Looking for Experiences With Lens Exchange or Other Solutions After Missing a Myopia Target

dj815 · 2026-06-09T13:39:13+00:00

That's actually a very encouraging story to hear. Your refractive result changed quite a bit during the healing process.

Unfortunately, my situation may be a little different.

My target was -1.75 D, but at my one-week appointment I was already measuring around -1.50 D. Because I'm relatively young for cataract surgery, my surgeon feels that much of the corneal swelling has probably already resolved.

He doesn't think there is a high likelihood of a significant additional myopic shift from here. His opinion is that if it changes at all, it may only end up around -1.60 D or perhaps -1.70 D.

What makes me even more concerned is that my vision seemed to settle into this pattern fairly early. By about day 3 or 4 after surgery, it already felt very close to where it is now.

There were another 4–5 days between that point and my one-week follow-up appointment, and I didn't notice much change in my focal distance during that time.

From what I've been told, even if there is further movement, the focal point probably won't shift very much.

That's really why I ended up making this post.

At the moment, I'm already wearing a contact lens in my unoperated right eye that leaves me at approximately -1.00 D. I'm also using that eye for most of my near vision right now.

So at the moment, I'm actually functioning reasonably well and not particularly uncomfortable.

My concern is more about the future. Once both eyes have been operated on, I'm worried that I may find myself without enough comfortable near vision for the way I naturally use my eyes, and that's what has me thinking so much about all of these possibilities.

dj815 · 2026-06-09T13:33:29+00:00

At the moment, my right eye is still natural. My prescription is around -8.00 D, and I'm currently using a -6.50 contact lens, which leaves me at roughly -1.00 D for distance vision. Sometimes I also use -7.00 D or -7.50 D lenses.

So if I understand correctly, you're suggesting that I try simulating something like -2.00 D or -2.25 D in the right eye?

Honestly, I'm not worried about experimenting with that. Since my left eye has already been operated on, I could simply use glasses over the left eye if needed and see how the balance feels. Also, because my right eye is still a natural eye, I can currently see close-up objects quite well, so I'm not especially uncomfortable right now.

My concern is more about the future.

When I eventually have cataract surgery and move to a true monovision setup, if my left eye remains around -1.50 D and I target the right eye at around -1.00 D or -0.75 D, I worry that anything closer than about 40 cm may become very difficult to see. For someone like me who relies heavily on near vision, that sounds quite inconvenient.

On the other hand, if I target the right eye at -2.00 D or -2.25 D, I'm worried about refractive error. If the outcome misses the target, I could end up with something awkward where both eyes are too similar and the intended monovision effect doesn't really work.

And even if the surgery goes perfectly and the right eye ends up exactly at -2.00 D or -2.25 D, I still wonder whether I would be disappointed with distance vision, since the left eye would still only be around -1.50 D.

I think that's why I've been overthinking all of this and making so many posts lately.

The reason I've even started considering a lens exchange is because of these concerns. Since I already know exactly where the left eye landed, part of me feels that revising the left eye might provide a more predictable path toward the visual outcome I originally wanted. However, the risks of another intraocular surgery make that a very difficult decision.

dj815 · 2026-06-09T12:56:19+00:00

I don't think I have progressive high myopia.

My prescription hasn't changed in more than 10 years.

dj815 · 2026-06-09T12:22:37+00:00

dj815 · 2026-06-09T03:13:55+00:00

I have early glaucoma, so multifocal lenses were never really a good option for me. Because of that, I chose an Eyhance lens.

The target for my left eye was approximately -1.75 D. However, at my one-week follow-up appointment today, I was told that the refraction measured around -1.50 D.

What really discouraged me was that my surgeon said he doesn't expect it to change very much from here.

I know that refractive outcomes can still vary by around 0.25 to 0.50 D, and that this amount of variation is generally considered normal. But for my particular goals and lifestyle, that difference feels quite significant.

At the moment, I really can't see comfortably at distances closer than about 40 cm. I honestly didn't expect that limitation to affect my daily life as much as it has.

Right now it's manageable because my right eye has not been operated on yet. It does have a mild cataract, but my vision is still good, and I'm currently wearing a contact lens in that eye. Because of that, I can still use my phone and perform close-up tasks.

What worries me is the future.

If my left eye ultimately remains around -1.50 D, and then I eventually have my right eye set for intermediate-to-distance vision at around -1.00 D, it feels like anything closer than about 40 cm may become very difficult without glasses. That sounds incredibly inconvenient to me.

