Lens Choices for Cataract Surgery
Congratulations on deciding to have cataract surgery! It is very normal to be excited about improving your vision, but, feel anxious about the whole thing at the same time. Don’t worry, that is normal and most everyone feels the same way.
In addition to deciding to have cataract surgery, there is another important decision to make:
What kind of lens do you want implanted?
When you have your natural lens removed (after all, a cataract is just your own natural lens which has become thickened and cloudy over time), we have to replace it with a new clear artificial lens. (If you are interested in the steps of cataract surgery or the materials the lens is made out of please see our FAQ section). No one lens is right for every patient – we tailor it to you, your lifestyle and your vision goals. You have choices on the kind of lens that is implanted. Your decision depends on a number of factors: How much do you like or dislike wearing glasses after your surgery? How much does it bother you to put on reading glasses to read? What are your financial constraints?
Extended Depth of Focus (Symfony) lens and Astigmatism Correcting (Toric) lens
There are new lenses on the market which allow you to see both in the distance (for activities like driving) and up close (for activities like reading), and there are lenses which correct your astigmatism. Patients who no longer want to wear glasses love these lenses! It offers them independence from glasses and allows them to do their daily activities without having to fumble for reading glasses. The biggest drawback of these lenses is that they are not covered by insurance and would be an out of pocket cost. Cataract surgery is one time in your life where you can decide how you are going to see and if you want to continue wearing glasses.
Standard, monofocal lenses
The standard lenses are also an excellent choice, will allow you to see much more clearly, and is covered by your medical insurance. The standard lens allows you to see well at one particular distance (i.e. monofocal-meaning one focus point) and most people choose to see well in the distance (for activities like driving, watching your golf ball at the driving range, looking at the top of the neighboring mountains or hunting), but for near activities like reading, threading a needle, or tying a fly, you will need to put on a pair of reading glasses. If you don’t like having to put on reading glasses after cataract surgery, you may opt to wear bifocals after your procedure or if you really don’t like the idea of having to wear any glasses after cataract surgery – it is time to think seriously about the specialty lenses.
Maybe you have worn contact lenses in the past which made one of your eyes an eye with which you see well in the distance and one of your eyes see well up close? If this is the case, you have monovision and may be an excellent candidate for monovision cataract surgery. This is where we will insert a new lens in one eye to make it a distance eye and a new lens in the other eye to make it a near eye. If you have a history of monovision, please let us know and we can talk about this option with you.
Maybe you like the idea of being able to see up close and far away, but, don’t want the financial expenditure of paying for a specialty lens? Well you may be a very good candidate for “mini”-mono vision. This is where we make one eye a good distance eye (for activities like driving) and one eye a computer distance eye (for activities like working on your computer, tablet or smart phone). We make the target vision in both eyes different enough that you see a wider range, but not so different so that your brain is confused by the amount of difference between the two eyes. This offers you significant glasses independence, however, there may be times when you will want to put on a pair of glasses for small print or when you want both eyes seeing well in the distance (for night driving or driving in unfamiliar places). So, this option is a good one if you mostly want to be out of glasses, but don’t mind having to use them every once in awhile.
****Special considerations for astigmatism:
Astigmatism sounds like a terrible affliction, doesn’t it? Well, it is not. It is a big scary sounding word which only means that the surface curvature of your eye is not a perfect dome shape- instead, if you have astigmatism, it means the surface curvature of your eye is steeper in one area and flatter in another. Some people may have described your astigmatism to you in the past as your eye being shaped like the end of a football or like a mountain and this again just means the surface curvature of your eye is steeper in one area. Astigmatism, the steep area of curvature, affects your vision by changing how the light focuses on the back of your eye. As light comes into your eye, it is bent and skewed by the area of steep curvature and this results in you not seeing as sharply. Glasses counteract the effect of astigmatism by bending the light so that if focuses clearly on the back of your eye.
When we do cataract surgery, we do not change the shape of the curvature of your eye very much at all, so whatever astigmatism you have before your cataract surgery, you will likely have afterwards. So, if you have a lot of astigmatism, you will likely need glasses after cataract surgery to correct for it. If you hate the idea of having to wear glasses after your cataract surgery, then consider one of the specialty lenses which corrects your astigmatism.
****Special considerations for near sighted people:
If you have been near sighted all your life (meaning you see well up close and probably take off your glasses to read) you will likely want to maintain some of your near-sightedness. Most people who have always been able to read without glasses or do close work without glasses want to keep this ability and use glasses for activities like driving. Because you have been near sighted all of your life it makes sense to your brain that you can see things up close, but, need glasses to see well in the distance. For near sighted folks we advise you to keep some of your near sightedness after cataract surgery, because in our experience it makes for a much happier patient. But, ultimately the decision is up to you. If you choose to have the standard lens and want to have it set up so you see well in the distance (because you have always dreamed of driving without glasses) we can do that, we would just caution you that you will no longer be able to see up close without a pair of reading glasses.
Still wondering what your best option is?
Please answer our questionnaire so we can determine what you think is most important when it comes to your vision and how we can tailor surgery and lens choice to best meet your needs.
Also visit “The Patients Guide to Cataract Surgery” for more information about specialty implants. There are multiple simulators that will give a visual representation of what the different implants can do for you!