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post catraract poor distance vision

Three weeks ago I had cataract surgery on my right eye which had severe myopia. The surgeon told me he would optimize for distance vision and if I paid extra for the more precise eye measurement and a better lens (the Alcon SN60WF) there would be a further 30% improvement in precision. While my vision is substantially improved to where I can make out most objects in my environment, things are only completely in focus between 1–3 feet and I cannot read anything on a standard eye chart.

Yesterday I saw another ophthalmologist at the same practice who told me I had 20/25 vision and a minus 1 lens. He suggested I ask my surgeon to go with a minus 1/4 lens for my left eye and that when the vision in my left eye was matched to the vision in my right eye (20/25) I would be completely happy although I might need glasses for distance vision at night. I feel like I am being misled. If I am not happy with 20/25 vision in one eye why would I be any happier with 20/25 vision in both eyes?

Last year a friend with worse vision than mine had 20/20 vision after cataract surgeries without paying any extra.

Am I wrong to be disappointed? Am I an imbecile for not understanding what I was told yesterday and thinking it makes no sense? What can I do to get a better result?

Also my lens has visibly shifted off center  to the left and yesterday I was told it was perfectly centered.
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Avatar universal
How is your vision up to the 1 foot point? Say from 8 inches to the 1 foot mark?
    It sounds like the surgeon is trying to give you mini monovision which gives you intermediate and distance (hence the .25 lens suggestion)
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233488 tn?1310693103
MEDICAL PROFESSIONAL
Yes you are wrong to be disappointed. The IOL is a monofocal IOL which means it can only give good vision without glasses at one distance.  with a proper progressive bifocal lens over that eye you should have good vision at all distances. You have good near vision when you have the second eye done you can have it set for distance. Your best vision for all distances will come with progressive bifocals.

Your situation is explained in the article I wrote which every patient should study before surgery.

http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

JCH MD
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Avatar universal
Actually the -25 suggestion came from a second surgeon at the same office.
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Avatar universal
Your article made things mush clearer. Thanks. My surgeon dislikes having to take the time to explain things to patients who are incapable of understanding what he is telling them and then having to take the extra time to convince them to make the choices he wants to make for them.

Vision in my right eye pre-surgery was -10 diopters. So the 1 diopter margin for error makes sense. My left eye, if I read my last prescription correctly,  is currently -2.26 diopters. What is the prudent margin of error in such a case and does it make sense to aim for better distance in the other eye? Keep in mind that I use the computer a lot. I would ask my surgeon but he makes it difficult to get the full picture.
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233488 tn?1310693103
MEDICAL PROFESSIONAL
Repeat to yourself. My best vision after this operation will come with progressive bifocals and that is the only way to use my two eyes together.

Now having said and accepted that. If your operated eye is -2.25 and you go for 0.00 or -0.25 that is "full mono-vision" and many people have trouble adjusting to it.   You could go for "mini-monofocal" and put the second eye at -1.00.  Without glasses you should have reasonable near and intermediate vision. Distance will be blurry but those of us that are myopic are use to that.

best to error on the myopic side as post cataract surgery lasik can be done to make the eye less myopic but if you end up farsighted (for example +1.00) that's much harder to fix and no distance is clear without glasses.

That's really all I can say.

JCHMD
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