Intraocular lenses for cataract surgery

Standard cataract surgery versus refractive cataract surgery  

If your doctor recommends cataract surgery, you will need to choose a replacement lens for your eye. In most cataract surgeries, an intraocular lens (IOL) is placed in your eye once the cataract is removed. Just like the lenses in glasses or contact lenses, IOLs help your eye focus. This focusing power can be customized for your vision needs. 

IOL choices for cataract surgery

At the Casey Eye Institute, we offer two types of cataract surgery: standard cataract surgery and refractive cataract surgery.

Standard cataract surgery

For this option, we use high quality IOLs designed to correct nearsightedness or farsightedness. These IOLs may allow you to reduce the strength of your glasses, but in most cases you will still need to wear them to see most things clearly. Your doctor may ask if you prefer your vision without glasses to be better for distance, or better close up. The doctor can then select the right IOL for your eye. Most patients prefer to have their vision without glasses better for distance, but some people who have been able to read without glasses all their lives prefer to keep their vision like this.

Refractive cataract surgery

For this option, we use either standard IOLs enhanced by refractive surgery techniques or premium IOLs (not typically covered by your health insurance). Patients who want to decrease or eliminate dependence on glasses or contact lenses choose this option.

For patients with substantial astigmatism (a common refractive error that is usually combined with nearsightedness or farsightedness), there are options to decrease your astigmatism using a technique called limbal relaxing incisions or by using a premium IOL called a toric IOL. Patients who choose this option have a good chance of eliminating their need for glasses or contact lenses when viewing things in the distance (more than six feet away). However, they will still need reading glasses for reading and viewing the computer (though it is likely only over-the-counter reading glasses will be required).

If you want to reduce or eliminate your need for glasses or contact lenses when viewing both distance and near images, there are two more choices: multifocal premium IOLs and accommodating premium IOLs. Multifocal IOLs have concentric rings that create simultaneous distance and near images. Accommodating IOLs have flexible hinges that allow them to change focus, similar to the way the human eye works. 

Both these IOLs have advantages and drawbacks that distinguish them from each other and from standard IOLs. Please talk with your doctor if you are considering these premium IOLs. None of these options guarantee the ability to see without glasses or contact lenses, but in most cases they reduce or eliminate the need for them. To achieve the best outcome from these lenses, it may be necessary to perform additional refractive procedures such as LASIK or PRK vision correction after cataract surgery.

Finally, some patients have used contact lenses previously to achieve “monovision,” a technique where one eye is focused to view distant objects and one eye is focused to view near objects. If you would like to achieve this after your cataract surgery, talk to your doctor. It can be achieved with a combination of standard and/or premium IOLs.

If you are interested in refractive cataract surgery, you will need a complete eye examination by one of our doctors and a variety of tests.

If you are interested in an evaluation, please contact the Casey Eye Institute Comprehensive Ophthalmology service at 503 494-7672.