Best option for bad nearsighted and can read up close without glasses

[dannerd]

I have to get cataract surgery and my doctor has recommended monfocal fixed at 10 feet for both eyes and I would need glasses for both reading ( which I do a lot of & can read my kindle & computer screen without glasses) I would also need glasses for distance greater than 10 feet. I’ve seen references to mini monofocal with bias but not sure what that means? Also not sure if Crystalens would be good for me. My 1st eye surgery is 12/14 and i’m getting panicked as too the total loss of near vision, for example, how do you put on makeup without being able to see in the mirror without glasses like I can do now. Thank you for any advice

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

Read this article completely then post what questions you have. Fixing both eyes to see at 10 feet without glasses and leaving you needing glasses for reading, computer and driving will almost certainly make you very unhappy.  You may need to reflect, step back and get a second opinion. In any case this is the primer. Read then post:   https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You--2019-2020-Update

[dannerd]

Thanks, I did read t.
If it helps my eyeglass prescription is
RE sphere -6.50, cylinder +1.50, axis 160, add +2.50
LE sphere -6.75, cylinder +1.25, axix 047, add +2.50
I know I am going to need glasses, my dilemma is whether to do a farther distance and hopefully use high OTC reading glasses for near or to correct for near say around 12 inches and then use glasses to correct for distance. Doctor is very good at Scheie Eye Institute at University of PA. She says my astigmatism is not bad enough for toric lens. I am typing this without glasses, rarely use my bifocals and could never get used to progressive glasses and hate contacts. I don’t have any high expectations of not needing glasses

[dannerd]

Forgot to add, I haven’t driven a car in over 10 years, so driving doesn’t necessarily figure into the equation

[dannerd]

I’m not sure what my eyesight is with glasses but I do know it is not 20/20

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

Crystalens would not be a good choice for you because of your astigmatism,  your glasses RX is right on the borderline ( 1 diopter) of what a toric lens helps.  When the ophthalmologist did your corneal tests you must have less corneal astigmatism than 1 diopter (astigmatism can come from the cornea (usual) or the cataract).     As I understand it what you prize most is being able to read without glasses, you are used to wearing glasses for distance (20 ft or further). You did not adjust to progressive no line multifocal glasses and wear bifocals.

So the thing that will make you unhappiest is not being able to read without glasses.   I cannot give you advice for you, only generalize what has worked well for other patients like this.  1. Don't rush into surgery if you are not certain. You can always post-pone the surgery and get a second opinion, either where you are now or from a different surgeon that is highly regarded for their skill.  Our forum is full of people that rushed into surgery and are miserable afterwards.

One option that has worked well is on the first eye is  use a post operative goal of -1.50     Do not be rushed into doing the second eye until the first eye is healed. (3-4 weeks).  During that time you will have a lot of trouble with your eyes working together but since you don't drive you should be able to work around it.  At 3-5 weeks in the eye that has had surgery see how well you are able to read and use the computer.  Your distance vision in that eye should be much better than the unoperated eye.  If your near vision is not good enough for reading without glasses the second eye could be targeted at -2.50  if you are happy with your near vision in the operated eye and would like better distance vision in the second eye.  Then the target might be -0.50

Last piece of information is a repeat. CATARACT SURGERY IS ELECTIVE SURGERY. IF YOU ARE NOT COMFORTABLE WITH THE PROPOSED GOALS OF VISION WITHOUT GLASSES BEFORE SURGERY POSTPONE IT AND GET A SECOND OPINION. HUNDREDS OF POSTS HERE OF PEOPLE THAT WISHED THEY HAD DONE JUST THAT.

Good luck.