Monofocal Lens Implants with Contact Lens for Near Vision

Question:  I currently use a contact lens in one eye to achieve simultaneous near and far vision. I am interested in having monofocal lens implants with my cataract surgery over which I would use a near vision contact lens to correct the deficit in near or far vision if I left the contact lens in all day. This is after all what I am used to now. I am fairly sure I want to avoid relying on having spectacles but could cope well with putting a contact lens in every morning.  I thought that the implant with addition of a contact lens might therefore provide good all round “crispness.” I didn’t grasp whether this scenario was a possibility.

Answer: It is possible to have monofocal lens implants and use a contact lens to correct the near vision. This is possible but begs the question as to if you are happy with a monovision correction, why not have the monofocal lens implant calculated with the monovision correction in the lens implants. This would allow you to eliminate the need for the contact lens. Your best next step is certainly to discuss this option with your Cataract Surgeon and see if it might be appropriate.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Glare after Cataract Surgery, Toric Lens Implants, LRI & LASIK

Question: I had cataract surgery with a toric lens implant for astigmatism. I also had Limbal Relaxing Incisions (LRI) in both eyes and LASIK in the right eye. I have a great deal of glare in my vision in both eyes when I am in a bright light outdoors, indoors with lamps on or looking out a window.  It is MORE than a starburst effect that I was told could be a side effect.  This is relentless, morning noon & night.  My astigmatism is improved & my vision tests better but learning to deal with this is as bad as trying to see around my cataracts.  My doctors don't seem to want to address my problem.  Am I going to have to live with this?

Answer: It is not possible to tell what the primary source of your glare is and how to remediate it without a considerable amount of additional clinical information. But, for sure the number of surgical procedures you have had is highly likely to have induced some very complex optical aberrations in the cornea-at a minimum. These optical aberrations are often compounded by the additional surgeries. It is not clear why you needed LASIK and LRI procedures after having a toric lens implant, however one would suspect that the optical outcome was not as targeted. If your Cataract Surgeon and other eye doctors are not willing or able to address the glare, it would be necessary to find the best Cataract Surgeon in your area who is also a LASIK Surgeon and possibly even a Cornea Specialist. Schedule a consultation and request that the aberrations in your eye be carefully evaluated by aberrometry, as well as the shape of your cornea by topographic imaging along with general results of the previous surgery so a possible solution can be offered.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Astigmatism Lens Implant Need

Question: Do I really need lens implants for astigmatism? My astigmatism is 1.00 D in the right eye and 1.5 D in the left eye. The cataract surgeon said both the basic lens implant would work but the toric lens implant will make things a bit sharper but costs $1,000 more for each eye. Will there be any noticeable difference with the toric lens implant?

Answer: Each cataract patient has a different tolerance to blur and defocus. However, depending on the  direction and the  orientation of the astigmatism it is possible that the defocus from the astigmatism will not only cause blurry vision but could also cause headaches and streaks of light at night as well as other distortions of light in dim or dark illumination. The astigmatism needs to be corrected. You can correct it by wearing eyeglasses after your cataract surgery, having a second surgery to correct astigmatism called Limbal Relaxing Incisions (LRI) or by having a toric lens implant at the time of cataract surgery-but the  astigmatism should really be corrected in order for you to see your best and be most comfortable after the cataract operation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Eye Bruises after Cataract Surgery

Question: I had cataract surgery on my right eye 5 weeks ago and the corner of my eye was darkly bruised after surgery. Now 5 weeks after the surgery the bruising in my right eye has lessened, but now I have dark areas in both corners of my eyes next to my nose. I checked pictures and this was not there before the cataract surgery. I am certain and I and my wife would have noticed it. I saw my doctor and he said it’s not from the surgery, but I am certain it is. Is there an explanation. It may seem a little trivial but I am a fairly young cataract patient- 40 and do not like the way this looks and also my operated right eyelid is a little droopy. Is there anything for me to do or will these things go away in time?

Answer: While it is impossible to tell or understand without a clinical examination, the types of bruises you are describing after cataract surgery as well as the time course do indeed make it difficult to really relate it to the  a complication of the cataract surgery. The bruises and the droopy eyelid may be worth investigating by scheduling a consultation with an Oculoplastic Surgeon who is experienced in cataract surgery as well as the conditions, problems and structure and functioning of the eyelids and soft tissue around the eye and the  orbital area. He or she should be able to provide and examination and consultation to help better understand what is happening here.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Dry Eye Help for Cataract Surgery

Question: I have a severe dry eye and need cataract surgery. Is it possible to have cataract surgery and reduce the risk of ending up with even worse dry eye problems?

Answer:  To have the most successful Cataract Surgery and avoid the risk of increasing your dry eye symptoms you should find a Cataract Surgeon who will aggressively treat your dry eye before the Cataract Surgery in preparation for a bit of a challenge to the integrity of your tears and tear film after the operation. Depending on the status of your tears and ocular surface, the aggressive preoperative treatment of your dry eye might include increased use of a carefully selected artificial tears, perhaps insertion of punctal plugs, prescription eye drops to help you make more tears such as Restasis® eye drops and nutritional supplements that might include certain types of Omega fatty acids or other vitamins. Cataract Surgery in and of itself can disturb the tear film and cause dry eye symptoms, so it would be important in the post operative period to continue the full course of dry eye treatment for a sufficient period of time or perhaps even permanently.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

ReSTOR® Lens Implant Problem?

Question: I had cataract surgery and a ReSTOR® Lens Implant placed in my right eye 3 weeks ago and I have a problem. My vision is still blurry and I have a dull achy pain in my eye and temple area. When can I expect this to improve? I'm afraid to have my other eye done for fear that these symptoms will occur again.

