6d progressives for both eyes, +2.5 for reading, and I could also remove my glasses for closer detail.
I'm now in the unhappy position of having done surgery on my right eye, which had a cataract making night driving dangerous, and had a monofocal distance implant (monofocal because that eye has an epiretinal membrane , my retinal surgeon wanted a clear view in the event of a membrane peel ,and distance because I hadn't done my research and the cataract surgeon went with the standard setting for distance. The presumption was that I would stil wear progressive glasses full time, which doesn't bother me,) Now I realize I'm in a jam, so canceled the projected left eye surgery while I weigh options. None of them seem good. I should mention that the right eye erm caused larger images before surgery.
A monofocal for distance in the left eye would bring me back to where I was prior to surgery, but without the natural lens accommodation which despite my age (70) seems quite good. With lack of focusing in my right eye less than about 30ft (hard to tell if the fuzz is focus or erm effects), it's very frustrating. I currently use my left eye  for everything, with my original progressive glasses, and my vision in that eye is 20/30, and subjectively great for all but prolonged reading), so I don't want to lose it, but the image size mismatch is now pretty large (seems to vary but probably ~20% bigger), obviously unsustainable.
Any good options? I don't mind wearing glasses full time.
Both retinal and cataract surgeon advised me to go ahead and do the monofocal at distance.

[John C Hagan III, MD, FACS, FAAO]

Start by reading this article carefully:    http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You  ;

Your glasses RX now is something like this:  
RE  plano  ( you don't give visual acuity (VA)  and not vision is blurry and bigger than LE  and ERM
LE   -6.00   (progressives with +2.50 add) 20/30 vision

1. Do you know the glasses refraction for your RE? and the vision with it?  
2. Older myopes (and I'm one) assume they have good accommodation. They don't. It's the myopia doing the work of reading.
3. One option is not do anything to LE as that is your best eye.  Although low risk cataract/IOL surgery is not no risk. Also higher risk of retinal detachment because of high myopia and cataract surgery ALWAYS in everyone increases the risk of RD.

I can't really answer the rest of your question till you tell me #1 answers

[PJ41NC]

Distance VA in the right eye was 20/50-1 a week after surgery, and 20/40 a week later. I don't have a prescription yet. My left eye was remeasured and it's -5.25 +1.25 *180 add 2.50, now 20/40 with a developing cataract, also asteroid hyalosis. My retinal surgeon says the left eye retina is normal, cataract surgeon says there's an erm, subjectively no problem.
Subjectively, with glasses, left eye vision is very good all the way from distance to reading and cellphone use. Right eye at distance a little blurry, a little distorted and an image maybe 20-30% bigger than left eye (and also different color but that doesn't bother me) and becoming blurry/unfocused within perhaps 20-30ft.
Contact lens on left eye to replace the glasses??
If that's not effective, is a retinal peel the only solution?
Can contacts be fitted to an eye that has has limbal relaxing incisions?

[JohnHaganMD]

You need a refraction on both eyes by your cataract surgeon.   There should be no disagreement between the two on whether the LE has ERM.  It is either there or it isn't and OCT of macula can tell.   CTL over LRI not a problem.      Get glasses test and numbers of Vision.