Lens Implant after Contact Lens Wear

Question: For 15 years I have worn a single +4.00 D contact lens for reading with no problems. I now have a cataract in this eye and my ophthalmologist sent me for biometry prior to surgery. It was discovered I have quite severe astigmatism (which has never been a problem to me) and there is now a problem deciding whether to have a toric lens implant or a regular lens implant. I do not want to wear glasses to read and my other eye is fine for driving and distance. Any advice enormously appreciated.


Answer: You do not say whether you are wearing a soft or a rigid contact lens. If you have been wearing a rigid contact lens, it is highly probable that after 15 years of wearing a thick +4.00 D contact lens, you would not know that you had astigmatism, as the rigid lens would correct it.

However, if you have been wearing a contact lens for that long, it is also possible that the contact lens has changed the shape of your cornea and induced astigmatism that was not present before-and thus it may very well be transient. That is, you will need to discontinue the contact lens for some period of time until the cornea returns to a more normal and stable shape. With rigid lens wear, it can takes weeks or even several months, to achieve stability. The corneal molding effect can even happen with soft contact lenses. Thus, the key step here is discontinuing your contact lens and to have the ophthalmologist perform serial corneal curvature measurements, serial corneal topography measurements and serial refractions over a period of weeks or longer, until you have demonstrated stability of these parameters, so that an accurate set of measurements can be taken for the calculation of lens implant type and power.

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 of 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.

Contact Lens after Cataract Surgery?

Question: I am having cataract surgery on my right eye with a lens implant that will give good distance vision. My left eye is extremely nearsighted. My eye doctor wants to correct the left eye with a contact lens, not glasses. I'm reluctant to be totally dependent on a contact. Is it possible to get glasses with a corrective lens for left eye and clear glass for the right?

Answer: Let's assume that after Cataract Surgery that your right eye sees well at distance without the need for any optical correction. If your left eye still requires a considerable optical correction and thus a relatively strong prescription eyeglass lens, the difference between the two eyes may cause your vision to be quite imbalanced and very uncomfortable. This is because the eyeglass prescription for extreme nearsightedness actually minifies or makes images look smaller. Thus, even though the vision might be good in each eye-there may very well be a difference in image sizes that causes you considerable discomfort.

Patients who have markedly different prescriptions in each eye-a condition called anisometropia-often complain of dizziness and headaches and even other uncomfortable symptoms when they try to wear eyeglasses. One option as your Cataract Surgeon described is to wear a contact lens. This equalizes the image sizes between the eyes and you would not actually be totally dependent on the contact lens as we are assuming that you will have good vision after the Cataract operation on the right eye.You do not state your age or whether you have the beginning of a Cataract in the left eye. If so, it is only a matter of time before you will have surgery on the left eye with a lens implant and then both eyes will have equal image sizes. If there is no Cataract in the left eye, another option-if your Cataract Surgeon approves and feels that it is medically necessary and safe and preferred or you are intolerant to a contact lens-the Cataract Surgeon can perform a Clear Lens Extraction and Lens Implant on the left eye which would also create equal image sizes in both eyes. The last possible option-if there is no Cataract in the left eye and you are not likely to develop one in the foreseeable future, is to have a Laser Eye Surgery procedure such as LASIK on the left eye to correct the nearsightedness. This would not be the best option if there was any chance you would need Cataract Surgery in the left eye any time soon. Eyeglasses after Cataract Surgery when one eye is extremely nearsighted is not the best option

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 www.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 of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.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.