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Which monofocal lens is best (after multi explant)
Can any of the doctors on this forum recommend any particular monofocal lens over another? I am looking at a bilateral explant of the hideous Restor.
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
My “wish list” is for the clearest and sharpest possible vision, and a lens that works optimally at night and in normal and often encountered dim light conditions, such as finding coins in a purse under a shaded awning, reading in cafes, walking poorly lit streets at night.
Are there any properties of a given lens that would make them easier or safer to insert after an explant, thus effecting the choices above?
Are there any “tradeoffs” with a lens that works well in poor light, eg is glare in bright light any worse for example?
I realize that the final outcome depends upon the surgeon and individual factors, not just the lens but any guidance would be most appreciated.
Regards, Restornomore
I think that you will see (literally) continued improvement in your vision.
Re dim light vision: My left eye did not have a cataract, so it provides a good test of vision with an aspheric IOL. I actually prefer my vision with an IOL to my best-corrected vision before surgery. I could read the 20/15 line with either. The progressive glasses with plano tops that I used to wear over my contacts before surgery worked just fine after surgery, i.e., everything within arm's length was blurry to the same extent. However, for at least 10 years before cataract surgery, I had dreaded driving to my sister's house at night because it involved stretches of unlit, winding suburban roads. I really think that my dim-light vision has improved (as the patient education video at www tecnisiol com claims), because I no longer feel the same anxiety driving those roads at night. (This benefit should apply to all aspheric IOLs, not just the Tecnis.)
Re dim light vision: My left eye did not have a cataract, so it provides a good test of vision with an aspheric IOL. I actually prefer my vision with an IOL to my best-corrected vision before surgery. I could read the 20/15 line with either. The progressive glasses with plano tops that I used to wear over my contacts before surgery worked just fine after surgery, i.e., everything within arm's length was blurry to the same extent. However, for at least 10 years before cataract surgery, I had dreaded driving to my sister's house at night because it involved stretches of unlit, winding suburban roads. I really think that my dim-light vision has improved (as the patient education video at www tecnisiol com claims), because I no longer feel the same anxiety driving those roads at night. (This benefit should apply to all aspheric IOLs, not just the Tecnis.)
Dear All,
I've been waiting a bit before posting more about explant no 1 as I wanted a bit more technical info first, which I still don't have. It went well, and after nearly a week the eye has settled down a bit. Dr told me I had come out of the Restor surgery significantly nearsighted for distance, which didn't help at all! Lens power correct by the measurements, but not correct "in the wild" in my head! Even with a distance glasses correction though, the Restor eye cannot hold a candle to the mono eye for clarity and acuity. The distance correction cut the blur, but did absolutely nothing for the other horrible effects, ghosting, bleeding of colours, haloing etc.
Right across the visual spectrum, till just before the proverbial "arms length" things are nicely sharp and clear without glasses. Unaided close up / close-intermediate vision blurred, but not nearly as bad as I'd been led to believe. My old reading glasses bring up the computer/print etc beautifully and predictably, though they are now no longer quite right. I needed readers with the Restor anyway, as the much-touted close up vision was hopelessly unpredictable and therefore less usable than one might suppose.
I feel (as did Lorraine, disappointed-no-more, Yay!) as though I can breathe again, and while (as Dr said) nothing can ever replace the subtle behaviour of your own lens, the world is now a more sane and normal place, not some House of Horrors.
Night "special effects" cut down by about 80%. There are still a few, but nothing in comparison - never thought I'd "appreciate" the traffic on our main road so much, I literally stood one-eyed and admired the lack of halos, the relatively "normal" traffic lights, tail lights etc. I also, in daylight, admired my fenceposts - the ghosting that used to surround them (and much else) was a particular grievance. Nothing like a major trauma to make one appreciate the small things in life, LOL. I also peered one-eyed at non-ghosted people in the street in a manner likely to lead to complaints...
Dim light acuity:
One drawback though - acuity in poor light, such as a very badly lit suburban street or park at night is bad. Things are clear enough, but many shades darker than I feel they ought to be, as though the "dimmer switch" is right down. Can you believe I'm not sure what implant I had, as Dr said he had tecnical worries with the eye measurements and getting the refraction correct, and might have to make different choices than he may have otherwise done.