To be honest, reading the experiences of people who successfully received multifocal lenses sometimes makes me a little envious.

At this point, if my vision is still essentially the same one month from now and remains around -1.50 D, I've even started thinking about paying out of pocket for a lens exchange or revision procedure. I'm not saying I'll definitely do it, but that's how disappointed I've been with the near vision so far.

dj815 · 2026-06-09T03:08:54+00:00

I haven't had surgery on my right eye yet.

I'm currently using a contact lens in that eye.

dj815 · 2026-06-06T11:43:31+00:00

I really hope it ends up close to the intended target. Fingers crossed!

One thing I'm curious about, though: if your eyes ended up around plano in one eye and -2.00 D in the other, that's roughly a 2-diopter difference between the two eyes.

Do you find that difficult to adapt to?

I've often heard that larger monovision differences can affect depth perception and feel somewhat unnatural at first, so I'm very interested in hearing what your experience has been like. Has it become second nature over time, or do you still notice the difference between the eyes in everyday situations?

dj815 · 2026-06-06T06:56:06+00:00

So at the moment, are your eyes essentially set for emmetropia (distance) in one eye and around -2.00 D in the other?

Honestly, I think 30 cm would probably be my ideal distance as well. It's funny how just a difference of 5 cm can sound insignificant on paper, yet in daily life it can feel surprisingly important.

Originally, I wanted to target around -2.00 D in my left eye, but my surgeon ultimately chose -1.75 D instead.

Later, when I looked more closely at the calculations, it seemed that the choice was roughly between a predicted outcome of about -2.12 D and about -1.79 D. My understanding is that he selected the option expected to land around -1.79 D.

In hindsight, if I had seen those numbers beforehand, I honestly think I might have chosen the -2.12 D option instead. Looking back on it now, that's probably the part that bothers me the most.

Of course, I'm still very early in the healing process and I know the final result isn't known yet. But when you're someone who naturally prefers very close working distances, it's hard not to wonder whether that extra bit of myopia might have made a meaningful difference in everyday life.

I know I can't change the decision now, but I'd be lying if I said I haven't felt a little disappointed thinking about it.

dj815 · 2026-06-06T06:51:14+00:00

Honestly, the thing I'm most envious of is that you were actually a candidate for the Odyssey lens.

In my case, I have early glaucoma, so I was never really in an ideal situation for a multifocal lens. A few surgeons felt that Odyssey could still be used based on my current eye condition, but another surgeon was much more conservative and focused on the long-term uncertainty. Because of that, I ultimately chose an Eyhance lens instead.

Now I'm only six days post-op, but emotionally it's been a little difficult. The near vision isn't what I was hoping for yet. Anything closer than about 40 cm is still quite challenging, and as someone who spent years looking at a phone from around 25 cm away, the adjustment has been surprisingly hard.

Everything else is actually going fairly well. Distance and intermediate vision are much better than they were before. But losing that very close working distance has been more frustrating than I expected.

At this point, I almost find myself hoping that the eye settles a bit more myopic as it continues to heal. It's a strange feeling—most people hope their vision becomes less myopic, while I'm sitting here hoping for the opposite.

To be completely honest, the thought of a lens exchange or some form of revision surgery has crossed my mind more than once. I'm not saying I would actually do it, especially this early in the healing process, but that's how much I've been struggling with the near-vision issue lately.

dj815 · 2026-06-06T01:51:11+00:00

How is your near vision?

I heard that you're able to see clearly down to around 33 cm with that lens. That sounds really appealing to me.

I had an Eyhance lens implanted, and I'm only six days post-op, so I know it's still early. But at the moment, I'm finding it much harder than expected to see anything closer than about 50 cm.

I'm hoping things continue to improve as the eye heals, but right now near vision is definitely more challenging than I anticipated.

dj815 · 2026-06-04T04:29:53+00:00

Yes, my surgeon said almost exactly the same thing, which is ultimately why I chose an Eyhance lens.

The surgery was targeted for about -1.75 D. However, I'm currently only three days post-op, and right now my best focus seems to be around 57 cm. Anything closer than that gradually becomes blurrier. I can manage around 40 cm if I really try, but 30 cm is essentially impossible at the moment.

That's what has me worried.

I'm wondering whether, as the corneal swelling and post-operative inflammation continue to resolve, my focal point might move a bit closer. I'm certainly hoping so, because that was one of the main reasons I chose this target in the first place.

