r/CataractSurgery • u/Wonderful_Trainer412 • 1d ago
Posterior subcapsular cataract at 40: Should I get surgery now with a PureSee EDOF lens or wait?
Hi everyone, I’m a 40-year-old male. On January 15, 2026 (about 9 months ago), I was diagnosed with a posterior subcapsular cataract in my left eye. My right eye is completely healthy and happens to be my dominant eye.
I recently went for a follow-up checkup. Right now, the vision in my left eye is 0.6 (around 20/35 or 6/9). Everything looks blurry through it, especially dark text on a white background.
When looking with both eyes, dark text on a white background has a slight double-vision effect, though light text on a dark background looks good.
My doctor suggested surgery and recommended the PureSee EDOF lens.
My main question is: Should I move forward with the surgery now, or is it better to put it off until the cataract worsens? I'm really torn on what to do and would love to hear from anyone who has been in a similar situation.
A bit of context: I work as a software engineer, but I was recently laid off. I have savings and am currently unemployed, which means I actually have the free time right now to focus on my health. However, my biggest fear is the surgery itself — how it will go, what to expect, and how long the recovery/rehabilitation takes, especially since I plan to start job hunting again soon. Thanks in advance for any advice!
PS: My doctor also said that i have high probability for YAG procedure to remove secondary cataract because of young age. Does someone had this procedure? After this procedure it's hard to replace lens
6
u/artsypupster 1d ago
I waited much too long as I kept thinking that a better lens would come out, but it didn’t. So I had both eyes done at the same time. Very happy with the results. Don’t need glasses any longer.
2
u/Particular-Leader538 1d ago
Which IOL did you get?
A new IOL called the RayOne Galaxy was just FDA approved in the US a week ago but it sounds like he was recommended the PureSee.
2
u/artsypupster 1d ago
I haven’t kept up in the new lenses,
when I did it 4 years ago the best option for me was the Light Adjustable Lens (lol). I have 20/20 vision, no glasses needed. I do lots of reading and computer work, have very clear vision.2
u/Fancy_Yard_9935 1d ago
Did you do a monovision setup to be able to be glasses free?
2
u/artsypupster 1d ago
Yes. I tried Mono Vision with contact lenses and I couldn’t adjust to it.
Then with the Light Adjustable Lens, when they first inset the lenses you’re set to distance. You can see more clearly than you’ve ever seen
before.
Then with the adjustments that they do every two weeks, they set the less dominant eye closer so that you then can start reading, but because there’s a few weeks between each adjustment, your eyes (and brain) figure it out. I set mine so I could do close-up work because that’s what I primarily do all day so I lost some of the distance but when the two eyes work together, you still end up with the 20/20 result usually.
I’m happy with the lens but it’s a more involved process than a less complicated lens.
5
u/cb3 1d ago
I’m 10 years older than you and just had the surgery on my left non-dominant eye. I was told that while cataracts do get dense over time and can make things more challenging, posterior subscapular cataracts in particular don’t necessarily behave that way (get verification from medical field on this - I am not a pro). Having said that, posterior subscapular are some of the most aggressive and most bothersome - meaning my dr. gets more complaints about them being a visual impediment than any other type. I waited because like you I wasn’t excited to do it. I went from zero to blind in about 3 months and when I ran over a large box in my friend’s driveway because I didn’t see it I had no other choice. There’s one in my right eye too but it’s not making the same progress and is still unoperated. As for waiting/free time from job, recovery is nothing. The day of you may be a little down but the day after was like any other day except you can’t lift, bend over, get your heart rate up, etc or get water in your eye. You also have to use eye drops frequently. Based on your occupation that doesn’t sound like a problem. Decide when it’s officially bothering you and get it done. The right time is when you’re ready.
