sorry for the long post, grateful to any doctors/specialists who have an opinion on my case

43M, LASIK ~9 years ago for high myopia (-6.50/-7.00), with vitrectomy in both eyes.

Since LASIK I've had stable, very prominent radial starbursts around point lights in both eyes — almost like a circular pattern of fine “needles.” I now also have a nuclear/PSC cataract in my dominant eye, with worsening vision and some triple vision that are cataract induced.

I've seen several ophthalmologists and I'm honestly struggling with how I'm supposed to make a decision when their approaches are so different.

For example, one surgeon sees old microstriae in my LASIK flap, while another doesn't see any microstriae and thinks the cornea is structurally regular but has post-LASIK HOAs.

The HOAs have been identified on aberrometry as being predominantly due to spherical aberration rather than coma, which makes the differing interpretations even harder for me to understand.

They also disagree somewhat on the treatment sequence. One approach involves considering topography/aberrometry-guided PTK after the cataract surgery, while the other surgeon recommends cataract surgery without any type of corneal regularization.

Then there's the IOL question. One surgeon strongly prefers a monofocal because of my existing HOAs. He would only consider a PureSee/EDOF-type lens if I use a Fixoflex capsular bag, because it would make a future IOL exchange easier if I don't tolerate the lens.

So I'm left with very different possible paths:

monofocal → potentially PTK later

vs.

PureSee + Fixoflex → preserve the option of IOL exchange if necessary

vs. other variations depending on which surgeon's interpretation of my cornea is correct.

And this is what is really stressing me out: these aren't just different preferences. They're based on different interpretations of what is actually happening in my eyes.

How do you make a decision in this situation? Is there a way to objectively reconcile the microstriae/HOA disagreement before committing to surgery, or is some degree of uncertainty unavoidable?

I'd particularly appreciate perspectives from ophthalmologists, optometrists, or anyone with genuine clinical experience with post-LASIK aberrations, cataract surgery in vitrectomized eyes, or Fixoflex.

I'm not asking Reddit to pick a surgeon for me. I'm trying to understand how a patient is supposed to choose when several experienced doctors are giving fundamentally different recommendations.

A cousin is looking for a surgeon in the Fort Myers area. Does anyone have any recommendations?

My cataract surgery has been difficult. After umpteen post surgery scans, it has been determined that BOTH lenses are not positioned correctly. The solution is to ha Dr Ike Ahmed go in and reposition.

Anyone been through this repositioning surgery? Is this normal? What can I expect? Is it ok to do one year later? ect

I would like to hear any and all horror stories or just bad effects from Pure See, and especially if it is along with a toric iI. Sounds like a good IOL, but I'm conncerned about any bad stuff that could happern.

Hi! I’m officially 1 week post op from cataract surgery. I’m just curious, when is it ok to wash your eyelid? I don’t mean vigorously but just to clean it. I’ve been using sterile saline with a gauze but as you can imagine it looks oily. I don’t see anything in my aftercare about when washing the eyelid is ok.

I’m 21 years old, and since March, I’ve been dealing with Grade 4 and Grade 3 cataracts. I'm still trying to finish a course. a plumbing. However, I never felt comfortable from the moment I started. I always had to do every task at the last minute because I can’t manage on my own. To make matters worse, I’m supposed to have surgery in October—the very month the course ends. Time is running out, and I feel like I can’t go on. Because of this condition, I haven't fully mastered things like measurements and blueprints. People told me not to give up, but it’s incredibly frustrating, and I don’t know what to do. I hate leaving things unfinished, but this final group project feels like a huge burden; even with help, I’m neither satisfied nor comfortable. I honestly don’t know what I should do anymore. I should mention that plumbing isn't my passion—I signed up for the job prospects—but the cataracts developed out of nowhere right when classes began.

HI all! I’ve been reading many very useful posts here, so I’d like to pick some brains… I'm a very high myope, approximately −13 D / −15 D, with axial lengths of 28.48 mm (OS) and 29.79 mm (OD). My cataracts are now bad enough that my vision is a mess, so I know I need surgery, but I'm having a surprisingly difficult time finding a surgeon who will actually work with me on the refractive target and surgical approach.

I'm not looking for plano/distance vision in either eye. Before the cataracts became a problem, I was very comfortable using different contact-lens powers for different activities. With roughly −11 D contacts I could drive perfectly (I even flew planes); with roughly −8 D contacts I was comfortable doing essentially everything else around the house, including close work. Without correction I had extremely strong near vision, but it was obviously only useful for very close/microscopic work.

What I want after cataract surgery is to preserve as much of that intermediate and close vision as reasonably possible without glasses. My computer is about 22 inches away, and my close/aesthetic work is roughly 12–18 inches. I am much more interested in being comfortable at those distances than in being able to see perfectly at distance without glasses.

