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Post-cataract corrective lenses, or mini-mono when the left eye gets worse?

Hello!

I'm 60 years old with successful vitrectomy surgery 4 months ago, now developing cataract in same eye (OD - right), cataract surgery scheduled in 6 weeks. I have worn multi-focal lenses for 20+ years.

Current status OD Distance & Intermediate CC=20/50 PH=20/40 with OD near CC=J2 while OS has early beginnings of a cataract.  Current status at OS Distance and Intermediate CC=20/20 and OS with OS Near CC=J1.  

Current glasses OD Sph -1.50  Cyl -0.25  Axis 40  Add. +2.25 while OS is Sph -2.00  Cyl -0.75  Axis 162  Add. +2.25.  

Manifest refraction is OD Sph -3.00, Cyl -.025 Axis 40 Add. +2.25 with OS Sph -2.00  Cyl -.075  Axis 155  Add. +2.25.

To be honest, there seem to be so many ways to go, and as such, is confusing to me.  I'm not crazy about contacts but have worn them long ago, I wear corrective framed lenses now, and for a long time and don't mind it.  I'm outdoorsy and active, and would think that I would want my surgically repaired right eye (dominant one) corrected for distance.  I also work on a computer and enjoy occasional reading.

Thank you for your input and help!
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Avatar universal
Hello, the good Dr. has a link I am sure that he will post for you to review (I can't seem to locate it now) regarding cataract surgery choices as well as some suggestions he can offer.   Good information in that link...read it several times.  In my case I had a vitrectomy in my left eye and developed a cataract.  Since I wanted to leave my good right eye alone until it needed intervention, my Dr. suggested making my vitrectomy eye (left one) a little nearsighted to be able to work with my right eye.  I couldn't be happier with this choice and seeing well with glasses.  Have worn glasses since I was six years old and having them actually saved me from injury over the years.  Best of luck, Jim
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177275 tn?1511755244
There is no 'best' IOL, no 'best' choice of uncorrected vision after cataract surgery. Please read this link carefully then if you have further questions please post:   https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You
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177275 tn?1511755244
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Avatar universal
Dr. Hagan, many thanks for your article and guidance.  I will be having questions for my surgeon.

XLTJIM, thank you also for your encouragement!

Blessings to you both.
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1 Comments
Happy to help.Remember no one answer for everyone.
Avatar universal
@dgsmitty I did virtually the same thing XLTJIM posted, with a vitrectomy in my LE in 2015 followed by cataract surgery in that eye only 18 months later. Has worked out fine that way for me so far.
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Avatar universal
@xltjim - Is your left eye the dominant eye?

@MrPresley - Is your left eye the dominant eye?

My dominant is right eye.  Thanks (again)!
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3 Comments
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My right eye is the dominant one.   Just to note - While I had intended to leave my right eye alone until intervention was required, I ended up with retina tears in that one recently and had to have a vitrectomy in that one as well.  My left eye has been doing all the "work" since and am seeing cataract surgeon on 2/8 to go over the next step.  But until the issue with the right eye I was seeing quite well.  Whatever you decide, the one thing I have learned is to have patience with all this.  It took several months for things to stabilize for me.
My LE has always been my dominant eye.  Following the vitrectomy/ERM peel performed on that eye my vision worsened due to the expected development of a cataract to 20/70 with glasses.  After cataract surgery using a monofocal IOL in approximate parity with my RE I now have 20/15 in that eye using distance correction only contacts, with 20/20 to 20/25 in my RE which has (so far) non-symptomatic macular pucker and a baby cataract.  My plan is to do nothing with my RE unless called for, and my retinal specialist and optometrist agree with that approach.  I have worn contacts for decades prior to having the vitrectomy in my LE, so I  preferred and was comfortable with going back to them once everything had settled out.
Avatar universal
xltjim - Jim, Thanks again for your perspective and input.  Your message of "patience" is timely and well received - best of luck on 2/8!

MrPresley, Your experience is most valuable to my learning curve along with xltjim and Dr. Hagan.  Your comment regarding taking a conservative approach hit home - thank you.
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Avatar universal
dgsmitty - My situation is somewhat similar to Jim's.  I had an emergency vitrectomy on my left eye (dominant) in April 2018.  The cataract developed quickly and I just had cataract surgery three days ago going with the near distance lens.  I went back and forth on making this decision.   As much as I would have loved to lose the glasses and go with the multi-focal lens replacement, or even the distance lens, it just made more sense for my situation to go with near distance and try to align the prescription with my "good" eye.   Plus, I've been nearsighted most of my life and I don't mind wearing glasses (covers some of my facial wrinkles, haha).  I can still wear contacts too.  Anyway, so far so good.  It's actually amazing how clear I can see everything.  Most definitely read Dr. Hagan's excellent article (I read it several times!) and go with what you believe will fit your situation the best.  Let's us know how it goes!  
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2 Comments
Thanks for the post
I just wish I could edit after posting (like fixing "let's us" … duh!).  
Avatar universal
@MjCg - I really appreciate your perspective and experience as it is in close relation to my own.  I've read Dr. Hagan's article a few times already, and will read again a few more - very helpful!  I definitely see the value of wrinkle-hiding too (!), and don't at all mind wearing glasses.  My question comes with the difference between my good (l) eye, and what will be the repaired eye for distance.  From what little I understand, the difference in diopters of my eyes (?) isn't very much so those image size issues may not be a concern, but I just am not sure.  I just really desire the best, easiest, clearest result I can get with minimal "fuss" and just do not know the best way to proceed regarding the replacement lens in the corrected/cataract eye.
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