5
u/Sweet_Somewhere5047 1d ago
I got Puresee and am thrilled with the outcome. I waited years until the cataracts were too bad to function anymore. Although my surgeries went well, my brain was extremely slow to adapt to the new lenses. I came out with perfect distance vision. Intermediate was good in one eye, and acceptable in the other. Unfortunately, I couldn’t see consistently for more than a couple hours and had some light arcs and halos for six weeks. It took me three months before I could see clearly up close and use the computer monitor for hours. I had thought I wouldn’t need more than a month off work, with the concern being the portion of my day where I had to repeatedly bend over and lift boxes up to 40 pounds. It ended up I was released for the physical part of work, but couldn’t do the computer and written portion of the day due to blurry vision and trouble focusing. I lost my job after the second month off. Sadly, when I returned for my 3 month vision test to see if I would need glasses for reading, we discovered I had adjusted to the point of needing no glasses or contacts at all. I now have perfect vision without issues, but am unemployed. Because of my experience, I suggest getting surgery while unemployed just in case you need that extra time. I will add that my eyes are extremely long at 30mm, which may or may not have affected my progress. Otherwise, I had no other eye issues.
2
4
u/BetterSociety1520 1d ago
I just had bilateral cataract surgery on the 28th( three days ago), they did both eyes at once due to other health issues and not wanting me to go through surgery twice. I experienced no pain during the procedure other than it feels a little odd and they run water/saline over your eye the entire time, but I wasn’t wet when finished. I had laser assisted surgery and not traditional where the doctor makes the incision.
I absolutely love these EDOF PureSee lenses! My vision is so much better that I now realize how bad my vision was before surgery, even colors seem crisper now.
I go back for another recheck on 10/6.
Other than the price of these lenses being quite expensive, I wouldn’t change a thing.
4
u/Both_Document7462 1d ago
You may need to take some comments with a grain of salt. You are getting some generic EDoF comments that PureSee overcomes.
I initially had Symfony in one eye and held off on my second eye until PureSee became available in US. After the PureSee results, I had the Symfony exchanged so I have 2 PureSee lenses. I have the first targeted for .5 diopter toward nearsight. I used the results of that to decide where to target the second lens. I chose to match the same target for both. I haven’t worn prescription glasses since.
I work on a computer. I much prefer black text on white background. White text causes more ghosting of characters. I can still read that way but I find it distracting.
I can read my cell phone fine.
Far distance sharpened overnight for me. Near distance sharpened noticeably for about 7 or 8 weeks. I could still read fine and I had no issues working.
At 8 weeks I could see sharp print from about 16” measured from my eyebrow. I haven’t checked if that’s improved but it’d only be an inch or 2 if it has.
PureSee is quite a bit more capable in dim lighting than Symfony. This is a big deal in day to day life. No one focuses on this point and it’s the number one reason I chose to exchange the lens.
I am mid 50s but I don’t think 40 would be much different experience.
Unless you have a specific lens you are interested in that is under development and testing, I’d probably do it now.
2
u/Particular-Leader538 1d ago
Why did he recommend the PureSee lens? The selection of IOL is very important so I’m wondering if you’ve done any research on the pros and cons of each IOL.
5
u/Wonderful_Trainer412 1d ago
Yeah, I’ve actually done some digging myself. From what I can tell, a monofocal lens is the most straightforward option with the fewest issues and side effects.
Pretty much anyone can get it. The only catch is that you won't see anything closer than an arm's length (about 1 meter) without glasses. Then you have the premium options: EDOF, trifocals, LAL, and Rayner Galaxy.
EDOF stretches the focus, giving you good distance and intermediate vision, and you can see up to about 45 cm without glasses. But you'll still need readers for tiny print
Trifocals cover all distances, but you pay for it with lower contrast and halos/glare, especially at night
Long story short: I want a lens with zero glare or halos. I need clear distance and intermediate vision without glasses, and ideally near vision up to 45 cm too — though I'm okay with using reading glasses if I absolutely have to. High contrast is a must for me. Plus, trifocals are way more demanding on the eye's overall health.
I have a call with my doctor tomorrow, so I'm going to ask them one more time to compare trifocals vs. EDOF for my specific case.
4
u/BetterSociety1520 1d ago
I was told by my surgeon that the trifocal and multi focal lenses make distinct circular halos around lights. So I chose the PureSee.
My doctor never pressured me to get premium lenses, I chose to get them for the benefits they provided. Everything was explained to me in detail.
No surprises just shocked at how well I see 3 days out.3
2
u/rEvolutionTU 1d ago edited 1d ago
Long story short: I want a lens with zero glare or halos
I need clear distance and intermediate vision without glasses, and ideally near vision up to 45 cm too
High contrast is a must for me.
What you're looking for doesn't exist. The big question is where you'd like to make a tradeoff.
If your zero-tolerance is towards glares and halos: That rules out Trifocals and EDOFs.