I'm pretty sure it's an Acrysof IQ like Jodie's - asked so many questions and let that one get away, it's been one very big stressful week. Can anyone comment on the dim-light situation? "Ordinary" poor light seems troublesome as well. I really was hoping that would improve as everything else has. I will take it up with Dr this coming Wednesday. I'm *quite* worried about this, but still have a vast improvement on the dreaded Restor.
Am scheduled for second explant on Sept 28. Still very worried about *everything* but will know a lot more after Wednesday's consult. I could worry about two ants crawling up a wall at present...
Regards, Restornomore
I've been waiting a bit before posting more about explant no 1 as I wanted a bit more technical info first, which I still don't have. It went well, and after nearly a week the eye has settled down a bit. Dr told me I had come out of the Restor surgery significantly nearsighted for distance, which didn't help at all! Lens power correct by the measurements, but not correct "in the wild" in my head! Even with a distance glasses correction though, the Restor eye cannot hold a candle to the mono eye for clarity and acuity. The distance correction cut the blur, but did absolutely nothing for the other horrible effects, ghosting, bleeding of colours, haloing etc.
Right across the visual spectrum, till just before the proverbial "arms length" things are nicely sharp and clear without glasses. Unaided close up / close-intermediate vision blurred, but not nearly as bad as I'd been led to believe. My old reading glasses bring up the computer/print etc beautifully and predictably, though they are now no longer quite right. I needed readers with the Restor anyway, as the much-touted close up vision was hopelessly unpredictable and therefore less usable than one might suppose.
I feel (as did Lorraine, disappointed-no-more, Yay!) as though I can breathe again, and while (as Dr said) nothing can ever replace the subtle behaviour of your own lens, the world is now a more sane and normal place, not some House of Horrors.
Night "special effects" cut down by about 80%. There are still a few, but nothing in comparison - never thought I'd "appreciate" the traffic on our main road so much, I literally stood one-eyed and admired the lack of halos, the relatively "normal" traffic lights, tail lights etc. I also, in daylight, admired my fenceposts - the ghosting that used to surround them (and much else) was a particular grievance. Nothing like a major trauma to make one appreciate the small things in life, LOL. I also peered one-eyed at non-ghosted people in the street in a manner likely to lead to complaints...
Dim light acuity:
One drawback though - acuity in poor light, such as a very badly lit suburban street or park at night is bad. Things are clear enough, but many shades darker than I feel they ought to be, as though the "dimmer switch" is right down. Can you believe I'm not sure what implant I had, as Dr said he had tecnical worries with the eye measurements and getting the refraction correct, and might have to make different choices than he may have otherwise done.
I'm pretty sure it's an Acrysof IQ like Jodie's - asked so many questions and let that one get away, it's been one very big stressful week. Can anyone comment on the dim-light situation? "Ordinary" poor light seems troublesome as well. I really was hoping that would improve as everything else has. I will take it up with Dr this coming Wednesday. I'm *quite* worried about this, but still have a vast improvement on the dreaded Restor.
Am scheduled for second explant on Sept 28. Still very worried about *everything* but will know a lot more after Wednesday's consult. I could worry about two ants crawling up a wall at present...
Regards, Restornomore
Glad to hear things are doing well and that you have one explant behind you. It took courage, but definitely worth it.
londonbridge
londonbridge
Hi,
Just wanted to update you on my progress. My computer was in for repairs for 4 days! I finally got back to Restornomore..
After about a week the fog started to clear up. Some days I wasn't sure because it was so gradual. I was just so happy I had that dreaded Restor removed. Now after almost three weeks I am seeing really well. The fog has completely gone and the vision in my left eye is 20/40 and better. I am wearing glasses with the left lens removed. When I take off my glasses, I see everything with my wonderful left eye! (except for reading) I can actually do some reading if the print is not too small. Still relying on my right eye for reading.with the glasses.
I have been afraid, but last night I ventured out in the complete dark. Quite an improvement on my night driving vision. Very little if no light glare. No problem.
