advice on eyeglasses after cataract surgery/IOL implants

I had cataract surgery in both eyes over a month ago, and with the new
IOLs, have gone from

O.D.-12.75
O.S.-14.00 sph / 0.50 cyl / 068 axis to

O.D.-3.00 sph / -0.75 cyl / 170 axis
O.S. -0.50 sph / -1.25 cyl / 010 axis

Needless to say this is a miraculous change, but not without
complications. I can now see the alarm clock, even read both print
and computer pretty well (right eye must be dominating), but I do need
glasses for distance (reading headlines on the TV, road signs). The
only suggestion my optometrist made concerning lens was to get
polycarb.

Having looked at the many informative exchanges on this group, I now
wonder if I should be considering other issues, such as abbe values of
lens materials, aspheric vs. spheric, etc. From previous discussions,
I gather that anything higher than 1.60 index is probably not going to
benefit my current Rx (I have had my fill with high-index lenses,
colored halos, and peripheral distortion); also that a good anti-
reflective coating and no polished edges are vital. I've picked
Flexon 717 frames with a 47 eye size, so light, small, and also
sitting close to the eyes. The optician is primarily hooked up with
Essilor and was very unsure about being able to get Trilex, but
thought that they could probably get Spectralite, possibly Sola and
Hoya 1.60s, I didn't ask about others.

Lastly I should add that I do experience noticeable glare and haloes
with the IOLs, and that I already know that I will have to have follow-
up surgery in a few months to zap the posterior capsular haze already
developing in both eyes (vision has certainly begun to deteriorate
post surgery). Hopefully the second set of surgeries will improve
matters again, but I'll certainly still need glasses afterwards for
distance. I'm in my late 30s, if that's relevant.

Being able to read, write, and work on the computer without strain is
my most important consideration. I understand that many factors are
at issue in "without strain" - thickness, distortion, weight, shifting
from near to far viewing distances (should I be thinking about
progressives?) - but I would be most grateful for any and all
suggestions/comments.

Florence

Florence H wrote:

> Having looked at the many informative exchanges on this group, I now
> wonder if I should be considering other issues, such as abbe values of
> lens materials, aspheric vs. spheric, etc. From previous discussions,
> I gather that anything higher than 1.60 index is probably not going to
> benefit my current Rx (I have had my fill with high-index lenses,
> colored halos, and peripheral distortion); also that a good anti-
> reflective coating and no polished edges are vital. I've picked
> Flexon 717 frames with a 47 eye size, so light, small, and also
> sitting close to the eyes. The optician is primarily hooked up with
> Essilor and was very unsure about being able to get Trilex, but
> thought that they could probably get Spectralite, possibly Sola and
> Hoya 1.60s, I didn't ask about others.

I'd go with regular CR39 lenses until things stabilize completely, as
you might need to change them once or twice. I'd go with TRIVEX if you
can, but the only come with a fairly glossy edge. Not bad, but if you
must have the frosted, ground glass type edge, you probably need cr39
anyway.

>
> Lastly I should add that I do experience noticeable glare and haloes
> with the IOLs, and that I already know that I will have to have follow-
> up surgery in a few months to zap the posterior capsular haze already
> developing in both eyes (vision has certainly begun to deteriorate
> post surgery). Hopefully the second set of surgeries will improve
> matters again, but I'll certainly still need glasses afterwards for
> distance. I'm in my late 30s, if that's relevant.
>
> Being able to read, write, and work on the computer without strain is
> my most important consideration. I understand that many factors are
> at issue in "without strain" - thickness, distortion, weight, shifting
> from near to far viewing distances (should I be thinking about
> progressives?) - but I would be most grateful for any and all
> suggestions/comments.
>
You could get progressives, but they are certainly not best for computer
use. For that function, a single vision lens might be best, and switch
to a regular bifocal, progressive, or a single vision distance lens for
driving (you can always look under the lens to read something).

w.stacy, o.d.

William Stacy wrote:
> Florence H wrote:
>
> > Having looked at the many informative exchanges on this group, I now
> > wonder if I should be considering other issues, such as abbe values of
> > lens materials, aspheric vs. spheric, etc. From previous discussions,
> > I gather that anything higher than 1.60 index is probably not going to
> > benefit my current Rx (I have had my fill with high-index lenses,
> > colored halos, and peripheral distortion); also that a good anti-
> > reflective coating and no polished edges are vital. I've picked
> > Flexon 717 frames with a 47 eye size, so light, small, and also
> > sitting close to the eyes. The optician is primarily hooked up with
> > Essilor and was very unsure about being able to get Trilex, but
> > thought that they could probably get Spectralite, possibly Sola and
> > Hoya 1.60s, I didn't ask about others.
>
> I'd go with regular CR39 lenses until things stabilize completely, as
> you might need to change them once or twice. I'd go with TRIVEX if you
> can, but the only come with a fairly glossy edge. Not bad, but if you
> must have the frosted, ground glass type edge, you probably need cr39
> anyway.
>

Thanks for this - I'm happy to pay now for any optical advantage, even
if later changes are needed, since I've had so much down time already
with eyestrain/headaches/unable to focus. Is Trilex preferable
because of the abbe value-weight factors?

