Seeing Without Glasses after Cataract Surgery: Your Lens Implant Options

- BY SCOTT W. TUNIS MD FACS

Cataract surgery with intraocular lens (IOL) implantation is one of the most common surgical procedures performed in the United States, with well over 1 million procedures performed annually. A cataract occurs when the normally clear human lens becomes cloudy and thereby causes blurred vision. Cataracts can be caused by medications, injuries, systemic illness and other conditions, but are most commonly associated with the aging process.

State of the art cataract surgery to restore vision is truly one of the wonders of modern medicine. Cataract surgery is a 10 minute procedure performed under topical anesthesia through a microscopic suture-less incision, in which the cataract is removed by phacoemulsification (liquefied by ultrasound) and then replaced with an artificial lens, or intraocular lens implant (IOL). Recovery time is minimal, visual recovery is excellent in a very high percentage of patients, and complications are uncommon.

As the aging of the population occurs and as we enjoy better health later in life, the prevalence of cataracts is increasing. Patients undergoing cataract surgery typically have active lifestyles with demanding visual requirements, and as a result, many patients undergoing cataract surgery desire minimal dependence on glasses after the surgery. The goal of reducing or eliminating dependence on glasses after cataract surgery can usually be achieved  through a careful consideration of the patients’ postoperative visual needs, including a thorough discussion of the advantages and compromises of each type of IOL,  and with final appropriate planning and selection of the IOL prescription to be implanted.

Intraocular lenses (IOLs) come in a variety of configurations and prescriptions allowing the patient and surgeon to select the lens which will best suit the patient’s postoperative visual needs. They are available in single vision prescriptions for distance or near, in bifocal prescriptions, and in prescriptions to correct astigmatism, as well as combinations of all of these.

Choosing both IOLs for clear distance vision and using reading glasses may be the best choice for one patient, monovision with one eye distance and one eye for near may be better for another, and bifocal IOLs may be the best choice for yet another. There is no “one size fits all” and the choice of IOL prescription must be tailored to each patient’s lifestyle.  Although cataract surgery with IOL implantation is a highly refined and successful procedure, it is not a “time machine,” and no surgical procedure or IOL type will restore vision to a quantity and quality that is identical to youthful glasses-free perfect vision. Yet with the advances in modern cataract surgery and IOL implantation, and with an array of IOL options available, most patients can enjoy clearer  vision and an active lifestyle with minimal dependence on glasses after surgery.