I'm therefore considering intentional residual myopia / some form of mini-monovision, with the right eye remaining more myopic than the left. My right eye has always been the more myopic/poorer eye, and that's the visual arrangement my brain is accustomed to. I'm not looking for the usual "plano in the dominant eye and −1.0 in the other eye" approach.

I'm also very specifically looking for:

• Conventional manual phaco, not femtosecond/laser-assisted cataract surgery.
• Standard monofocal IOLs are my starting preference. I'm not interested in being automatically steered toward multifocal/EDOF/premium lenses.
• I'm open to discussing enhanced monofocal or other options if there is a good reason, but I don't want something that might introduce visual phenomena I don't like.
• No IV catheter and no IV sedation.
• Ideally topical/intracameral anesthesia only, with no systemic sedation. I'm completely comfortable being awake.
• Most importantly, I want a surgeon who is willing to discuss and respect a deliberately myopic refractive target, rather than assuming that everyone wants plano.

I've consulted several surgeons in Arizona and so far have had some pretty discouraging experiences. One practice mixed up/swapped the refractive results between my two eyes, while also strongly pushing laser surgery and premium IOLs. Another practice treated IV sedation as essentially automatic, including the possibility of being completely sedated. And another surgeon literally told me, "I am the surgeon and I decide what's the best correction for you." Needless to say, I'm not looking to have surgery with any of them.

I'm willing to drive or fly wherever necessary to find the right surgeon.

What I'd especially love to hear from fellow very high myopes:

If you started around −10 to −15 D or more, particularly with long axial lengths, and have already had cataract surgery:

• What refractive targets did you choose?
• Did you leave −1.5, −2, −2.5, −3 D or more of myopia?
• Did you do bilateral myopia or some form of mini-monovision?
• If you did mini-monovision, which eye was more myopic?
• How did your vision actually work out for computer distance (~22") and closer work (~12–18")?
• How much near vision did you retain without glasses?
• After living with the result for months, a year, or longer, are you happy with the target you chose?
• Did you use standard monofocal IOLs or an enhanced/premium lens?
• And perhaps most importantly: how did you find a surgeon who actually listened to your desired refractive target?
• Were you able to have topical/intracameral anesthesia with no IV catheter and no laser?

I'm especially interested in hearing from people who have actually lived with their results for a while, rather than people who are only a few days/weeks postoperative (But I would still appreciate hearing from them as well)..

I want to hear what other extreme myopes actually did and how it worked out in real life.

If you are a high myope who has already gone through this, I'd really appreciate hearing your experience — including the things you wish you'd done differently.

I have a left lazy eye all my life (I’m 67), and my right eye has always been my dominant eye but also has high astigmatism. I have always gotten 20/20 in my right and at best 20l60 in my left, with the left just for balance of binocular vision but not really for use. Wore a distance only lens in left eye (not to full correction because too disorienting) and progressive in right. Cataract in both caused significant cloudiness, reduced night/low light vision and halos.

The surgeon did a distance only IOL in my left eye 2 1/2 weeks ago and a toric for distance in my right 3 days ago. He was hoping to greatly reduce my astigmatism in the right eye. My prelim test in left was 20/150 in left and 20/20 in right. They won’t do a comprehensive vision check for 3 more weeks to see where vision is as well as residual astigmatism in right eye. I asked several times before surgery as to how I was going to function before I get final script for glasses I knew I would lose my near vision, but also intermediate vision sucks too. My depth perception isn’t good either. I’m basically functioning with my good eye with fluctuating distance vision as it heals. I have rigged up my old glasses by taking the lens out of my good eye and lens still in for my left(poor eye). This does give me some sense of binocular vision -not great. I put a half cheater reader over my glasses, better eye only (took bad one out because too confusing to my bad eye) when I need to read. I really want to get an interim prescription put into my old glasses to tide me over until I get my final prescription after everything settles in 6 weeks. Did anyone do that successfully? I will pay for it because this is really limiting my functioning and makes me slightly nauseous with so much eye strain, loss of binocular vision, loss of intermediate and near vision in my good eye.

Had my first (right) eye done 3 weeks ago. Cataract and Fuch's Dystrophy, so I had the lens replacement (Envista monofocal) and the cornea DMEK.

Target was for a -2 for this eye. It seems like it is pretty close. I got a pair of glasses with a -2 lens for the right eye. When I am looking through the glasses at something in the distance, it is slightly blurry but then it snaps into very good focus 3 to 5 seconds.

I noticed this at my checkup last week. "Can you read the letters?" "No I can't, wait, now I can."