> > Lastly I should add that I do experience noticeable glare and haloes
> > with the IOLs, and that I already know that I will have to have follow-
> > up surgery in a few months to zap the posterior capsular haze already
> > developing in both eyes (vision has certainly begun to deteriorate
> > post surgery). Hopefully the second set of surgeries will improve
> > matters again, but I'll certainly still need glasses afterwards for
> > distance. I'm in my late 30s, if that's relevant.
> >
> > Being able to read, write, and work on the computer without strain is
> > my most important consideration. I understand that many factors are
> > at issue in "without strain" - thickness, distortion, weight, shifting
> > from near to far viewing distances (should I be thinking about
> > progressives?) - but I would be most grateful for any and all
> > suggestions/comments.
> >
> You could get progressives, but they are certainly not best for computer
> use. For that function, a single vision lens might be best, and switch
> to a regular bifocal, progressive, or a single vision distance lens for
> driving (you can always look under the lens to read something).
>
> w.stacy, o.d.

Will do, and again, many thanks.

Florence H wrote:

>
> Thanks for this - I'm happy to pay now for any optical advantage, even
> if later changes are needed, since I've had so much down time already
> with eyestrain/headaches/unable to focus. Is Trilex preferable
> because of the abbe value-weight factors?
>
I wear Trivex (with a V, not an L) because it is very light, fairly
thin, exceedingly strong, and optically very good. I like drilled
rimless, so it is the best option for me, and due to the abbe value,
much better than polycarb. However, if you are not having them drilled,
ordinary CR39 plastic is really the best optically. Whatever you get,
go for a high quality anti-reflection coating, one that comes with full
anti-scratch protection and a warranty.

William Stacy wrote:
> Florence H wrote:
>
> >
> > Thanks for this - I'm happy to pay now for any optical advantage, even
> > if later changes are needed, since I've had so much down time already
> > with eyestrain/headaches/unable to focus. Is Trilex preferable
> > because of the abbe value-weight factors?
> >
> I wear Trivex (with a V, not an L) because it is very light, fairly
> thin, exceedingly strong, and optically very good. I like drilled
> rimless, so it is the best option for me, and due to the abbe value,
> much better than polycarb. However, if you are not having them drilled,
> ordinary CR39 plastic is really the best optically. Whatever you get,
> go for a high quality anti-reflection coating, one that comes with full
> anti-scratch protection and a warranty.

Just learned that my optician can get Trivex, so I'm going to go with
that and will ask about the coatings they offer. Would an aspherical
lens be of any benefit, do you think, at my Rx, or would it raise more
problems? Sorry for the vagueness of the question, but I find the
whole aspherical/spherical issue pretty confusing. With thanks in
advance,

Florence

Florence H wrote:

>Would an aspherical
>lens be of any benefit, do you think, at my Rx, or would it raise more
>problems? Sorry for the vagueness of the question, but I find the
>whole aspherical/spherical issue pretty confusing. With thanks in
>advance,
>
>
I never, ok almost never, recommend aspheric because like you I've not
been convinced that they are better than spheroidal lenses for most
Rxs. Of course if you decide on progressives, you're going to be
getting aspheric surfaces anyway, like it or not.

Anon E. Muss wrote:
> On 18 May 2007 10:20:28 -0700, Florence H <(E-Mail Removed)> wrote:
>
> >Just learned that my optician can get Trivex, so I'm going to go with
> >that and will ask about the coatings they offer. Would an aspherical
> >lens be of any benefit, do you think, at my Rx, or would it raise more
> >problems?
>
> I recommend aspheric lenses for most plus prescriptions < +3.00 in the
> distance (IOW, not for +3.00 reading single vision lenses).
>
> I don't think aspheric lenses do much, if any, in high minus
> prescriptions but I recommend them anyways because it comes included
> with most hi-index plastics that I do recommend.

Would you say the same for minus (I'm a minus) in that range?

More generally, what are aspheric lenses good for and why are they
recommended? Like you said, hi-index materials and aspheric designs
seem to always go hand-in-hand, and certainly every pair of glasses
I've had in recent memory before surgery was both hi-index and
aspherical (I was always told that the chief benefit was further
thinning the lens, which was certainly thick and heavy even with all
the extras). But when I went to fill my new and considerably less
strong Rx, they still said I should get aspheric lenses. If aspheric
lenses are good no matter how strong or weak the Rx, then why aren't
all lenses aspheric? And Dr. Stacy also expresses reservations about
aspheric lenses.

rkautz48 wrote:
> Florence
> You need your prescription run through the essilor computer program that
> minimizes anisometropia>
> You need an add in your prescription>|
> and you need to quit trying to tell the optician which lens you need> what
> was the cause of the cataracts at such an early age? diabetes? auto_immune
> disease? steroids? hereditary? congenital? trauma? this is probably a very
> important consideration also and hopefully is being addressed>
> rkautz

No diseases, no history in the family, no trauma, no steroids - I'll
tell you exactly what the optometrist said about what was causing the
rapid development of posterior capsular haze after my cataract
operations: that "whatever etiology" was responsible for the early
cataracts was probably also responsible for the rapid capsular
hazing. So in short, no idea about the cause, and none of the
opthamologists I saw for the cataract surgeries suggested a particular
explanation ("it could be genetics, it could be UV rays...").

Thanks very much for the suggestions. Can I ask what does an "add"
mean in this situation?.

As for the lens issue, I guess I wouldn't have been tempted to
investigate the options if the optician had talked with me in any
detail about what lens I needed and why - if they'd said, for
instance, "we're going to try to reduce the problems raised by the
fact that your eyes have pretty different prescriptions, and here's
how the lens we recommend addresses that issue". I'm not trying to
second-guess the optician - it's their specialty, not mine - but I
would like to have the sense that the recommendations they make are
specific to my eyes, as opposed to "this is how we always do it", "we
work exclusively with this brand", etc.

Thanks again for your comments.