A 70-year-old friend recently asked me why I thought her friend needed glasses after cataract surgery. She asked me, did something go wrong? This is a great question and one that will be the subject of this day’s blog.
First of all, let’s review what the term ‘cataract’ means. From my desktop dictionary: cataract |ˈkatəˌrakt|noun1 a large waterfall.• a sudden rush of water; a downpour: the rain enveloped us in a deafening cataract. 2 a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision: she had cataracts in both eyes. ORIGIN late Middle English: from Latincataracta ‘waterfall, floodgate,’ also‘portcullis’ (medical sense 2 probably being a figurative use of this), from Greek kataraktēs‘down-rushing,’ from katarassein, from kata-‘down’ + arassein ‘strike, smash.’
So where is the lens? There’s solid description on our website, along with videos that will show you where the lens sits in the eye. Once the opaque lens is removed by your surgeon, there is now opportunity to replace it with a variety of lenses. Before cataract surgery, an intraocular lens implant measurement is made to determine the lens power. This measurement will incorporate your glasses prescription. Now to answer your question.
1) A standard lens is designed to give you vision at one focal point. Most patients who choose a standard lens will have great vision for distance, but will require glasses for reading up close or even on a computer.
Monovision. A few patients ask their surgeon to choose a standard lens correction set in one eye for reading and the other for distance. This is called “mono-vision”: One eye sees in the distance and one eye sees up close. When both eyes work together the brain decides which eye to pay attention to. This option is not for everyone. So those who have used contact lenses successfully with mono vision might be a happy candidate for this option, and those who have never heard of mono-vision would probably pass on this plan.
Some patients have astigmatism, and they will require glasses after surgery to correct the astigmatism and to be able to read up close.
2) Toric lens implant. Some patients with astigmatism, ask their surgeon to consider implanting a toric lens implant . This implant is designed to refocus vision so that a patient may see clearer after cataract surgery for distance. This patient would still require reading glasses and might opt for glasses with no correction on the top of their glasses and only a correction on the bottom (reading portion). Sometimes patients choose this because they do not like to take their glasses on and off.
3) Multifocal premium lens implant. The happiest patients in our practice are those who opt for a multifocal lens implant. There are several lenses available and your surgeon may match your lifestyle to the performance of each lens. Patients expect be less dependent on any glasses, near, intermediate or far. And, these are the people you may see spectacle-free after cataract surgery. They have opted for a lens implant upgrade. While most insurance companies will pay for the standard lens and will pay this portion for all patients no matter what lens is chosen, the multifocal patient will pay an additional fee for the presbyopia correcting function of the premium lens.
Cataract surgery’s purpose is to provide a clear lens. The answer is, yes, cataract surgery is considered successful even if patients are dependent on some type of glasses after surgery. It can be even more successful for those patients who are good candidates for multifocal premium lens implants.
Please feel free to comment with your questions. We are a refractive cataract and iLASIK eye surgery where people are treated with extraordinary care.
Barbara Aliaga, Practice Administrator, The Harman Eye Clinic