Case #33: Woman in her 70s from Suginami, hyperopic eyes (monofocal lenses: near target)

She first came to us with eye pain from a corneal erosion, and asked about surgery because her mother had become almost blind from cataracts. Because of hyperopia from short eyes she had strong presbyopia, and not only near but also corrected distance vision had fallen, so, also for the benefit of refractive correction, we recommended surgery. She was initially considering multifocal lenses, but reading glasses made her dizzy, and she strongly wished to see near without glasses, so after discussion we recommended surgery with monofocal lenses.
She had good eyes when young (seeing well at distance without glasses), so we explained several times that setting monofocal lenses for near would make distance, without glasses, actually harder to see than now.
I once had a patient with similar refraction whose target we set for near as she wished, and who regretted it after surgery, wishing we had set it for distance..., so I checked repeatedly; but she said that as long as distance vision would be better than now with glasses when needed, she still wanted reading distance as the target refraction. After discussion, we set the powers for near micro-monovision with monofocal lenses, so she could see from reading to the chopping board when cooking.
There was corneal opacity, making visibility during surgery poor, but the surgery was completed without problems, and after surgery, contrary to my fears, she was very satisfied to see near clearly without glasses.
This was the reverse of Cataract Surgery Case #32, in which an originally myopic patient was set for distance: an originally hyperopic patient set for near; we added it to the cases in the hope that it will be useful to those considering surgery. Lifestyles are diverse and everyone's wishes differ, so clarifying your own priorities seems to lead to satisfaction after surgery.