Refractive Lens Exchange - what can I expect for reading vision?

[Hellqueen]

I am 52 and am looking for some advice.
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 saw an eye surgeon last week with a view to getting rid of my contact lenses for good. I need to have the soft contact lenses with the higher water content as others I've tried make my eyes dry after a few hours and glasses, with their even higher prescription, make me dizzy as my eyes are very unbalanced. He recommended a refractive lens exchange for a monofocal IOL set for distance in my left, shortsighted eye, and leaving my right eye uncorrected at around +2 for the moment, maybe laser treatment later if necessary.
This all sounded fine until he said that I wouldn't have much near vision as it wouldn't work like my natural lens would, and would have to wear glasses for this! For me this is a backwards step as I want to be glasses or lens free for most of the time. I was told I would NOT be suitable for monofocal or accommodating IOL's.
He said that I could try the monovision option, my optician is arranging this and I will pick the trial lenses up this week.
What I would like to know is - what sort of near vision would I have afterwards? Would I be able to see my face in the mirror to put on make up? Could I see my car dashboard when driving? Would I be able to read my mobile phone screen? Computer work? What would happen with my intermediate vision?
I have no doubt about my surgeons competency, he was recommended by my optician and has many years experience but he wasn't very clear about what my options were and I didn't know what questions to ask!
If I have a monovision trial, would it be an accurate representation of the result I could expect, especially as I'm getting the benefit of my natural lens working for distance and near in my left eye with a lens trial? Presumably that would not be the same once I had a lens exchange as the focal length would be set.
Can anyone advise me about blended vision? Is it the same as monovision? What is mini-monovision?

Sorry for all the questions. I feel I only get one proper shot at this and am willing to wait if that's what it takes.

[Ray T Oyakawa, MD]

I would not recommend an RLEX in only one eye.


Dr. O.

[Hellqueen]

Thanks for your reply. My surgeon said on the initial consultation he did not think I would get a good result with an accommodating IOL and would not recommend it in my case. Also I read that it's not recommended to have it done in just one eye and I don't intend to have a lens replaced in the other eye. I am worried about the focusing ability and won't go ahead if I don't think I'm going to get a good result.

[Ray T Oyakawa, MD]

For RLEX, I would recommend a Crystalens.  This will give you the best range of vision.  At your age your lenses still have some accommodation and you will give this up with monofocal IOLs.

Dr. O.