cataract IOL for myopia

[nian49]

I am 49 years old. .Recently been diagnosed with early cataract.  

1) presently, mainly affecting night drive vision.  Can function but with decreased vision. Work as physiotherapist. Need vision.  Should I have cataract surgery soon or wait till very bad vision ?

2) Myopia both eyes, wearing glassess.  -9 and -10 progressive.  What type of  IOL if surgery ?  Should I do monovision ?  Should I try monovision contact lens first ?  One opthamologist recommended Crystalens. Another not.

Thank you very much.

[Michael J Kutryb, MD]

If you are happy with your glasses, then just wait until glasses no longer give you the vision that you want or need.  Your surgeons should be able to guide you as to when would be the best time to make the move for cataract surgery.  Since you don't wear contacts, you would likely want to wait until BOTH eyes are ready for cataract surgery, otherwise you would be forced to wear contacts in the unoperated eye. I think that distance in the the dominant with just a little myopia in the other eye (mini-monovison) might be a good bet but would need to talk with you more.  That can be done with a monofocal lens or a crystalens which will cost about 2500 cash extra per eye.  You would likely get more near vision with this lens so you would need to weigh the benefits.  On the downside, it there is some residual myopia (in about 5% of cases) then a laser touch up with PRK or Lasik may be needed or considered.

MJK MD

[nian49]

Thanks for your reply.

More questions :

1.  Why seems to be the conventional wisdom to delay cataract Sx as much as possible.  Is it because of the risk of this Sx ? For me, who have been myopic all my life, if need Sx some time anyway, why not have benefit of not needing glasses/contact , at least for distance ?

2.  Heard some doubts about Crystalens, although it sounds so promising for people like me.  Any precautions of getting these lenses ?

3. From your reply, my understanding is mini-monovision may work best for me.  Is it -1.75 different the best in your opinion ?

Thank you so much, Dr. Kutryb, for taking the time.  Very much appreciated.