Response from the owner - a year ago
We are very committed to fully answering patient questions about their medical condition and provide as much information as necessary about recommended corrective procedures. We are concerned any time we learn of patients experiencing side effects following their corrective procedures. In such cases, we always encourage our patients to return to our office so we can investigate and address their concerns. Following any surgical procedure, we want to be sure that our patients know to contact us if they experience anything out of the ordinary, or if they have questions.
We are glad to share some general information regarding presbyopia, lens implants and monovision. To start with, presbyopia, or the loss of accommodation of the human eye, is an expected process that occurs due to natural aging. In this process, the lens in the eye loses the ability to change shape, typically beginning in the early 40s, thus affecting the ability to change focus from near objects to objects that are far away. Accommodation is totally absent after someone undergoes cataract surgery (unless a special lens is used).
When someone is undergoing cataract surgery, several types of intraocular lens implants (IOLs) can be used—single power (called monofocal—not to be confused with monovision), multifocals or accommodating IOLs. Multifocal IOLs provide far and near vision; accommodating IOLs provide a small degree of something called pseudo-accommodation; and, a monofocal IOL can be used to correct either distance or near vision, but not both.
When a patient has been successful with monovision via contact lenses, then monofocal IOLs with a monovision strategy often make sense. In monovision cataract surgery, one eye receives an IOL implant for near vision and the other eye gets a lens for distance. Typically, patients who have already adjusted to monovision with contacts do not have any trouble adjusting to IOL monovision. Nonetheless, as with most medical treatments, some side effects can be expected. One of the potential side effects of monovision is decreased ability to see at night. Another is loss of some depth perception. These are concerns we discuss with patients before offering monovision treatment.
Occasionally, a patient will end up with a monovision correction that’s not identical to the correction they adapted to with contacts. When that happens, there are frequently solutions available to resolve the problem, and sometimes the solution can include another procedure. Prior to another procedure, it’s not unusual for a contact lens to be used for a repeat trial run to make sure that the next procedure has the highest likelihood for success.