Cataract surgery lens question

[Lee363]

I had cataract surgery last week (right eye, dominant, near vision before surgery). As I already have natural monovision, the doctor recommended I opt for the same or similar vision after surgery. He assures me the lens is for near vision, and my vision in that eye is currently 20/25. However, my intermediate vision is good and far distances seem crisp and clear, while my near vision is less sharp. In fact, I have some double vision at reading distances. Despite assurances to the contrary, I need my reading glasses more now than before (I almost never used my glasses for reading before, unless my eyes were very tired).

The lens used is Acrysof, model MN60AC, power 18.5 D. Is it possible he reversed the calculations, and actually corrected my right eye for close vision instead of far? Is it possible/likely my eye will continue to change and my near vision continue to improve?

[wanlien3]

There are actually 2 possibilities, if your eye power does end up stabilising at the current spectacle power.

1. The more likely scenario is: There are imperfections in the IOL calculating formula resulting in variations from the predicted post-operative refractive error. IOL calculating formulas work really well for 'average' eyes, with average corneal curvatures and axial lengths, but are less accurate for less average eyes.

2. The less likely scenario is a mixup. You cannot tell if this happened based on the information you have provided. You would actually need to get the print out of your biometry, and look at your implanted lens power and the corresponding predicted post operative refractive error on that printout to be certain which of these 2 possibilities it is.

[KayakerNC]

My eyesight was blurry after surgery and started improving on the 3rd day.  Same thing when they did the other eye.  
So, yeah, give your eye time to heal.  Everybody is different in the healing process, I'd give it till the 1 week follow-up.

[Lee363]

Thank you. Yes, you are right - I know my focus is more far. I guess what I was wondering is, is it possible they mixed up the intent, and he measured my right eye for far, rather than near? (Believe me, I can tell you lots about mix-ups with my info there this week!) Is that something you can tell simply based on the lens power of the implant?

He did say it might still change, but so many people tell me how great their eyesight was 24-48 hours later, I was wondering if my situation was different. Perhaps many others did not choose a more custom lens, so had different expectations - IDK.

[wanlien3]

At the moment, your focus is more far than near. You know it yourself, without the doctor telling you. If you can see 20/25 for far, you can't have more than about -0.50D of myopia, which is not good enough for reading.

However, it's been only one week, and your refraction is not stable yet, You will get a better idea what it really is a few weeks down the road, especially for a 3 piece lens like the MN60.

[Lee363]

Sorry, that should read "is it possible he corrected my right eye for far vision rather than near?". He says :near", I see better "far" right now.
Thanks so much!