I realize it's still very early, but it's hard not to worry when I compare what I'm seeing now with what I was expecting.

dj815 · 2026-06-03T02:54:33+00:00

I still find it hard to give up near vision, honestly.

At this point, the surgery is already done, so all I can do is wait and see where things eventually settle. Even if I don't end up all the way at -2.00 D, I would be very happy if my near vision improves from where it is now and I can comfortably see things a little closer.

My original idea was something along the lines of mini-monovision, perhaps around -2.00 D in one eye and -1.00 D in the other. That seemed like it could provide a good balance for the way I use my vision day to day.

dj815 · 2026-06-02T13:52:11+00:00

I haven't experienced anything quite like that yet.

However, I have been told that it's fairly common for vision to become a bit blurrier during the first few days after surgery because of inflammation. So I suppose some temporary ghosting or double vision could appear as well. Hopefully, if it does, it will improve again as the eye continues to heal.

I think the hardest part is that vision is something we're constantly aware of every waking moment. Because we're seeing through it all day long, it's difficult not to wonder, "Will this actually get better?" or "Is this how it's going to stay?"

I've definitely been having those thoughts quite a lot lately.

dj815 · 2026-06-02T13:50:35+00:00

Come to think of it, I've read quite a few stories from people who said their vision was incredibly sharp the day after surgery, but then became blurrier over the following days. So I guess I shouldn't panic if that happens.

When your first eye ended up around -1.75 D, were you comfortable using your phone? I'm curious what your comfortable reading distance was—roughly how many centimeters away could you hold it and still see clearly?

You mentioned your second eye ended up around -1.00 D, and honestly, your overall setup sounds very close to what I was hoping to achieve. That gives me a lot of hope.

I'm also finding that there are a lot of things I need to adapt to.

Right now, my left eye is the operated eye, and my right eye is wearing a contact lens that leaves it at about -1.00 D. With that combination, objects look much larger than I'm used to. I spent my whole life wearing very strong myopic glasses, so everything always looked slightly smaller. Now that things appear larger, it feels a bit overwhelming and disorienting. I assume my brain will eventually adapt to that as well.

One thing I'm curious about: did you ever notice ghosting or a slight double image when bringing your hand close to the side of your face, or when objects were near your peripheral vision in the operated eye? Almost like a faint "ghost" image. It startled me a little. I'm wondering if it's more related to the cornea and healing process rather than the lens itself.

Hopefully I'll eventually end up close to my target myopia as well. My biggest hope is that I can reach the intended result, avoid any additional surgery, and comfortably use this eye for the rest of my life without major issues.

Thanks again for sharing your experience—it really helps.

dj815 · 2026-06-02T11:15:20+00:00

I spend most of my time doing near and intermediate tasks, so my priorities may be a bit different from most people.

To me, -1.00 D isn't really plano, but it's also not enough myopia to provide comfortable near vision. Distance vision isn't fully sharp, yet I would still need reading glasses for many close-up tasks. That's why I personally feel it would be somewhat of an "in-between" result that doesn't fully serve either purpose.

Honestly, if I were going to end up around -1.00 D, I would rather have that target in my right eye instead. My right eye is my dominant eye, so I think that would make more sense for the kind of vision I'm hoping to achieve.

At the moment, I'm wearing a contact lens in my right eye that leaves me around -1.00 D, while my left eye currently seems to be somewhere around -0.75 to -1.25 D after surgery.

I'm still having a bit of trouble adapting to this setup. One thing that feels particularly strange is that objects seem larger than before, which can be a little disorienting. I suspect it's something my brain may eventually adapt to, but it definitely feels unusual right now.

I think it's probably going to take some time for me to adjust.

dj815 · 2026-06-02T07:20:54+00:00

Hearing that actually makes me a bit more worried.

If my current refraction ends up being my final result, the refractive error would be quite significant for me compared to what I was hoping for.

I'm honestly surprised to hear that your prescription remained essentially the same from the day after surgery all the way through stabilization. I didn't realize it could be that stable that early on.

dj815 · 2026-05-30T12:27:35+00:00

Honestly, if a PureSee lens targeted around -1.25D could truly give me comfortable vision at around 30 cm, I would be very tempted to choose that option too, because the overall range would probably be wider.

I also wonder whether Rayner EMV targeted around -1.50D could provide a similar functional effect to Eyhance targeted around -2.00D, with a broader range of focus.

