Toric or Bifocal IOL choice with Cataracts operation

[robertmm31]

Hello,
I would like to ask Dr. Hagman this question (I am not sure if I am posting it in the right place) but anyone else's input would be greatly appreciated.
I am a 38yrs old male and have developed cataracts in both eyes - they are progressing rapidly so I will have an operation within a month or so.  I like playing tennis - 4-5 times per week and I do spend a lot of time in fron of computer (app. 4hrs per day).  I also do some paperwork - i.e. completing paper applications.
Here is my dilemma:
One surgeon is suggesting Toric lenses set for distance and the use of glasses for near vision.  This doctor eliminated the Bifocal IOL althogether due to my astigmatism.   He stated that this is the best option for me as I have moderate astigmatism (app 1.5 in both eyes) and this will also be the best option for my tennis.  Although I am fine with wearing glasses for reading and other near vision tasks, I am terified at the same time because up until last year I have never worn glasses in the past.  My main concern is switching from glasses to none during i.e. driving the car and looking at my blackberry or things like that.
Another surgeon suggested Tecnis Multifocals because it will be easy for me adjust and I might not need to wear glasses at all other than for fine print reading.  I could then afterwards have LASIK and correct Astigmatism or just simply keep using eyeglasses for clear distance i.e. for driving, watching tv etc etc
My questions are as follows?
Is the surgeon with bifocal IOL suggestion correct?  Can I have the Bifocal implants even though I have Astigmatism?
With me playing tennis a lot, would the Toric be a better option?
Since I have never worn glasses until last year and since then I only wear for driving at night and watching tv, maybe I should just opt for monofocals without correcting Astigmatism via Toric IOL,s?  I haven't needed glasses until last year which would indicated to me that the astigmatism did not bother me as much.

Thank you in advance,
Robert

[baggyrinkle]

I recently had monofocal IOL's, distance, with perfect results. My wife had slight astig like you and she went with the Alcon Toric IOL set for distance. Worked perfect for her and me too. we only need cheap readers for close up reading. Stay away from multifocals. INMHO. Having cataracts early in life may be a good thing since IOL's should give you permanent good vision without the aging we all had to go thru before getting our vision back. Good luck.

[robertmm31]

Thank you Dr, Hagan

Robert MM

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

As we age our eyes lose focus power (presbyopia). I have many club, state and one national seniors tennis players. They complain that they cannot adjust fast enough to hit through no line bifocals or that they cannot focus on the ball as they age.

This happens to other athletes as well. The middle age and older tennis player learns to hit a "fuzzy" and out of focus ball.  With one eye set for distance (20 feet or further) you should be able to see the opponent serve and follow the ball with that eye well, as it comes closer than 20 feet the -1.00 eye will become clearer and will help you see the ball as it enters our racquet. It has proved satisfactory to other tennis players in middle age. Again you need sports goggles to protect against a slam to the eye. Does happen.

JCH MD

[robertmm31]

Thank you Dr. Hagan,
I was leaning towards toric IOL's so that helps me.
One last question - if I do the mni-monofocal with distance bias as you are suggesting, will it not affect my tennis - especially perception of depth?  Or is it because it is only -1.00 (mini-monofocal with distance bias) it won't have any effect on things like that.

Thanks again,

Robert

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

When you play tennis you should wear sports goggles to protect your eye. We see at least one serious tennis injury/year.

If you did not have cataracts you would still need reading glasses between agres 40-45 (presbyopia).

There is no one correct answer. Bifocal IOLs in both eyes and LASIK in both eyes is a lot of surgery and very expensive much of which your insurance will not pay.

Use the search feature and archives to read about the problems associated with multifocal IOLS including difficulty driving at night.

The safest, least expensive option would be toric IOL one eye set for distance  and a toric IOL in the other eye set for about -1.00 (mini-monofocal with distance bias). You would still need no line bifocals for some things but without glasses most people manage quite well.

Do your research, understand what you're getting into.

JCHMD