Cataract Surgery Options

You may have decided to have cataract surgery to improve your vision.  Cataract surgery involves removing the cataract and replacing it with an intraocular lens (IOL).  While some risks exist with any operation, cataract surgery has proven to be incredibly successful in most patients.  There are a few things to consider when having cataract surgery, including your lifestyle, your vision needs, and the cost.  We can discuss these and determine the different options that may be available during your cataract surgery.  

Please consider the following questions prior to cataract surgery:

How important is it for you to reduce your dependence on spectactles after cataract surgery?

What activities are most important to you:  distance (driving, sport, walking),  intermediate (computer work), or near (reading, writing, sewing)?

Do you spend a significant amount of time with near activities?

Do you mind wearing glasses for reading?

Do you spend a significant amount of time with intermediate activities? 

Do you have significant astigmatism?

Do you have any other eye or ocular condition, including dry irritable eyes or excessive tearing?

Have you had any prior eye surgery, including any laser eye surgery or refractive surgery?

Have you had any prior trauma or damage to the eyes?

Options at the time of cataract surgery include:

Monofocal (standard) intraocular lens (IOL): This is the most common type of IOL inserted.  It provides the best clarity and sharpness of vision while minimising potential side effects. 

Distance vision in both eyes: Most people opt to be targeted for distance vision in both eyes with monofocal IOLs placed in both eyes. A small distance correction may still be required for your best vision.  Spectacles will be required for reading, computer work, and any other near tasks. 

Monovision: Monofocal IOLs are placed in both eyes, with the dominant eye set for distance and the non-dominant eye set for near or intermediate vision. This method minimises the need for glasses in all situations.  The brain ignores the vision in the eye that is not being used.   Some people adapt well, while others do not and may feel out of balance.  A contact lens or spectacle trial before surgery is the only way to tell if you will be comfortable with this difference in focus between the eyes.

Enhanced cataract options include:

Toric IOL: This lens is designed to correct for astigmatism, or blurry vision that results from an irregularly shaped cornea.  They may not completely eliminate the need for glasses, however, people usually have better vision without spectacles and less frequently require spectacles after surgery if they have toric IOLs placed instead of standard monofocal IOLs.  Some additional tests are required prior to surgery, to ensure you are a good candidate for this type of lens. 

Multifocal IOL: This lens has zones that are focused in the distance and zones that are focused at near.  Both near and far vision can be clear, depending on which part of the lens you look through.  Better near vision without glasses can be achieved compared to standard, monofocal lenses.  The different zones may cause glare and halos, particularly at night, or if you have a large pupil.  Many people adapt to these conditions, however some do not.  Therefore, there is a higher chance that this lens may need to be exchanged for a monofocal IOL (with a second surgery) if it causes problems.  These lenses are not appropriate for patients with high visual requirements or have any other condition affecting the eye.