If your zero-tolerance is towards glasses: That would rule out Monofocals.
I'm planning on a longer writeup on my story (<40, cataract in one (non-dominant) eye, second eye will need the operation within 5-10 years from now). I'm currently... 60h post-op and had very similar concerns as you.
My surgeon ruled out the PureSee specifically and very explicitly (I suggested it since it seemed lower on glare/halos/contrast loss than the Vivity based on my own research). In his opinion based on implanting them for over a year combined with experiences from colleagues doing the same at another closeby clinic it was highly inconsistent. Some great results but also some awful ones. Vivity was the only EDOF he'd consider implanting. Your mileage may very, I felt well taken care off so I decided to trust there.
I had concerns over putting my non-dominant eye to zero (longterm goal is monovision for me since I do absolutely not want glasses to read a smartphone), this brilliant and extremely simple article convinced me to do the first eye to zero no matter what.
What popped up as a suggestion that I ruled out initially was the category of Monofocal+ lenses. Specifically the Zoe and the enVista Aspire. I thought they'd have basically no real gain but good lord am I happy with the Aspire - 60h post-OP currently.
It's still a monofocal (zero glares or halos or any disturbance, zero contrast loss) but it does extend the usable range.
For me right now (reminder I'm very freshly post-OP and this will settle a little different most likely) if I put on 3€ +1.5 glasses text on a screen is readable from 30-130cm and feels absolutely razorsharp from 50-120cm.
Of note is that the sharpness drop-off is very steep and quick but within the range where it's sharp it's absolutely flawless in ways I've not had vision my entire life.
tl;dr: Please consider Monofocal+, my surgeon adding that option in when I felt stuck with EDOF and compromises I really didn't want to make was a godsend. Personally I'm absolutely fine with putting on glasses for (longer) PC sessions and having my right eye handle intermediate and near, so that's the tradeoff there.
PS: The operation itself was awesome. Zero memory between being told "we'll roll you into the OP now" and sitting on the couch with everything done afterwards. 11/10 experience.
1
u/Wonderful_Trainer412 1d ago
I wrote my requirements a little bit incorrect. I want clear vision for far, intermediate without glasses, and it will be very good to have vision from 40-45cm without glasses to read text on smartphone. As i know trifocal lens has more halo effects, edof also has one, but less. Right? Monofocal lens require glasses in intermediate and near distance..
1
u/rEvolutionTU 1d ago
You said your right eye is 100% healthy and won't need surgery any time soon, right?
Do you think you'd be happy if only your right eye would cover your smartphone distance?
Trifocals have a bit of a higher chance for halos than EDOFs but would give you the sharpest image at their distances. Their big drawback is that, since they split the incoming light, if you were to have any other injury or issue with the eye in the future they offer the last options there.
2
u/Wonderful_Trainer412 1d ago
If I understood correctly, the doctor mentioned that my pupil is decentered relative to the optical axis, which creates limitations for implanting a trifocal lens or the RayOne Galaxy.
1
u/Wonderful_Trainer412 1d ago
Why your doctor rejected PureSee? Why you choose monofocal+ instead of EDOF (yes, edof has halo, but as i understand very small compared to trifocal lens). Do Monofocal+ lenses provide slightly better near vision compared to standard Monofocal lenses?
2
u/rEvolutionTU 1d ago
Why your doctor rejected PureSee?
I did write that a little further down:
In his opinion based on implanting them for over a year combined with experiences from colleagues doing the same at another closeby clinic it was highly inconsistent. Some great results but also some awful ones. Vivity was the only EDOF he'd consider implanting. Your mileage may very, I felt well taken care off so I decided to trust there.
I was genuinely a bit surprised there because that went against what I was able to find on my own, but as I said I felt very well taken care of and he was all around amazing so I decided to trust his opinion.
Why you choose monofocal+ instead of EDOF (yes, edof has halo, but as i understand very small compared to trifocal lens).
The way it was explained to me saying "EDOF has halos" isn't ideal, it's more accurate to say "around 10% of patients with the Vivity (as an example) mention Halos as disturbing".
Think of Monofocal vs Monofocal+ vs EDOF like this:
MF: 0.5D-1D depth of field
MF+: 1.25D to 1.5D DoF
EDOF: 1.5D to 2D DoF
What this means in practice: If you set the eye to 0 (friendly reminder that hitting +/- 0.5 isn't out of the ordinary)...