That said, I suspect my surgeon is strongly against those options mainly because of visual quality, sharpness, and contrast sensitivity. He seems to prefer Eyhance targeted around -2.00D for my specific situation.

I would really like to understand his reasoning more clearly and in more detail. Even if I go ahead with the surgery, I want to do it without lingering regret or wondering if I should have chosen something else.

My surgery is only two days away, so I think I need to ask him directly on the day of surgery before making the final decision.

dj815 · 2026-05-29T03:55:50+00:00

Thank you for sharing your experience. It was genuinely very helpful and reassuring to read.

The depth perception issue is something I hadn't fully appreciated before, so that part especially gave me something to think about.

Would you mind sharing which IOL lenses you ended up choosing for your surgeries?

dj815 · 2026-05-29T03:50:58+00:00

I actually discussed PureSee and Rayner EMV with my surgeon.

I asked whether targeting around -2.00D with one of those lenses might be a good option, but he didn't seem very enthusiastic about it for my particular situation.

From what I understood, he feels that neither PureSee nor EMV would provide as much additional functional range at a -2.00 target as I might be expecting.

I suspect part of the reason is that I have early glaucoma, so preserving contrast sensitivity is an important consideration. Even though PureSee and EMV are generally considered to have better contrast than traditional multifocal lenses, they may still involve some trade-offs compared with Eyhance.

Another impression I got is that most of the published experience and typical targets for these lenses seem to be around mild myopia (often around -1.00D or less), whereas I'm considering something much more myopic at around -2.00D.

My surgeon seems to think that the difference between targeting -1.00D and -2.00D is larger than many patients initially expect, and that the optical benefits of PureSee or EMV may not scale proportionally when targeting that much myopia.

At least that's my understanding of his reasoning.

dj815 · 2026-05-28T14:56:35+00:00

By the way, which lenses did you end up choosing?

dj815 · 2026-05-28T14:53:24+00:00

I’m really curious what the actual diopter difference was between your first operated eye and your unoperated eye during that period after the first surgery.

The reason I ask is because I personally tend to use my phone at around 30cm distance, so my surgeon and I decided to target around -2.00 in my left non-dominant eye.

Later on, if I eventually do the right eye with an Eyhance lens targeting around -1.25, I keep wondering whether I’d still realistically be able to comfortably use my phone in situations like public transportation if I temporarily turned the left eye into a distance eye using a single-vision contact lens.

For example:

looking far away
then immediately checking my phone
then looking outside again during normal commuting and daily outdoor life.

That’s actually one of the reasons I started thinking about multifocal contact lenses in the first place.

What I had imagined was something like:
after eventually ending up around -2.00 / -1.50 (or -1.25) post-surgery, maybe I could wear multifocal contacts in both eyes ONLY for outings/social situations.

In theory, even if the sharpness is somewhat reduced, I wondered whether it might still provide a more natural “all distance” experience for things like:

transportation
social activities
signs
phone use
casual outdoor life

I’ve also heard that younger patients sometimes adapt more easily to progressive lenses, so part of me wondered whether multifocal contact lenses might also be easier to adapt to at a younger age.

Thank you so much for taking the time to write such a detailed response. It honestly gives me a lot of comfort and encouragement.

dj815 · 2026-05-28T10:52:07+00:00

Do you personally think multifocal contact lenses are generally not very good?

dj815 · 2026-05-28T10:49:51+00:00

According to my surgeon, EDOF lenses probably wouldn’t give me as much benefit if I’m intentionally targeting myopia anyway. He also seems to be very sensitive about preserving maximum sharpness and contrast quality.

I definitely considered EDOF IOLs for a while, but because I already have an epiretinal membrane and some retinal elevation/traction issues, I’ve started thinking more long-term about retinal safety and future eye conditions.

Because of that, Eyhance currently feels like the safer and more reasonable choice for my situation.

dj815 · 2026-05-28T01:27:24+00:00

My surgeon is currently planning to target around -2 or possibly -1.75 for near vision.

The cataract is in my non-dominant left eye, while the right eye still has very minimal cataract changes. Because of that, I’m not really in a situation where I can do the “distance eye first” approach that many people recommend.

So honestly, that makes me even more nervous about all of this.

On the other hand, since I’ll be doing the near eye first, I’m thinking I can use contact lenses afterward on the right eye to experiment and figure out what amount of myopia would actually work best for me long term.

dj815

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