Question: I just turned 50 and have been to a cataract specialist and he recommends cataract surgery since I'm having a lot of trouble seeing close. Apparently the cataracts are mostly in the bottom of the lens. I have worn glasses for distance since I was 12 but, just started needing them for reading. I really would like to wear no glasses but am not sure which upgrade lens to go with or my percent chance of not needing glasses.
Answer: We are unable to reconcile some of the information you have provided. First, is the formation of a Cataract interfering with your vision or is the fact that you are presbyopic and thus having near vision focusing problems what is causing your complaint? Developing a Cataract at the "bottom" of the crystalline lens is not likely to cause a disturbance beyond the presbyopia as it would probably be off the visual axis. You do not state what type of refractive error you had that necessitated the wearing of glasses from the age of 12. Depending on the degree of correction required, if you were simply nearsighted or farsighted then having a Cataract or even a clear lens extraction with implantation of a near vision presbyopia correcting Lens Implant is one of the possible options to help you achieve a "glasses free" form of vision correction. If you have even the beginning of a Cataract in any location, one would not recommend Monovision LASIK due to the generally progressive nature of the Cataract. Now, there are really two types of near vision presbyopia correcting Lens Implants-Multifocal Lens Implants and Accommodating Lens Implants. Each of these is actually available in different designs with different optical characteristics. Thus, the choice of which type of Lens Implant to use is really dependent on how you use you eyes each day and what types of activities you engage in as these activities. This will determine the distances of clarity that you require and the type of functionality that the Lens Implants needs to provide to help you be "glasses free". In order to have a proper selection of a Lens Implant type it requires a thorough set of measurements and a discussion with your Cataract Surgeon about what activities you need clarity for and how you use your eyes.
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