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June 21, 2019

There are a lot of different options with a cataract surgery. We can do things from regular cataract surgery or standard cataract surgery (which is still a lens replacement) and then usually about a week after the procedure, patients get their glasses – whether it’s for driving or for reading or for both. Now for patients who would like to see without glasses or at least have us do whatever we can to minimize their need for glasses after surgery, there’s a whole host of things we can do and we consider this to be refractive cataract surgery. Of those options, one common thing would be to have both eyes corrected for distance vision. So whatever astigmatism (nearsightedness or farsightedness) that needs to be corrected, we’d be able to do that so that patients could see to drive without glasses and maybe just where some over the counter reading glasses. Other patients would like to do a little bit more where they could see far and near without their glasses. To accomplish that, we might correct one eye for distance and one eye a little more for in-close. It may be for reading or maybe just close enough to see the cell phone and do text messages without having to go off and on with their glasses. The fanciest thing we can do is to put in these lens implants that we call multifocal or extended depth of focus lenses. What those do is they enable patients to see both far and near out of both eyes – so both eyes are for distance and both eyes are for up-close. It’s kind of the fanciest thing to do. Now, all of these different techniques do have potential drawbacks. Obviously with the monovision, patients might (if they’re not accepting of it) feel a little imbalanced between the two eyes, it could be bothersome. A lot of patients have tried the monovision prior in contact lenses or with LASIK, so they already are familiar with it. With the multifocal lenses, while they’re very strong and powerful at providing both distance and near vision, one of the drawbacks is that patients might see a ring around things or a halo when driving at night – so looking at point sources of light can have kind of a ring pattern to it. Fortunately, the chance of that being a bad problem is very, very low, but it’s important for patients to know that it’s possible to see it so that they don’t panic about it if they’re noticing it and can be reassured that it typically improves over time. It’s very important that a lot of detailed testing is done at the preoperative consultation because it’s at that visit that the doctor is really able to figure out what the patient is the best candidate for and what the patient’s needs are so that their goals can be achieved.

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