Only correct one eye during cataract surgery

[JackM829]

I'm 33. I have retinitis pigmentosa and I'm nearsighted. (-9.00 in right eye, -10.5 in left eye).

I have to have cataract surgery in both eyes.

I expressed to my surgeon that I wanted to keep my very near vision (right up to my face). I cherish the ability to bring something very close to my eye and read it. With my contacts in I can read the computer fine, drive (during the day), and function quite normally.

After expressing my desire to maintain my near vision, my surgeon recommended not correcting anything. To basically leave me nearsighted. This seems fine to me. They're doing my left eye first since it has the much larger cataract.

My question is this. If the left eye surgery goes well, and my very near vision is razor sharp (again very near meaning right up to my face), as it is now would it be possible to then just correct my right eye? Then I could just use a contact lens in my left eye.  Would I basically be able to see as well as I do with contact lenses?

I haven't discussed this with my surgeon yet, but surgery is two months away at this point so I have time.

[JackM829]

I met with Dr. Coleman Kraff today. Very nice man, and would definitely recommend him to other potential cataract patients in Chicago.

He recommended, if I decided to get the surgery, to fix distance in my dominant eye, and leave me as a -2 in the other eye. He wasn't sure if cataract surgery would help relieve my symptoms of glare and "like looking through a dirty window" as it is probably more a symptom of the RP than the cataract. But he basically said the cataract is big enough that you could go either way on removal.

Now I'm deciding on whether to have the surgery or not. I think any chance of even slight improvement in my vision is worth it - plus no longer needed contacts/glasses would be quite nice too as I've worn them since I was 6.

Thanks again for the recommendation.

[JackM829]

I met with Dr. Coleman Kraff today. Very nice man, and would definitely recommend him to other potential cataract patients in Chicago.

He recommended, if I decided to get the surgery, to fix distance in my dominant eye, and leave me as a -2 in the other eye. He wasn't sure if cataract surgery would help relieve my symptoms of glare and "like looking through a dirty window" as it is probably more a symptom of the RP than the cataract.

Now I'm deciding on whether to have the surgery or not. I think any chance of even slight improvement in my vision is worth it - plus no longer needed contacts/glasses would be quite nice too as I've worn them since I was 6.

Thanks again for the recommendation.

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

Manus Kraft and his son are well known and respected. I would be interested in knowing what they have so say and what their recommendations are.

JCH MD

[JackM829]

Thanks for your reply.

That's actually how I prefer to read small print though as it's the only way I see anything very clearly when reading. I've tried putting reading glasses on while wearing contacts and it never really felt right. With glasses on, any small print always looks blurry, so to read tiny print I flip up my glasses or pop out a contact lens and bam, razor sharp crystal clear up close vision.

I can read my phone, usually from an arm lengths, but if the font is small, I just flip up my glasses and bring it close and I can read it crystal clear.

I can read my computer just fine as long as I zoom in and increase the font.

I was told by the surgeon that if they did any correction I would lose that ability to see razor sharp up close.

I'll be setting up an appointment with the Kraff Eye Institute here in Chicago today to get a second opinion.

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

Because I have never taken care of a patient that would want their "near point" 1/9 to 1/10 of a meter (about 4 inches) and everything further than that extremely blurry without glasses and still needing thick glasses.

A contact lens over your cataractous eye does not simulate what post cataract surgery with a residual refractive error of -2.50 would be.  As I said I would get 3 opinions and I would really be surprised at any surgeon that would leave you  -9.00 and -10.00

JCH MD

[JackM829]

Also, I don't understand why you wouldn't perform the procedure. Can you explain why?

[JackM829]

They gave me contact lenses with a power of -2.5 to try out and I didn't like how my very near vision became fuzzy, which is why I asked if it were possible to just remain the way I am, and just wear my contact lenses/glasses.

They said that was no problem.

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

I have either performed or managed over 25,000 cataract patients and never left anyone with a post operative refractive error of -9.00 or -10.5  Nor would I operate or manage that person. If they wanted left that myopic I would just send them to someone else to operate on; the converse is that some of our happiest patients are those that are highly myopic and choose to be left about -2.50 to 3.0 in one eye and -1.50 to -1.25 in the other eye.

I would get some additional opinions about your choice of targeted post op refractive error.

JCH MD