For the majority of our patients, the desired refractive result following cataract surgery is to obtain the best possible distance visual acuity without glasses and anticipating the need for reading glasses. Many patients feel that their distance vision without glasses is sufficiently clear after cataract surgery that they do a variety of things without glasses at all. However, most patients will achieve their sharpest vision after cataract surgery when wearing glasses both for distance and reading. For that reason, many patients choose to update their distance glasses after cataract surgery, even though their vision may be sharp enough that they do not choose to wear glasses all the time. The reason for residual refractive error (nearsightedness, farsightedness and astigmatism) after cataract surgery is because the lens implant inside the eye heals into position in a way that is not entirely predictable in advance, even with perfectly performed cataract surgery and highly advanced preoperative measurements and calculations.
Not all patients choose to target distance vision. For instance, some patients who are myopic (nearsighted) prior to cataract surgery may enjoy the benefit of being able to see at a close distance without glasses. These and other patients may choose to remain near sighted after cataract surgery with the goal of being able to read without glasses. For these patients glasses will be needed for distance vision tasks (such as watching TV or driving). Alternatively, some patients have had success with “monovision” in contact lenses and would like a similar plan for lens implants placed during cataract surgery. Monovision focuses one eye in the distance and the other eye up close for reading. Many people are not comfortable with monovision, as one eye or the other is always out of focus depending on where they are looking. A patient interested in monovision might consider working with an optometrist to try monovision in contact lenses prior to making a decision about lens implant choice for cataract surgery.
During the preoperative consultation the doctor and the patient will have a discussion regarding the desired postoperative refractive outcome. In doing so, appropriate post surgical expectations are developed by both the patient and the surgeon. Although an individual’s dependency upon glasses or contact lenses may be reduced following cataract surgery, the objective of cataract surgery is to improve the best corrected vision. To achieve the best level of vision following cataract surgery eye glasses or contact lenses may be needed.