Cataract Surgery: Key Questions About Lens Choices and Timing

Q: Cataract Surgery: Key Questions About Lens Choices and Timing

Hello： <br>1. <br>The degree of vision reserved during the left eye surgery to see a 40 cm mobile phone subtitle depends on individual visual needs. <br>If 300 degrees is reserved, the vision may be sufficient to clearly see the mobile phone subtitles, but it is important to note

Cataract lens

Hello! I had cataract surgery on my right eye on March 21, with a monofocal aspheric lens set at 0 diopters, and I am scheduled to have surgery on my left eye (with a prescription of -9.00 diopters) on March 28.
I would like to ask the doctor:
1.
How many diopters should be reserved for my left eye to see subtitles on a mobile phone at a distance of 40 cm? If I need to reserve 3.00 diopters, will my brain be able to fuse the images?
2.
What are the advantages of short-range and long-range extended focus lenses?
3.
Can I switch to a multifocal lens for my left eye?
4.
Is it appropriate to have a one-week gap between the surgeries for each eye? (The right eye has recovered normally.)

Li, 70~79 year old female. Ask Date: 2024/03/25

Dr. Gao Pilin reply Ophthalmology

Hello:
1.
The degree of vision reserved during the left eye surgery to see a 40 cm mobile phone subtitle depends on individual visual needs.
If 300 degrees is reserved, the vision may be sufficient to clearly see the mobile phone subtitles, but it is important to note that the brain needs time to adapt to different degrees of vision.
Although the brain has a certain capacity for adaptation, sudden changes in prescription may require some time for adjustment.
Therefore, it is recommended to discuss this with your ophthalmologist before the surgery to determine what is best for your situation.
2.
Short-range multifocal intraocular lenses primarily focus on distance vision but also provide a certain level of near vision, allowing patients to usually see clearly at distance and intermediate ranges without glasses or with only mild glasses post-surgery.
The advantages of short-range multifocal lenses include:
* Reduced dependence on glasses
* Improved night vision
* Decreased glare
Long-range multifocal intraocular lenses primarily focus on near vision but also provide some distance vision, enabling patients to typically see clearly at near and intermediate ranges without glasses or with only mild glasses post-surgery.
The advantages of long-range multifocal lenses include:
* Reduced dependence on reading glasses
* Improved efficiency for near tasks
* Increased convenience in daily life
Comparison of Short-range and Long-range Multifocal Intraocular Lenses:
| Feature | Short-range | Long-range |
|---------------------|---------------------|---------------------|
| Focus Distribution | Distance > Intermediate > Near | Near > Intermediate > Distance |
| Distance Vision | Good | Fair |
| Intermediate Vision | Moderate | Good |
| Near Vision | Fair | Good |
| Dependence on Glasses| Reduced | Reduced |
| Night Vision | Improved | Improved |
| Glare | Decreased | Decreased |
| Adaptation Period | Short | Long |
| Cost | Lower | Higher |
Selection Recommendations:
Both short-range and long-range multifocal intraocular lenses have their advantages, and patients should choose based on their personal needs and lifestyle.
Here are some suggestions:
* Individuals who frequently drive or look at distant objects may opt for short-range multifocal lenses.
* Individuals who often read or use electronic devices may choose long-range multifocal lenses.
* Those wishing to reduce dependence on glasses can consider either short-range or long-range multifocal lenses.
* Individuals sensitive to night vision or glare may also consider either option.
Please understand that this is merely online advice; it is crucial to consult your attending physician before selecting an intraocular lens to choose the appropriate one based on the physician's recommendations.
3.
Whether to switch to a multifocal lens depends on your eye condition and personal needs.
Multifocal lenses can provide good vision at distance, intermediate, and near ranges, but may cause side effects such as glare and halos.
It is advisable to discuss this with your attending physician before the surgery to determine if multifocal lenses are suitable for you.
4.
Generally, a one-week interval between cataract surgeries for both eyes is a reasonable timeframe.
Since your right eye surgery went well, indicating successful recovery, proceeding with the left eye surgery should be safe.
However, it is essential to follow your attending physician's advice to ensure that the timing and method of the left eye surgery are appropriate for your individual situation.

Reply Date: 2024/03/25

More Info

Cataract surgery is a significant procedure that can greatly enhance your vision, especially when dealing with conditions like myopia (nearsightedness) and presbyopia (age-related difficulty in seeing close objects). Your questions touch on several important aspects of the surgery, particularly regarding lens choices and the timing of the procedures. Let’s address each of your inquiries in detail.

1. Choosing the Right Degree of Correction for Your Left Eye: You mentioned wanting to reserve a certain degree of correction in your left eye to see your phone screen clearly at about 40 cm. If you are considering reserving 300 degrees, it is essential to understand how this might affect your vision. Generally, if one eye is corrected for distance and the other for near vision, your brain can adapt to this difference over time. This phenomenon is known as "monovision," where one eye is optimized for distance and the other for near vision. However, the degree of adaptation can vary from person to person. Some individuals may experience difficulties with depth perception or visual clarity, particularly in low-light conditions. It’s crucial to discuss this with your ophthalmologist to determine the best approach for your specific needs.

2. Short vs. Long Focus Lenses: Short-focus (or near-focus) lenses are designed to provide clear vision for tasks like reading or using a smartphone, while long-focus (or distance-focus) lenses are optimized for seeing objects at a distance, such as driving. The advantage of short-focus lenses is that they can enhance near vision, which is beneficial for activities that require close-up focus. Conversely, long-focus lenses are better for general activities where distance vision is more critical. Some patients opt for a combination of both, using multifocal or extended depth of focus lenses, which can provide a broader range of vision. Each option has its pros and cons, and the choice largely depends on your lifestyle and visual needs.

3. Switching to Multifocal Lenses: You asked whether you could switch to multifocal lenses for your left eye. Multifocal lenses can indeed be a good option if you want to address both near and distance vision simultaneously. However, the success of multifocal lenses can depend on various factors, including your overall eye health, the presence of any other ocular conditions, and your personal visual demands. It’s essential to have a thorough discussion with your eye care provider about whether multifocal lenses are suitable for you, especially considering your current prescription and the outcomes of your right eye surgery.

4. Timing of Surgeries: Regarding the timing of your surgeries, having a one-week gap between the two procedures is generally considered acceptable. Many surgeons prefer to perform cataract surgeries on separate days to allow for proper healing and assessment of the first eye before proceeding with the second. This staggered approach can help ensure that any complications or adjustments needed can be addressed before the second surgery. Since your right eye surgery has gone well, this timing should be appropriate, but always follow your surgeon's specific recommendations.

In conclusion, cataract surgery and lens selection are highly individualized processes. It’s essential to have open communication with your ophthalmologist about your visual goals, lifestyle needs, and any concerns you may have. They can provide tailored advice based on your unique situation, ensuring you achieve the best possible outcomes from your surgeries. Remember, the goal is to enhance your quality of life through improved vision, so take the time to explore all your options thoroughly.

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