Reading Glasses after Cataract Surgery

Question: I am 51 years old and have been advised that cataract surgery and a lens implant is needed in my left eye.  I recently switched to multifocal contact lenses (-9.5 power) and am disappointed to have been told that I am not a candidate for a premium multifocal lens implant IOL and that I will need to wear reading glasses after the surgery.  My doctor said this was due to the shape of my eye.  Is there any hope of me consulting with another cataract surgeon and being told that cataract surgery can leave my free of needing reading glasses?

Answer: Your disappointment with not being a good candidate for a multifocal lens implant after cataract surgery to avoid having to wear reading glasses is understandable-especially in consideration of your adaptation to the multifocal contact lenses. It is not clear from your description what part of the “shape of your eye” is the issue-and you don’t state whether you are wearing rigid or soft lenses, so it is difficult to offer much more than some general comments. First, if you are a rigid gas permeable lens (RGP) lens wearer this could very well complicate the precision and accuracy of the measurements and calculations used for the lens implant. If you had induced astigmatism or other shape changes from the contact lens wear this could be a challenge. With less complex lens implants, the calculations are still subject to this variation, however with the multifocal lens implant the lack of precision will lead to a much greater level of dissatisfaction if it is present. You do not say if the shape of your cornea is otherwise normal or regular and thus one suspects that you might have a great deal or natural or induced astigmatism-which also could make the successful implantation of a multifocal lens implant more of a challenge as the astigmatism would ten need to be corrected after the cataract surgery either with a Limbal Relaxing Incision (LRI) or LASIK surgery in order to obtain full functioning and vision correction. If there is any doubt in your mind it is never inappropriate to get a second opinion. Find the best Cataract Surgeon in your area who is also a LASIK Surgeon and schedule a consultation. By finding a Refractive Cataract Surgeon you will avail yourself of the best information regarding your complex optical situation along with the need for cataract surgery.

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.

Starburst after Cataract Surgery

Question: I had cataract surgery one month ago and had a toric lens implant. Immediately after surgery I have experienced a horizontal star burst with 4-6 long flares/rays at night while driving with oncoming headlights. Halogen and LED lights produce the most vivid star bursts. My cataract surgeon thinks this may be caused by a wrinkle or crease in the back of the capsule. He suggests a laser procedure to remove a section of the capsule to eliminate the crease. This sounds reasonable to me.  What are your thoughts?

Answer: The type of visual symptoms that you are describing are very possibly due to a crease or wrinkle in the posterior lens capsule that is left in place in order to support the lens implant. This does happen from time to time and is immediately alleviated with a YAG Laser Capsulotomy which should in short order eliminate the starburst if this was the cause. While it is possible that there are other causes this is a logical place to begin and you should follow 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.

Multifocal Lens Implant for Artist

Question: I have poor distance vision and am due for cataract surgery shortly. An artist by profession I need good all round vision. However I have not coped well with multifocal spectacles and wonder whether the Lentis Mplus Multifocal Lens Implant that I have been offered may not suit me. I do not wish to experience alterations in my color vision or my area of vision to be restricted. I already suffer with glare and halos and poor night vision and was hoping that cataract surgery would get rid of this. Would I be better off choosing a standard lens implant and using glasses for close up work? What would my mid-distance vision be like?

Answer: As an artist you certainly have more demanding vision requirements than the average person, thus your caution and concern in choosing a lens implant after cataract surgery is well founded. That said, multifocal lens implants are very complex optical systems and ALL multifocal lens implants have optical limitations which do present some compromise to vision quality depending on their specific design. For this reason you should strongly consider having the lens implant with the BEST possible optics even though it may require that you wear eyeglasses for near or intermediate vision. This will likely be an aspheric wavefront optimized design that minimizes or eliminates aberrations including spherical aberration and chromatic aberration. Please discuss this with your cataract surgeon who can assist in the choice of lens implant and help you determine the working distances that will require eyeglasses.

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.

Toric Lens Implant for Astigmatism

Question: Does the toric lens implant for cataract surgery totally remove astigmatism?

Answer: Toric lens implants for astigmatism correction after cataract surgery “correct” but do not “remove” astigmatism. If the astigmatism is regular and caused by the shape of the  cornea being unequal in curvatures, toric lens implants are quite effective at correcting the  vision if they are measured properly and implanted correctly.

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.

Floaters after Cataract Surgery

Question: I had cataract surgery in October with an AcrySof® IQ Lens Implant. I told my cataract surgeon that I was seeing floaters ever since the eye surgery. The floaters seem to be getting worse. What should I do?

Answer: Floaters after cataract surgery and lens implants are not uncommon. In most cases the floaters are the result of changes in the vitreous gel inside the eye. This can be due to a vitreous condensation, liquefaction or detachment-called Posterior Vitreous Detachment (PVD). If the floaters are increasing or if you see distortion, bending or bowing or bubbling of your vision-especially if there are flashes of light, it would be important to return to your cataract Surgeon and have a thorough examination of the  retina and the vitreous to be sure there is no traction, tears or detachment of the retina.

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 Vision Problem

Question: My father had cataract surgery and multifocal lens implant about 18 months.  He is 85 and active and is still having problems seeing with the lens implant that was used.  He has symptoms that sound like a decentered or dislocated intraocular lens implant.  The eye doctors at the facility had some problems inserting the lens implant at the time of surgery causing swelling to occur. They told him this would get better over time and that his vision would improve. Swelling went down but vision did not improve.  He has returned for several visits and they tell him everything is fine, but his vision in the eye is still not correct.

Could there be a problem with the lens implant or some other issue that they are not discussing?  I am planning to visit the doctor with him in the next 2 weeks and wanted to know if there were other questions I should ask or if there is anything that can be done to correct the problem.  He can't drive at night and they have told him to get regular glasses to correct the vision problem.

Answer: Unfortunately it is impossible to know from your description the actual nature of the vision problem. Is it glare, halo, blur-at what distances-far, near, intermediate? You state he cannot drive at night-why? Glare-halo-blur? Or something else that might suggest a problem not with the lens implant itself but perhaps with the capsule left in place to support the lens implant.  Was the cataract surgery itself complicated-was the capsule ruptured? You state there was “swelling”.  Where was the swelling-the cornea or retina? As you can see there are MANY questions that need clarification through a clinical examination and then explained to you as the reason for your father’s difficulty with the multifocal lens implant. Or, it just may be possible that this is as good as his vision can be with the multifocal lens implant as, depending on the  type of multifocal lens implant, they do often present a number of potential vision compromises which are exaggerated if the  lens is not centered perfectly. That said, you certainly should be present and discuss the possibilities with the cataract surgeon after the next visit and exam.  If the discussion does not give you a reasonable explanation and path to improvement-if possible-then find the best cataract surgeon in your area and schedule an appointment 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.

Monofocal Lens Implants for Near Vision

Question: Can I have a lens implant that is focused so that I have to wear eyeglasses to see clearly at distance but when I take them off I can see clearly to read? What is the distance that the reading capability kicks in and I'd have to remove my distance glasses?  Would these lens implants reduce glare at night or halos around lights compared to multifocal lens implants?

Answer: The simple answer is yes you can have a monofocal or aspheric lens implant that is calculated in prescription strength so as to allow you to see clearly for near vision such as reading. This would then require that you wear eyeglasses to see at distance as you would be rendered “nearsighted” by the les implants. The distance that the near vision would be clearest would be a matter of you discussing this with the eye surgeon and determining the approximate distance at which you wanted it to “kick in” as this is a mathematical and optical calculation that is adjustable.

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.