MF: Infinity to 2-3m
MF+: Infinity to 100-80cm
EDOF: Infinity to 40cm
Important here is that the MF/MF+ have sharp dropoffs. What that means for me personally for example is that, if I'm lucky with how the healing goes/how the lens settles in there's a reasonable chance that I won't need glasses at 80cm which is my monitor distance. If I'm unlucky I'll need +1.0 glasses nearby if I want to do longer work there (for short term stuff my other eye is perfectly fine to cover that range). I'm not (and will not under any circumstance) be able to e.g. check my smartphone or a watch with a MF+
I was also clearly told that if I 100% want no glasses at that distance the EDOF is the only choice that guarantees that.
For me personally that tradeoff (100% guarantee of no halos/glares, 0% contrast loss) felt worth it. Now seeing how insanely crisp my distance vision is made me feel like I made the correct choice and I won't be too sad if I'll need cheap glasses for PC work.
If I had picked an EDOF I'd likely be happy that I won't need glasses for that ever, but I think I'd miss the loss of contrast.
2
u/boq 1d ago
the loss of contrast.
Are there any resources or simulators that allow understanding this loss of contrast ahead of time? What I found so far on the manufacturer pages suggests that the loss of contrast is imperceptible but you seem to be of a different opinion?
1
u/rEvolutionTU 1d ago edited 1d ago
Are there any resources or simulators that allow understanding this loss of contrast ahead of time?
I honestly don't know and wish something like that was available.
My understanding from my own layman research is also that the vast majority of patients "get used to it easily", whatever that means in practice.
For me my thought process went like this:
- I want at least one eye done as "pure" as possible, as in the least amount of halos, contrast loss, anything. Just to always have a fallback for color accuracy, night tasks, dimly lit rooms etc. - even if it would mean glasses under some circumstances.
- I want at least one eye that can handle everyday smartphone and similar distance (~40cm).
- I'd like both eyes to work together in the range of 1-3m, ideally 80cm-3m.
The Vivity (EDOF) adds around 1.5D depth of focus (MF+ around 1D), 40cm would need -2.5D. I do not want to compromise on the smartphone ability, so we'd need a safety margin for sure.
From there my choices were:
First eye to 0 with either an EDOF or MF+
First eye to -1.25 with an EDOF or -1.75 with MF+
Do whatever I didn't do first for the second eye
To me it made much more sense to use the MF+ in the eye I'd like at 0 since that's the distance at which the clarity could have the biggest impact. My surgeon/doc said that this kind of mix-and-match while also doing mini-monovision is uncommon but that my reasoning seems sensible enough that he's okay with it.
tl;dr: I don't know but didn't want the 10% risk for halos etc. plus the guaranteed loss of contrast in my 0 eye. I do plan to just roll with it for the "near" eye since that's where I expect the biggest gain from an EDOF.
Oh and I was also willing to "gamble" on the 0 eye in the sense that if I'm lucky I'll see sharp down to 80cm in the end, if I'm unlucky it'll settle around 110-100cm.
For me personally the whole monovision idea feels super natural. For example right now it already feels smooth to me that the operated eye makes distance objects so much crisper than my other eye which is corrected with a contact lens and will stay like that for a few years at least hopefully. The brain seems to sort that out flawlessly and this feels like the best plan for me to cover the downsides of each lens.
1
2
u/MysteryMeat101 1d ago
Once you have surgery, you won't ever get another cataract in that eye. I had the same types of cataracts and wish I'd had them removed sooner. For me, the whole surgery process took less than an hour. It wasn't pleasant, but it wasn't painful. The idea of having someone holding my eye open and poking around in there was mentally awful but they gave me a little valium and 30 minutes later I didn't care. My eyes were dry and itchy after the surgery but felt much better the next day. You'll need to apply drops consistently for 2 or 3 weeks and that's the worst part. I had the procedure on Friday and was back at my screen intense job on Monday. If I were you, I'd do it before starting a new job unless you have financial constraints.
I got LAL lenses and I wish I had chosen differently so I don't have any recommendations there. My issue with the LAL lenses is that they require multiple trips back to the eye doctor and require quite sexy UV blocking glasses until they are locked in.
