Cataract surgery is the most common eye surgery performed worldwide, with the earliest known procedures dating back to over 2000 years ago. Modern surgical techniques allow the procedure to be quick, painless, and highly consistent. Most patients achieve their desired visual result within one to two weeks, and are finished with their follow ups after one month. The most significant decision a patient must make after deciding to proceed with cataract surgery is choosing the lens implant.
A cataract lens implant is a small disc most commonly composed of a specialized plastic. Once the cataract is removed, the implant replaces it. The implants are clear and pre-selected to correct the patient’s vision depending on their needs. The most common style of lens is called a “monofocal” lens. A monofocal implant acts similarly to a standard eyeglass lens, as it is focused on one specific distance. Most patients choose monofocal lenses set for the distance in both eyes. Some patients may choose to have each eye adjusted differently, such as one for distance, and the other reading. This is called “monovision” and is also achieved using contact lenses in patients that prefer to not wear reading glasses. Some patients spend most of their time reading, and thus choose to set their lens implants for near. Monofocal lenses offer the best vision at the desired distance, but each of these lens setups offer their own unique pros and cons and should be weighed carefully by the patient.
More recently, multifocal lens implants have become mainstream. These lenses aim to minimize the cons associated with a standard lens design. Multifocal lenses function similar to a multifocal contact lens in that they offer usable vision at several different distances. Most patients fitted with multifocal implants will achieve close to 20/20 at distance and near. Although these lenses reduce the need for glasses, the optical techniques used to design them can create problems with glare and halos in certain lighting conditions.
There are new lens technologies on the horizon as well. One of the newest lens technologies, FDA approved in 2017, is called the Light Adjustable Lens (LAL). The LAL allows doctors to make changes to the prescription of the lens once it has already been implanted, providing enhanced accuracy and the potential for better visual outcomes. Researchers are also looking into ways to develop lenses that act like our natural lens, which focus and defocus depending on our needs.
The decision to undergo cataract surgery is a significant one, and the options can be overwhelming. I highly recommend a thorough discussion with your surgeon prior to cataract surgery to outline the pros and cons of each option available. Your doctor may also have recommendations based on your particular eyes, as some lenses may not be right for every patient. For more information, see the links below.