Case #16: Woman in her 60s from Suginami (monofocal lenses, high myopia), set for distance

This is a case of nuclear cataract and cortical opacity with high myopia, in a hard contact lens (HCL) user with extreme myopia exceeding −10 D. Usually, when people with strong myopia want monofocal lenses, we often set the intraocular lens focus for near (about −2 to −3 D = 50 to 30 cm); but she used reading glasses over her HCLs for near and goes swimming at the pool as a hobby, so we thought it more comfortable to follow her existing lifestyle, and after discussion she agreed to focus for distance. Deformation of the corneal shape from HCLs affects lens power selection, so, though it must have been hard, she stopped wearing HCLs for a week before the tests for lens power. As a result, there was no postoperative refractive error, and she was delighted with uncorrected distance vision of 1.2, something she had never experienced.
About 20 years ago, when I was a resident, postoperative refraction was set at −1.0 D (focal distance 1.0 m) unless there was a special wish; but times have changed from an era when it was enough just to see after surgery to one that demands better quality of vision. Each patient values different points, and the choice of intraocular lens type and power seems to have become as important as the safety of the surgery. "Leaving it to the doctor" is not bad, but telling your doctor your wishes clearly before surgery seems important to raise your own satisfaction afterwards. As specialists, we will explain the pros and cons and propose an appropriate lens, so please feel free to consult us.