• What type of IOL should I get for myopia and astigmatism?


    Question:

    I wear glasses to correct myopia (nearsightedness) and astigmatism (irregularly shaped cornea). My glasses are no-line progressive lenses and I’m planning to have cataract surgery now at age 74. I’m thinking I’ll choose either an IOL for near and intermediate vision and wear glasses for distance vision, or get an IOL for distance and use glasses for near/intermediate vision. I am likely to continue working and using a computer for another five years and I also read a lot. Which option do you think might work best?


    Answer:

    It is not possible for me to tell you what intraocular lens (IOL) combination would work best for you, as this is a very personal decision. There are three basic ranges of vision: distance, intermediate and near. As it stands today, many intraocular lenses can provide excellent vision is any two of these three ranges, but none of the available intraocular lens provides excellent vision in all three ranges. There are many ways of using multifocal and monofocal lenses to deal with this problem:

    • Multifocal IOL in each eye for distance and near with intermediate range glasses
    • Multifocal IOL in each eye for distance and intermediate with near glasses
    • Multifocal IOL in both eyes for distance and intermediate but deliberately setting the IOL power of the non-dominant a slight bit nearsighted which makes distance vision slightly blurry if the dominant eye is closed, but does not affect distance vision when using both eyes and gives a small boost for reading when both eyes are open.
    • Multifocal IOL in each eye distance and intermediate, however, set such that the non-dominant eye’s distance vision is slightly off focus to the nearsighted side, allowing a boost for near vision.
    • Monofocal IOL for distance in dominant eye and non-dominant eye set for intermediate. This is called mini-monovision.


    And there are more options you should discuss with your ophthalmologist.


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