A cataract is caused by the clouding of the natural human lens. When the cloudy lens is removed with surgery, a new artificial lens is placed in the eye to focus images properly.
When considering cataract surgery, it is important to discuss the risks and benefits of the surgery with your eye doctor. With advancements in artificial lens technology over the last decade, discussing the type of new lens to be placed in the eye has become very important as well.
When a person reaches their 40’s, they begin to note that they are no longer able to see up close without glasses. While patients often have much decreased need for glasses for distance vision after cataract surgery, with a standard lens they will still need reading glasses for near vision.
Fortunately, patients now have additional lens options. One of these options is called a multifocal lens. This type of lens corrects both near and distance vision. One survey found that 4 out of 5 patients with this type of lens reported never wearing glasses. Many patients find that these lenses add greatly to their quality of life and enjoy the convenience of not having to keep up with reading glasses.
However, these lenses are not for all patients. In order for these lenses to work well, patients must have relatively healthy eyes. Those with severe dry eye, macular degeneration, or advanced glaucoma are not good candidates. A patient also must not have much astigmatism in order for these lenses to work well. Patients with larger amounts of astigmatism would likely benefit more from an astigmatism correcting intraocular lens.
Patient personality plays a role as well. While multifocal lenses are very good, they are not capable to giving patients the vision they had when they were 20 years old. Like all technologies they have limitations. Patients often note haloes around lights and can have glare issues, especially at night. However these symptoms are less noticeable with time. In one study, 6 months after surgery, only about 6 percent of patients described these problems as severe. Reading with these lenses requires adequate lighting, so patients may still need reading glasses in a dimly lit restaurant. There may be some decreased sharpness as compared to standard lenses, especially at night and in rainy or foggy conditions. This means that patients who know themselves to be perfectionists wanting the clearest possible vision at every distance, may do better with a standard lens and reading glasses. Finally, these lenses are considered to be similar to LASIK or cosmetic surgery by insurance companies. Therefore they are not covered by insurance and require an additional fee. However, even given these limitations, 93% of patients receiving one popular type of multifocal lens say they would choose to have a multifocal lens again.