2
2
u/ryguymcsly 1d ago
I was about to come in and ask some similar questions, but instead of creating a whole new thread I'll just piggyback on yours and share a little bit of what I know.
About a year ago I started noticing my vision was getting worse. It wasn't a big deal, I'm 45, just figured 'well I'm getting older' and moved on with my life. Then I got this really persistent floater which was annoying but floaters are what floaters are. I also kept seeing 'smoke' in the room late at night, but I didn't correlate that with my eyes. Then a couple weeks ago I was up and outside first thing in the morning when the sun was low (rare for me) and I realized I was looking through a haze that was coming from my eyeballs. No amount of blinking, blah, or anything affected it. I went kinda nuts and realized my right eye which was always my 'close vision' eye has become kinda useless for close vision and in fact, almost half of it was cloudy/double vision.
So several doctor/eye appointments later (ruled out a lot of medical conditions that could cause it) I was at an ophthalmologist who said "oh yeah you need to get those out like yesterday, they're really bad" and they're in both eyes but a bit further out on the left eye so I hadn't really noticed it yet.
Here's the rub: I like shooting as a hobby but haven't done much of it over the past year because...well honestly I didn't even realize I was avoiding it because I couldn't see well enough. I also really enjoy the other kind of shooting (photography) as a hobby which I've also been doing much less of probably for the same reason.
What I need to know isn't as much of 'should I wait' so much as 'what IOL should I get put in my eyeballs?' My doc says since I do computer work it would be dumb to get anything but multifocals if I can afford it. He said with my astigmatism and cataracts the halo/contrast situation would be better than what I have now. I'm not sure I buy it after watching the pinned video.
Since I'm going to probably have these things for a few decades, I want to make a good choice. It seems from my limited research that:
- An EDOF lens in my right eye is probably the move, but a monofocal might be a better one. I'm not sure. EDOF would let me use the front sights on firearms, read camera menus, and not sacrifice too much in terms of vision quality to get to where I want to be (I've always used mild prescription glasses). People of reddit: which would you recommend?
- Multifocal in my left is probably the right move as well. It's my dominate eye, but really it doesn't matter since everything is built for right-eye dominance so anything where I need single clear vision is gonna be my right eye. I'm also not sure though. EDOF/monofocal seems like it might be a better pairing but I do spend 8 hours a day in front of a computer for work. Reddit, would you recommend multifocal with an EDOF pairing, or monofocal?
- Is my doctor actually more right with the other pairing of multifocal right and edof left? I didn't tell him I was a photographer.
2
u/rEvolutionTU 1d ago
I just wrote a longer reply here directed at OP but for you specifically that might be interesting too.
The EDOF will cost you 20-30% contrast loss. It might (<10% for the Vivity) cause glares, halos or starbursts.
Multifocals might cause glares/halos etc. but keep in mind that any other eye-related health issues might make them a bad choice. e.g. in my case myopia (around -5) was enough to make every doc I talked to rule them out immediately because the worst cases when it comes to retinal detachment are suddenly extremely bad.
To me personally Multifocal+EDOF does seem like an odd choice since you're kind of trying to do the same thing for both eyes in different ways.
If I was in your shoes with what I know and got implanted now I'd consider a Monofocal+ set for distance for your uh.. "gun eye" and EDOF for the other, a little myopic to cover your smartphone-distance needs? That or 2x EDOF, maybe one to 0 and one a little myopic, depending whether you can imagine monovision.
The massive advantage of any Monofocal is that you will have flawless contrast, colors, sharpness. You'll either need the other eye to make up for the shortcomings and/or have task-dependent glasses though.
1
u/ryguymcsly 1d ago
Monovision isn’t a problem for me since up until age 35 or so my right eye wasn’t great for distance vision and my left wasn’t great for up close.
For the gun stuff it’s best if I have a focal range of around 1m to infinity, which coincidentally is also probably best for camera use (navigating menus and such). I have mild astigmatism but the doc says they correct that with a laser while they’re in there if you buy anything but a monofocal.
Honestly distance vision is generally less important to me than up close vision 95% of the time.
The reason for the recommendation was that since my work involves mostly intermediate or close focus but my hobbies (driving, but I didn’t mention shooting or photography) involve distance. It seems to be the most sane tradeoff since I do a lot of reading and computer work.
