Cataract surgery is the single most common surgery in the United States with over 4 million procedures performed each year. The goal of every cataract surgery is to restore vision by replacing the eye’s cloudy lens with a new, clear, intraocular lens (IOL) which will also reduce the patient’s need for glasses or contact lenses. However, we try to avoid using the phrase “eliminate glasses or contact lenses” as patient’s expectations of post-surgical vision can vary greatly.
A Look Back: Early Cataract Surgery
Before the advent of cataract surgery using IOLs, the natural lens was removed without implanting an IOL. This usually left patients completely dependent on thick glasses with a very magnified appearance. Cataract surgery using IOL’s was first developed in the 1950’s and has seen continued advancements over the decades. These earlier surgeries involved IOLs which were designed to allow patients to see distance objects with as little prescription as possible. However, calculating the proper IOL power to provide the desired visual outcome and margin of error in the healing process often left patients with a glasses prescription for both distance vision and near vision.
Improving Accuracy and Visual Outcomes
As accuracy of cataract surgery continued to improve into the 1980’s and 90’s, most patients could reasonably expect to have acceptable distance vision without glasses but a definite need for near vision glasses. If desired, patients could also choose to have the IOL’s set for near objects thus reducing the need for glasses at near but increasing the need for distance glasses. Patients also had the option of monovision which is one IOL set for near and the other set for distance vision. This was (and continues to be) a good option but definitely not perfect and is usually best for patients who have worn monovision contact lenses previously.
Most recent advancements in cataract surgery technology have dramatically increased IOL accuracy and improved visual outcomes, further reducing the need for post-surgical glasses or contacts. These advanced “premium” IOLs can often correct higher amounts of astigmatism and are also available in multifocal designs which allow patients to see both distance and near with minimal or (sometimes) no need for glasses. New “light adjustable” IOLs can even allow vision to be fined-tuned after cataract surgery which is an amazing advancement. However, these premium lenses can be significantly more expensive and are not usually covered by insurance.
Do You Still Need Glasses After Cataract Surgery?
So, who usually needs glasses or contact lenses after cataract surgery? Depends on patient expectations, personality, and tolerance to blur after cataract surgery! Since no lens option is completely perfect, a post-surgical residual correction (glasses prescription) can almost always be found, even in those patients who choose a premium IOL. Hence, patients who are expecting a perfect 20/20 or better at both distance and near, may be disappointed and still want to wear glasses to fulfill their desired acuity. For those patients who can accept and be happy with vision that may be a little less than perfect but acceptable for their day-to-day tasks without glasses, may find themselves glasses free or possibly just some very occasional use of readers or light distance correction.
A Procedure That Truly “Turns Back the Clock”
Fun, final note…cataract surgery is one of the few surgeries that can actually “turn back the clock” with minimal recovery time compared to other procedures which can “repair” and hopefully regain lost function, sometimes after a very lengthy recovery time. Ok, that was a little poke at our friends in orthopedics with whom I am a frequent flier and do appreciate their efforts!
See the World Clearly Again
If you’ve noticed cloudy vision or glare, cataract surgery could restore your clarity and confidence. Book a consultation today to discuss your lens options and find the solution best suited to your visual goals.