Lens Implant for Monocular Patient

Question: I have monocular vision in my left eye, and have 2 kinds of cataracts, including posterior sub capsular cataract. My vision is now requiring lens changes to my glasses about every 2 months, so it is likely time for cataract surgery. I have found a good local cataract surgeon, but I wonder what kind of lens implant would be best and safest for my situation. I do have astigmatism, and currently wear lineless bifocal glasses and am 67 years old.


Answer: For most patients having Cataract Surgery and Lens Implants today, the goal of modern Cataract Surgery is to use advanced technology Lens Implants to help them become "glasses free" after Cataract removal-IF this is of importance to them. The decision of the type of Lens Implant to have is really best made after a careful discussion with your Cataract Surgeon regarding your personal vision correction goals. That said, there are some unique considerations in the case of monocular patients.

First, you might want to consider the role eyeglasses play in your eye protection. In monocular patients wearing eyeglasses with polycarbonate lenses offers a good measure of safety against flying objects, fingers and accidents in general. For that reason one could argue that you SHOULD wear eyeglasses after your Cataract operation even if you did not need to wear them. The next consideration is whether you should have a near vision presbyopia correcting lens implant. In general, near vision presbyopia correcting lens implants work best when implanted in both eyes in order to maximize the optical performance of the designs. Having vision in a single eye is likely to decrease the performance of this type of lens implant-thus it is probably not a great idea. On the other hand, if you have astigmatism that needs correction, it is worth considering using a toric lens implant as this will allow you to have the best distance vision even when you are without glasses-such as at night around the house-and thus require mainly a prescription for intermediate arm's length and near vision, which can be accomplished with no line progressive lenses.

Toric lens implants do not pose any additional safety risks, but do require a greater degree of precision in the testing, measurements and calculations. Your best next step is to discuss these considerations-along with your expectations and goals-with your Cataract Surgeon who will be able to assist you in making the best choice.

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