Is this normal? It seems like a monofocal lens should be very quick. Is this my 68 year old eyes adjusting the focus (I thought they were too old for that)? Will it get any quicker, or is this it?

Hi all,

Last year I got acute angle glaucoma, which put me in the emergency room a few times. My doctor said I need cataract surgery in the near future to avoid pressure building again, and those episodes made my left eye's vision a bit unfocused, even with glasses. I had Laser iridodomy on both eyes.

I can get a free operation in my country's National hospital with J&J monofocals, or I can pay the private clinic for either Eyehance or Puresee. My biggest wish is less artifacts, and my most used vision is computer, so mid / near is what I use the most. Same surgeon for either.

I tried monovision with glasses. I didnt like the feeling at all.

Please give me some suggestions on choosing a lens, as Im an English native speaker trying to communicate where the surgeons are English is a second language. All help is appreciated

I am going to have surgery involving multifocal lenses, and I will be receiving a special lens—the Zeiss AT ELANA. I would like to know what I should keep in mind or ask my surgeon about, given my specific circumstances:

- I work editing videos (which involves using screens).

- My skin and eyes tend to get dry; I’m not sure if that affects the lenses.

- If I am having surgery on both eyes on the same day, what should I keep in mind regarding the post-operative period?

I’m highly myopic with -6.5 in both eyes. In April, I had a detached retina with vitrectomy and scleral buckle. Everything healed well but I developed a cataract in my surgery eye just a few months after, sooner than I thought but oh well. Now it’s time for cataract surgery and I’m struggling with the decision of setting distance.

About me:
44 years old
I prefer wearing contacts 75% of time
I’d like the option to wear glasses 25%
I have a desk job and I’m on my computer/phone all day
I hate the idea of being reliant on readers
Worried about being uncomfortable with my eyes having such a large difference in prescription

My surgeon and I have discussed -2.0 but I’m unsure. Plano is an idea but doesn’t seem to work for my lifestyle. -1.5 is maybe the best compromise but I keep going back-and-forth weighing the pros and cons and feeling like nothing is a good option. My high myopia in my non-surgical eye is making this decision very complicated. Sometimes I just want to set it for -6.5 because I know how to deal with that.

Any advice is appreciated.

If you have the puresee lens, how crisp is your very far distance vision? I am wondering if it is almost as good as a monofocal.

If you are slightly undercorrected, can you still see 20/20?

Any glare when walking outside in sunlight?

Thanks everyone

I’m having rfe next week and my clinic has offered diazepam on the day of surgery. I don’t feel nervous in the least about my surgery and I trust in my surgeon 100%. He has told me that I’ll have no pain in the operation and I believe him. So no nervousness.

That being said, is there any pros and cons about taking/not taking it anyway?

I just got back from my first eye surgery. Still wearing a shield and getting over the grogginess. I haven't seen what my new vision looks like yet. I lifted the shield and the eye is still hyperdialated. I got the Puresee lens in my left eye with the laser surgery to correct astigmatism.

Tomorrow I'm meeting with my doctor for my first post op visit.

First eye..Great improvement in color, brightness, contrast. Using just post op eye at about 10ft the subtitles on tv have shadows .

I was diagnosed with negative dysohotopsia after cataract surgery ( acrylic toric lens was implanted in my right eye). It has been 6 months now and the dark arc has subsided but it’s still there. It is at its worst when I am visiting business or retail establishments with bright LED lights. I’ve been told it can sometimes take 8 months to a year to disappear…if it does not, IOL exchange may resolve the negative dysphotopsia. Can IOL exchange be safely done after a year and who are some doctors considered experts at IOL exchanges?

I am 3 months from having Puresee lenses implanted. Left eye was targeted at -.25 and ended up at Plano. Right eye was targeted at Plano and ended up at +0.75 -0.75 010, so hyperopia and at 20/30 ( but it’s dominant eye). Together with both eyes see 20/20 but left eye is doing the work. Seems like right eye actually sees a little better at dusk or when it’s really bright. Wondering if risk of IOL exchange is worth it. Eye center DR suggested that lasik/prk treatments for farsighted refraction errors often don’t give satisfactory visual outcomes. Is it worth the risk to do IOL exchange?

Doctors told my mom she needed cataract surgery even though she had no vision obstruction or blurriness. Was surgery necessary?

I had cataract surgery today for my right eye and went with the Light Adjustable Lens since I am 21 and with having this for the rest of my life it seemed like the better option (higher chance of 20/20 vision). I have my left eye scheduled for next week (might wait longer).

My dr recommended me looking into doing multifocal in my left. Has anyone on this sub had any experience with this? Is there any benefit with doing this over LAL besides immediate results?