Cataract Surgery: Vision Correction and Eyewear Choices

What level of vision correction should be achieved after cataract surgery, and how should glasses be worn for the eye that has not undergone surgery?

Hello, doctor.
I apologize for the interruption.
Recently, I have experienced a decline in my vision.
After a consultation, it was confirmed that one eye has myopia of -11.50 diopters and cataracts, and I am planning to undergo surgery soon.
The other eye has myopia of -7.50 diopters and mild cataracts.
I would like to ask the following questions:
1.
As a homemaker who primarily focuses on near vision, would it be better for me to choose a monofocal intraocular lens with a focus on near distances?
2.
Should I reserve some degree of correction to address presbyopia? What factors determine the amount of reserved correction?
3.
I understand that there are limitations to using glasses to correct binocular disparity.
After surgery, should I temporarily wear contact lenses for the eye that is not operated on?

yfycki, 50~59 year old female. Ask Date: 2021/03/22

Dr. Cai Wenyuan reply Ophthalmology

1.
Depending on individual needs, discussions can be held with the surgeon based on actual circumstances.
2.
If presbyopic correction is reserved, distance vision may be unclear; it still depends on individual requirements.
3.
It is not always the case; some patients may be able to wear glasses, depending on the postoperative situation.

Reply Date: 2021/03/22

More Info

Understanding cataract surgery and the subsequent choices for vision correction can be quite complex, especially for individuals with high myopia and other ocular conditions. Based on your situation, here are some insights and recommendations regarding your questions.

1. Choosing the Right Intraocular Lens (IOL): Given that you are primarily a homemaker and your daily activities involve a lot of near vision tasks, opting for a single-focus IOL that is set for near vision may indeed be beneficial. This choice would allow you to perform tasks like reading, sewing, or using a computer without the need for additional glasses. However, it’s important to consider that this may limit your ability to see clearly at a distance, which could be a drawback if you need to drive or engage in activities that require good distance vision. Discussing your lifestyle and visual needs with your ophthalmologist will help in making the best choice for your IOL.

2. Presbyopia and Reserve Power: As you age, presbyopia, or the gradual loss of the eye's ability to focus on nearby objects, will likely become a concern. It is common practice to leave a certain amount of "reserve power" in your IOL to accommodate for this condition. The amount of reserve power you should leave depends on several factors, including your age, the degree of your myopia, and your visual demands. Typically, a reserve of +1.00 to +2.00 diopters is considered to help with near vision tasks as presbyopia progresses. Your ophthalmologist can provide tailored advice based on your specific circumstances.

3. Addressing Anisometropia (Difference in Refractive Power): After cataract surgery, if one eye has undergone surgery and the other has not, you may experience significant visual disparity, known as anisometropia. This can lead to discomfort and difficulty in visual tasks. In such cases, wearing contact lenses in the unoperated eye can help balance the vision between both eyes. However, the choice of whether to wear contact lenses or glasses should be based on your comfort and the advice of your eye care professional. They can assess your vision post-surgery and recommend the best corrective options.

In summary, your choices regarding IOLs and eyewear should be guided by your lifestyle needs and the professional recommendations of your ophthalmologist. It’s crucial to have a thorough discussion about your visual goals, the potential for presbyopia, and how to manage any differences in vision between your two eyes after surgery. This collaborative approach will ensure that you achieve the best possible outcome from your cataract surgery and maintain a good quality of life. Always remember that each individual's situation is unique, and personalized care is key to addressing your specific needs.

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