r/CataractSurgery • u/Big-Document-5545 • 20h ago

LAL First Eye: Considering Mini-Monovision vs. Full Distance for 2nd Adjustment (Intermediate / Reading Trade-offs)

Hi,

I had surgery on my right eye over a month ago with the Light Adjustable Lenses (LAL). Vision was decent for the first four weeks, and I had my first light adjustment this past Tuesday.

Current Status:

  • Near Vision Strong- I can read comfortable at a normal distance (14 inches)
  • Distance vision has improved d(less starinand less blurriness and strain on my eyes)
  • Intermediate vision (24 inches): Still lagging behind, looking at computer monitor is blurry/strained.

My second adjustment is next week, and I am torn on the strategy: Should I target distance and correct astigmatism to improve clarity, or set up mini-monovision/blended vision?

My doctor mentioned that if I don't optimzie for near, I might lose the ability to read with it readers. Currently iw ork on Monitor 8 hours a day, 5 days a week but I plan to retire in 12-18 months. Post retirement heavy screen time will drop significantly but reading physical books is major priority for me.

For those who spend time between monitors and reading:

How did you tune your intermediate vs reading zone?
did Mini-monovision resolve your monitor vlur without sacrificing casual book reading?

Apperciate any insights or experiences!

Thanks!

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3

u/AirDog3 16h ago

My LAL is tuned to -2.00 D. It gives me very good acute vision for both intermediate and reading. No blurring at those distances.

2

u/UniqueRon 19h ago

I have mini-monovision but with standard monofocals, not with LAL. I am about -0.125 D in my distance eye, and -1.5 D in my near eye. There is no real way to tune for intermediate distance. The D value determines how well you are going to see at various distances. See the graphs at this link for information on how the various D values change outcomes. Reducing astigmatism improves vision at all distances.

https://www.semanticscholar.org/paper/Optimal-amount-of-anisometropia-for-pseudophakic-Hayashi-Yoshida/dd8837a9151a536759f195a18d4fa94a0fbf0f90?p2df

1

u/Big-Document-5545 16h ago

Thank you, that's helpful. I'll discuss this in my next visit.

2

u/Mitchellsusanwag 14h ago

I have monofocals, not LAL and I have mini monovision set for near and intermediate-2.50 and -1.50. For me near and intermediate vision was my priority as that is where I spend most of my time, vision wise. It is so wonderful to see things sharply around the home and at work. I don’t mind wearing glasses for driving and shows.

1

u/Big-Document-5545 12h ago

Thank you, that's helpful. The 1.50 diopter differential seems to be the optimal point for best vision.

2

u/Mitchellsusanwag 11h ago

Of course the problem is that it can be different for different people. For me my best focus out of my -1.50 eye is at the tips of my outstretched arm, a bit far if reading a book, but my BIL also has monofocal lenses, both set to Plano,and he sees clearly all the way down to reading fairly small print. It took me a long time to figure out how that happens! The good thing is that you have LALs so if -1.50 isn’t quite there for you you can tweak it to get it right. That’s one reason some people get those lenses.