Monovision contact lens trial

[Hellqueen]

My left eye is very short sighted, around -8, with a tiny degree of astigmatism and my right eye is slightly long sighted, around +2, with a slightly larger astigmatism. I don't have my exact prescription in front of me.
At present I'm getting reasonably good vision with just a normal soft contact lens in my left, myopic eye at -7, with the other remaining uncorrected. My distance vision is good, and near vision is good too, I can use the computer and read books, though tiny print and low light present a bit of a problem these days. My corrected eye is very much the dominant eye and the unusually it is the one that seems to do all the work for both distance and near.

I am interested in refractive lens exchange in my left eye as I have the beginnings of a cataract (although it's not bothering me at all yet) and I would like to be glasses-free. I have seen an eye surgeon who said I am not suitable for any laser treatments or similar and I would be a good candidate for refractive lens exchange. I'm ONLY suitable for a monofocal lens and not a multifocal or accommodating lens. I would prefer to stick with a monofocal lens anyway as I know many people are unhappy with them. I am not planning any surgery on my right eye at +2

I'm just starting a monovision contact lens trial with two options 1) to under correct my left eye with a -5.5 lens and nothing in my right eye which is around +2. And also 2) my left eye fully corrected -7 and right eye corrected with a +2 lens.
I've only just started the first trial, with the 5.5 lens in the left and nothing in the right and this seems perfectly satisfactory. I can see far enough away to drive, and I can read. I'm tempted to go for this option. However, my question is this - after the surgery my new lens presumably will not be accommodating. How can that be simulated with contacts as my natural lens is still doing this? Presumably this is not accurately simulating the sight I will get after surgery? I must also stress that my left eye although very short sighted without correction, performs brilliantly with a contact lens and is DOMINANT for everything, near and far vision.

Does anyone have any advice for me? To be honest the thing I'm most worried about is what sort of reading vision I'll have afterwards as my job involves lots of reading and computer work. That's why I feel an under correction in the left eye may be the best option, and using my +2 left eye for distance. Or is it just worth waiting a few years and hope there will be a perfect solution for me?

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

Carefully read and re-read this article which is in Today's Pulse

http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

JCH MD

[Hellqueen]

Thank you for the link, I have read the article. I don't NEED the surgery yet as my cataract is not bothering me. I don't really want to go back to wearing glasses as they make me dizzy, one eye is -9 corrected and the other eye is +2 uncorrected. My surgeon thinks it would be worth having a RLE exchange in my shortsighted eye as the difference between my two eyes is so great. I would also like to have it as the contact lenses I wear are the extra high water content ones as my eyes can't tolerate others, they don't come in the exact prescription I need. I guess you are trying to say don't have surgery unless you absolutely need it? Therefore not to bother at the moment?

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

RLE is refractive lens exchange, and for those who don't know its doing a cataract operation and insertion of IOL in a clear lens and is done to change lens power.

Everything I posted would apply.  NOTE: a successful RLE or multifocal IOL insertion rarely ever makes you glasses free. The purpose of the operation is to make you LESS GLASSES DEPENDENT and improve vision without glasses. Most "very happy"  with vision without glasses wear glasses for things like night driving, computer use, prolonged reading, etc.

JCH MD