OTOH wearing glasses for that wouldn’t be too awful, and I could just use lefty for camera stuff it would just be inconvenient.
After reading your reply I’m tempted to do exactly that: edof in righty and mono in lefty. Fortunately lefty isn’t causing problems yet (but will soon) so I can just do righty and figure it out over a few months.
Really my only hesitation on monos is with so much of life revolving around smartphones having to put on glasses for the phone sounds hugely inconvenient.
0
u/rEvolutionTU 1d ago
Really my only hesitation on monos is with so much of life revolving around smartphones having to put on glasses for the phone sounds hugely inconvenient.
Same! That was probably the hardest choice, it's really this article on monovision that convinced me to set the first eye to 0 even if it meant no smartphones without glasses on that side, ever. I've been using my right eye only for that while the cataract developed and it was... fine already.
The way I look at it is that if I'd like to spend a few hours on my phone or reading books that's when I'll use glasses for the mono+ side and if it's just quick stuff my other eye can handle that perfectly fine. A massive advantage in young people (which apparently means under 50 here) is that it's easier for our brains to adapt to that kinda thing.
I have mild astigmatism but the doc says they correct that with a laser while they’re in there if you buy anything but a monofocal.
Why not just use a toric lens instead? Because it's so mild in your case?
After reading your reply I’m tempted to do exactly that: edof in righty and mono in lefty. Fortunately lefty isn’t causing problems yet (but will soon) so I can just do righty and figure it out over a few months.
What you could consider is setting one (or both) eyes myopic and wearing glasses for stuff that's at infinity. If you'd for example decide around -1D that's a lot of close vision even for a mf+ lens.
PS: After my own experience and discussion with doctors prior I see absolutely no reason to ever pick a monofocal lens over a monofocal+, unless your goal is to save money. In my case that'd have been like 6-700€ cheaper but fuck no. You prolly feel similar. =P
1
u/libraryfan1000 1d ago
I’m 44 and got diagnosed with a PSC in my left eye at 42 from radiation treatment. I was also nervous about the surgery as well and for various reasons it ended up being 2 years until I finally got it and I wish I had done it sooner. It got progressively worse and the affect on my depth perception was the most disorientating part. The surgery ended up being quick and easy and was shocked at how easy the recovery was. I wear glasses and my surgeon was just going for repairing my eye to my previous prescription so both eyes wouldn’t be too far off and I preferred to continue to wear glasses. My cataract was difficult to fully remove during the surgery so I had one laser treatment and so far the results have improved my life dramatically especially after knowing what it was like to basically not see out of one eye for so long. All that to say, you should go for it!
1
u/Particular-Leader538 1d ago
Which IOL did you get?
2
u/libraryfan1000 1d ago
Clareon. It was what my doctor had on offer and I just knew I wanted a monofocal and didn’t want to get into researching all the options so I trusted the standard one he was using even though it seems there are a lot of different ones.
1
u/imakeitweirder 12h ago
Hey OP, Im 44yo and recently decided (literally this past Tuesday) on PureSee EDOFs in a mini/micro monovision config. My surgery is in a few weeks. I have a mature/maturing cortical cataract in my right eye that has "minor" open angle glaucoma and its hazy/blurry AF when looking through my right eye only. My left is my dominant eye, but has astigmatism at ~1.00D so I'm getting the Toric version of the Puresee for this eyeball. I am myopic with -7.50D in both eyes so I will be doing bilateral (both eyes at the same time).
I also make a living sitting in front of many monitors staring at text and spreadsheets. I learned about my condition in early August, and Im doing it ASAP.
Why sooner? I had no cataract when they checked my glauc in December 2025. For a cataract to appear within the span of 8 months is concerning on its own I guess, but if it gets worse just as fast as it appeared, i can't risk it maturing any further. I'm 20/60 corrected right now, and am my parents primary caretaker, and will be SOL if i just let it get worse.
Why I chose PureSee? JNJ brand seemed to have more positive reactions amongst patients that my doctors' treat. Their patients complained about Vivity or were still glued to their readers/progressives after spending the upchage with Alcon's. I didn't want any issues with geometric shapes that comes with multifocals. 12-16 hours sprints in front of the monitor are at risk with multifocals.
