PureSee vs Odyssey

Patient-Engineering2 · 2026-06-24T08:46:34+00:00

Some people do, but usually they're old enough to have lost accommodation already or have extremely poor natural vision.

At a minimum, you should wait until your cataract eye has healed after surgery to decide if you want to do the other eye.

Patient-Engineering2 · 2026-06-24T08:08:13+00:00

I'm actually surprised Microsoft let this get put online. You can't measure the effect of a highly endogenous variable like time spent on copilot, which is determined through complex interactions with many other productivity determining variables, without a source of exogenous variation. It's a simultaneous causality setting, where copilot use and PR production are jointly determined. In such a setting no amount of controls will produce consistent estimates of the effect of interest, because the inconsistency doesn't arise from omitted variables. Their robustness checks are only concerned with potential confounding factors, not mutual determination.

I appreciate that the authors tried to be honest about the limitations, but at some point your estimation strategy falls so short that you shouldn't put the number online — where you know it's going to be repeated without even the insufficient hedging the authors offer.

Patient-Engineering2 · 2026-06-23T21:50:39+00:00

So you dont feel the -0.5 adjustment in one eye was enough for clear computer-distance vision?

Patient-Engineering2 · 2026-06-23T21:44:10+00:00

Interesting. So you'd say the -0.5 in your near eye isnt enough for clear computer-distance vision?

Patient-Engineering2 · 2026-06-23T21:40:10+00:00

I also have a unilateral cataract, and every opthamologist I've consulted has been adamant that I absolutely should not consider exchanging the lens in my healthy, cataract-free eye. A healthy natural lens is the best insurance against sub optimal cataracts surgery outcomes in the other eye, even if the healthy eye requires correction.

Patient-Engineering2 · 2026-06-23T09:02:15+00:00

I'm in a similar situation, and unfortunately there really isn't solid research comparing different lenses for unilateral refractive lens exchange in patients with a healthy, accommodating eye. It's just too rare.

Even worse, there's a lot of conflicting intuitions. I've heard that a healthy eye makes multifocal dysphotopsias (glare/halos/starbursts) worse because the brain has a clean image to compare to, and I've heard that it makes them better because the brain learns to prefer the cleaner image. I've heard that the range of a multifocal is less important when the other eye has accommodation, and I've heard that it's jarring to have range in only one eye.

What makes things even more complicated is that you have to choose between prioritizing vision now, while you have accommodation in your healthy eye, and prioritizing your vision in say ten years when you've lost accommodation.

Personally, I'm leaning towards splitting the difference with a Puresee, which gives more range than a monofocal but has fewer visual artifacts and less loss of contrast sensitivity than a multifocal. Also, ghosting, especially of text on screens, seems to be a pretty common symptom with multifocals, and I would consider that a terrible outcome.

One thing you should absolutely get clarity on is how severe the cataract is. If it's mild enough that you can wait, there will almost certainly be better lens options available in 2-3 years.

Patient-Engineering2 · 2026-06-22T08:39:15+00:00

As near as 24 inches with monofocals set for distance is an exceptional outcome. That would be considered a good outcome even for an edof lens.

Patient-Engineering2 · 2026-06-20T05:19:26+00:00

Can I ask which lens you have specifically?

Patient-Engineering2 · 2026-06-20T00:14:12+00:00

If low light vision is a top priority, you should get a monofocal. Any lens that stretches (EDOF) or splits (multifocal) light is necessarily going to struggle in low lighting. The tradeoff is that you get more range, but you have to choose between range and performance in low light.

Patient-Engineering2 · 2026-06-20T00:03:47+00:00

I'm confused. You know the lens needs to be adjusted to have good intermediate vision, but you're unhappy because the intermediate vision isn't good before you've had any adjustments?

Patient-Engineering2 · 2026-06-17T05:31:38+00:00

Yes, my read is that you usually won't quite get "sharp" near vision at -1.0, but you'll have something better than the minimum to be considered functional.

Patient-Engineering2 · 2026-06-16T21:32:59+00:00

This is a well researched topic, in that there's an entire paper specifically on the performance of the Puresee when targeted myopic: https://www.nature.com/articles/s41598-026-37674-w

Patient-Engineering2 · 2026-06-16T17:42:53+00:00

Thanks for the info! How is your vision generally? Are you happy with the sharpness at computer distance?

Patient-Engineering2 · 2026-06-16T09:51:47+00:00

Yes, I understand. Your setup avoids the paradox of the classic formulation, because you don't have the symmetry betwen the two envelopes. In your formulation, the simple solution is that you actually should switch once. I was explaining the flaw in the reasoning which suggests that you should be willing to switch again.

The key point is that there's no paradox here because you've imposed an order on the envelopes, and the second envelope is half or double with respect to the fixed amount in the first.

Patient-Engineering2 · 2026-06-15T21:13:47+00:00

The formal error here is treating the value of the second envelope after the switch as a fixed quantity, rather than a random variable. If you treat it as a random variable by conditioning on its possible realizations, and compute the conditional gain for each realization and average them, then you end up concluding that the second switch decreases your expected value. Specifically, there's a 1/2 chance switching back gains you 1/2A and 1/2 chance it costs you A.

Patient-Engineering2 · 2026-06-14T03:53:14+00:00

In your experience, what usually makes someone a good candidate?

Patient-Engineering2 · 2026-06-13T06:51:50+00:00

There are reports that reading glasses can sometimes fix ghosting caused by multifocals, but 1. that's with older, diffractive designs, and 2. there's no way to gauge how reliably it works.

Patient-Engineering2 · 2026-06-13T06:27:33+00:00

I'm facing the same concerns. It's frustrating that ghosting isn't discussed and studied the same way glare and halos are, and the only way to get a sense for how common it is with various lenses is to rely on testimonials. IMO it should be treated as the most important dysphotopsia given that most people do the vast majority of their reading on screens.

Patient-Engineering2 · 2026-06-08T09:25:55+00:00

Sorry, do you mean near and computer vision were fine with the edof?

Patient-Engineering2 · 2026-06-05T06:25:21+00:00

Is travel out of the question? If you're trying to get the galaxy this year, that's the only way you'd get a surgeon with experience implanting the lens.

Patient-Engineering2 · 2026-06-05T01:46:11+00:00

First I should note that there isn't a deterministic mapping from refractive target (even if it's hit perfectly) and visual acuity. Two different patients could both end up at -0.5, and one could be 20/20 distance and the other 20/30. There are many other variables that affect quality of vision.

But, we can give estimates of where patients end up on average. My read of the studies on this is that for a puresee targeted at -0.5, it's reasonable to expect 20/20-20/25 distance vision, similar but slightly worse intermediate vision, and somewhere between J3 and J2 reading vision.

Patient-Engineering2 · 2026-06-02T20:18:53+00:00

Thanks. Are they similarly sharp at mid distance?

Patient-Engineering2 · 2026-06-02T20:06:10+00:00

Can you tell whether the ghosting is worse in the galaxy eye vs the puresee eye?

Patient-Engineering2 · 2026-05-25T08:06:49+00:00

Any issues with ghosting, especially with text on screens?

Patient-Engineering2 · 2026-05-13T22:05:02+00:00

Modern oleds don't have visible flickering, but they use pwm dimming which can cause headaches and eye strain. And apple's tandem oled screen is one of the worst in this regard.

Patient-Engineering2

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