I still have to have the right eye done. Will probably have it done sometime in November. I am happy the way I am right now for the time being. I can see everything and read!
My question is, when I have the right eye done should there still be an improvement in all areas?
Again, thank you both so much with all your advice. I would not be where I am if it weren't for you.
Oh, another bit of news. My old surgeon charged me for the Restor lens. He said I was not covered. I found out last night that my insurance DID cover it and I should not have had to pay a penny! I better be getting a refund from him!
Keep in touch.
Disappointed No More (L)
p.s. You are both so right --patience!
Just wanted to update you on my progress. My computer was in for repairs for 4 days! I finally got back to Restornomore..
After about a week the fog started to clear up. Some days I wasn't sure because it was so gradual. I was just so happy I had that dreaded Restor removed. Now after almost three weeks I am seeing really well. The fog has completely gone and the vision in my left eye is 20/40 and better. I am wearing glasses with the left lens removed. When I take off my glasses, I see everything with my wonderful left eye! (except for reading) I can actually do some reading if the print is not too small. Still relying on my right eye for reading.with the glasses.
I have been afraid, but last night I ventured out in the complete dark. Quite an improvement on my night driving vision. Very little if no light glare. No problem.
I still have to have the right eye done. Will probably have it done sometime in November. I am happy the way I am right now for the time being. I can see everything and read!
My question is, when I have the right eye done should there still be an improvement in all areas?
Again, thank you both so much with all your advice. I would not be where I am if it weren't for you.
Oh, another bit of news. My old surgeon charged me for the Restor lens. He said I was not covered. I found out last night that my insurance DID cover it and I should not have had to pay a penny! I better be getting a refund from him!
Keep in touch.
Disappointed No More (L)
p.s. You are both so right --patience!
Hi Restornomore,
I restled with the exact same issues as you are now. I went back and forth between doing distance/distance and distance/intermediate.
I chose distance/intermediate and have been pleased with the results. I still wear a contact in my nonoperated eye for distance and will have my second eye set that way when I finally get an IOL. I did my nondominant eye for intermediate, since that was my Restor explant. I also dislike discrepency and have always strived for the sharpest vision. I feel that my distance vision is fine this way and I can function most of the time without glasses. I do use no line bifocals for reading and for when I want to not have to take my glasses on and off such as at work when switching between tasks. My glasses correct for a slight astigmatism as well.
My surgeon also proposed distance/distance intially, probably for the same reason, I had so much trouble adapting to the restor vision and distance/distance seemed the most conservative to him.
Since I am still very nearsighted in my non operated eye, my eyes are -8.0 different in diopters without my contact and this is annoying but I have adapted and know that I can correct that eventually when I have surgery.
Hope this helps. I think even if you go distance/distance you will be 100% happier than with the restors and will adjust no matter what.
take care.
londonbridge
I restled with the exact same issues as you are now. I went back and forth between doing distance/distance and distance/intermediate.
I chose distance/intermediate and have been pleased with the results. I still wear a contact in my nonoperated eye for distance and will have my second eye set that way when I finally get an IOL. I did my nondominant eye for intermediate, since that was my Restor explant. I also dislike discrepency and have always strived for the sharpest vision. I feel that my distance vision is fine this way and I can function most of the time without glasses. I do use no line bifocals for reading and for when I want to not have to take my glasses on and off such as at work when switching between tasks. My glasses correct for a slight astigmatism as well.
My surgeon also proposed distance/distance intially, probably for the same reason, I had so much trouble adapting to the restor vision and distance/distance seemed the most conservative to him.
Since I am still very nearsighted in my non operated eye, my eyes are -8.0 different in diopters without my contact and this is annoying but I have adapted and know that I can correct that eventually when I have surgery.
Hope this helps. I think even if you go distance/distance you will be 100% happier than with the restors and will adjust no matter what.
take care.
londonbridge
With both eyes at plano, everything within arm's length is blurry. I would recommend mini-monovision to most people (distance/intermediate)--much more versatile, and distance acuity is about the same as distance/distance. With a little luck, you would only need glasses for prolonged reading or seeing small print.
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