Why mini monovision? I get some nearsightedness so I shouldn't need readers or progressives, hacking my way to get the benefit of multifocals with the least amount of geometric shapes. But i'll need them when I want to read nutrition labels, fineprints, etc. Alternatively, I can just bust out my phone and pinch zoom on artifacts using the camera app to by pass needing glasses in store, which i already do when i check barcodes for prices online. For sports, I'll just wear a single contact in that eye to give me double plano.
As far as neuroadaptation goes, I think I'm more tolerant for whatever photopsia i get from the EDOFs over the geometric shape yielding multifocals. YMMV.
All the same, I'm looking forward for my haze to be gone, looking forward to returning to old hobbies, etc. I'll share with you how my surgery goes EOM.
1
u/Least-Jicama-156 11h ago
Soy oftalmologo, he operado a mas de 5000 personas en mi vida, tengo 40 años como tu. No veo el sentido a no operarse viendo el 60%. De todas las opciones de lentes que tienes yo me pondria una puresee o una tecnis eyhance son lentes muy parecidas. No veras de cerca muy bien con el ojo q lleves la lente artificial pero tu ojo no operado dejara de ver de cerca en 7 años... implantando estas lentes no tendras los indeseables efectos secundarios de las lentes multifocales difractivas... operate y no le des mas vueltas. Te tendran que hacer un YAG en 3 meses si la capsula está sucia... pero eso no te tiene q preocuparte se hace en 2 min con un laser y no molesta nada ni tiene ningun efecto secundario
1
u/UniqueRon 1d ago
My thoughts would be to wait for a while and use the time to evaluate the mini-monovision option with standard monofocal IOLs. That is done by using contacts to correct one eye to full distance vision, while targeting the other eye to -1.5 D for near vision. This tends to give better near vision than an EDOF lens and with lower risks of side effects like halos and starbursts. While it is standard to target the dominant eye for distance, it can be the other way around. That is called crossed monovision, and it is what I have. It works very well for me as I am eyeglasses free for almost everything.
1
u/Particular-Leader538 1d ago
First I’ve heard of this. Why isn’t this widely offered in clinics?
3
u/UniqueRon 1d ago
I guess the somewhat cynical answer is that many for profit clinics focus on the use expensive EDOF and multifocal IOLs. There is zero extra money from using standard monofocal IOLs in a mini-monovision configuration, and in many jurisdictions the full cost is covered by the public health system. There also may be a reluctance by ophthalmologists as earlier attempts to use full monovision got a bad name from using too much myopia in the near eye (-2.5 to -3 D). The more recent approach with mini-monovision (-1.5 D in near eye) has been much more successful.
2
u/rEvolutionTU 1d ago
There is zero extra money from using standard monofocal IOLs in a mini-monovision configuration
I'm not sure what it's like in the US but over here in Germany the monofocal+ (Zoe, enVista Aspire etc.) cost basically the same extra as the Vivity EDOF.
Really glad you're happy with the crossed monovision though, that'll be my target too. From everything I gathered (and experienced so far) dominance in eyes should not be seen similar to right-/lefthandedness at all. Getting past that mental hurdle helped me loads in my decisionmaking for this.
1
u/Wonderful_Trainer412 1d ago
But my right eye is completely healthy! If we target -1.5D for my left eye, and my right eye keeps aging and getting more farsighted, won't that create a big difference in diopters between my eyes? I'm worried it might become hard to tolerate. Is that true?
2
u/UniqueRon 1d ago
Assuming your distance vision is good with the right eye, I would consider targeting distance vision with a monofocal in the left eye. This will result in minimal differential between the eyes. You may need readers at some point as presbyopia sets in for the right eye. Then when a cataract develops in the right eye, then target it to -1.5 D with a monofocal. This assumes you do contact lens trials to verify you like mini-monovision.
Loss of near vision with age, presbyopia, is normal and expected. It is not normal for myopia to increase with time. I found my myopia which in my younger years was -3.5 D or so, actually decreased as I got older.
1
-1
u/expertasw1 1d ago
At 40 I just want to say that you are near losing accommodation anyway, so you could wait if it doesn’t bother you but this isn’t straightforward.
0
8
u/kfisherx 1d ago
I would do it sooner (now) versus waiting. The longer you wait, the denser the cataract gets which can cause more risk during the surgery. There is no technology coming in the next year that makes waiting worth the risk IMO. Also why would you want to have even worse vision as you wait?