Answer: One would typically expect you to be comfortable and see pretty well 3 weeks after a Cataract Surgery and Lens Implant operation. It would be important for you to schedule an appointment with your Cataract Surgeon so that he or she can evaluate the status of your surgery and determine the cause of the ache-which may or may not be related to the Cataract operation and/or the Lens Implant. If after having a follow-up examination with your Cataract Surgeon you are still dissatisfied with the explanation and outcome, then consider scheduling a second opinion consultation with the best Cataract Surgeon you can find in your area in order to get a resolution to the problem.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Vision Problems after Cataract Surgery

Question:  I had Cataract Surgery in July and I am having problems with my left eye which feels like my eye is constantly dilated and it's like I'm looking through a dirty lens. My  Cataract Surgeon says everything looks okay and it's my brain playing tricks. It is driving me absolutely crazy. I have been back to my surgeon three times and he refuses to admit there is anything wrong. Please help what can I do?

Answer: Unfortunately there is no real way to tell why you are having the symptoms and vision problems you are experiencing without a thorough examination. Also, you do not indicate the type of Lens Implant that was used to correct your vision-which may be material to the problems. However, there are many other reasons including the possibility of posterior capsular opacification or even some irregularities in the posterior lens capsule that is typically left in place to support the Lens Implant. All of these items should be detected upon examination. Your best next step is to find the best Cataract Surgeon in your area and schedule an examination and consultation for a second opinion.  

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Dry Eye Pain after Cataract Surgery

Question: I had cataract surgery in my right eye one year ago.  Problems began immediately, starting the day I left surgery with severe "stabbing" pains as if glass shards were cutting into the eye.  This abated, only to be followed by severe pain that has persisted.  It may be a form of dry eye caused by nerve damage during the surgery, and I can't help thinking something might have gone wrong with the surgery that I have not been told about.  How can I find out a) whether the surgery had problems, and b) if it is dry eye, how to cope with it.  I've tried Restasis and pretty much all the drops with no success. 

Answer: As you do not seem to have confidence at this time in your primary Cataract Surgeon it might be worthwhile to arrange a consultation with another Cataract Surgeon for a second opinion in order to determine the actual diagnosis and reason for your pain. At this time you should consider finding a Cataract Surgeon who is also a Corneal Specialist and well versed in both Cataract Surgery complications as well as ocular surface disease such as dry eye.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Multifocal Lens Implant Choices

Question: The AcrySof® ReSTOR® Multifocal Lens Implant has been recommended to my husband who is in need of cataract surgery.  He received little information from the cataract surgeon about this lens other than he only offered the ReSTOR® Multifocal Lens Implant or the basic replacement lens implant.  After doing some research we think the ReSTOR® might be the best choice but we are concerned about the reports of halo or glare experienced during night vision since he drives often at night.  I don’t know that all the all the information we have found is very current so we are wondering if the halo/glare is still an issue with this particular lens? He is interested in not having to wear glasses but being able to drive at night is a must.

Answer:  All Multifocal Lens Implants are complex optical designs that utilize various types of refractive, diffractive or combination optics to achieve their effect. These optical designs ALL can cause some degree of glare and halo-or night photic disturbances. Further these night vision problems can actually be exacerbated without exquisitely precise surgical technique and implantation as their centration and positioning is critical. Also, some designs can cause a greater or lesser amount of night vision disturbance depending on pupil size. That said, in general the AcrySof® ReSTOR® Multifocal Lens Implant tends to cause a lesser degree of night vision problems when optimally implanted in patients with appropriately sized pupils-BUT still all patients should be aware of the  possibility of night vision problems. As you are raising a valid question and concern it might be wise to seek a second opinion by finding the best cataract surgeon in your area who uses multiple multifocal and accommodating near vision lens implant technology platforms in order to have the best and most broad based evaluation.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery Variable Vision

Question: I had cataract surgery almost 1 month ago but have variable vision so that my far vision is sharp in the morning but turns blurry within a couple of hours. I can see well up close but I wanted the far vision to be clear. Is there a way to tell if the wrong lens implant were used? If so can the lens implant be taken out and others put in their place?

Answer:  There is no way to tell why your vision is variable throughout the day as this is not typical after cataract surgery and lens implants. You certainly should discuss this with your cataract surgeon. It is not likely that an incorrect lens implant power would create this kind of variable vision, however if once your vision was stable there was in fact a need to adjust the implant strength, as long as your eye were healthy overall it should be possible to have a lens exchange at the direction of your cataract surgeon.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Time to Remove Cataracts

Question: I have cataracts in both eyes and my eye doctor said they can’t be removed until about 2 years from now. My right eye is worse than the left and although my eyes have always been sensitive the cataracts really bother me now. I want to know why I have a cousin that is 10 years younger than me and he was able to have his cataracts removed.

Answer: The time to remove cataracts is when they are bothersome enough so as to cause you sufficient visual discomfort, inconvenience or limit your mobility and safety in your daily activities. This usually means that there is noticeable blurry, cloudy or fuzzy vision with or without glare or light sensitivity. While many insurances and Medicare have certain thresholds of vision loss and symptoms that must be met in order for them to pay for cataract surgery and lens implants, it is pretty typical to have met these standards if you are manifesting the degree of symptoms described. In the distant past it was necessary for cataracts to be “ripe” before they could be removed. That is simply not the case today with modern cataract surgery techniques. If you are not satisfied with the opinion of your eye doctor it would be a good idea to consider scheduling an appointment for an examination and consultation with the best cataract surgeon you can find in your area and see what they recommend.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery or Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.