Q: When I took my mom in for her pre-cataract surgery exam, they asked what kind of implant she wanted. We were at a loss, having no knowledge about this sort of thing! How should we decide?
A: We hear this often, as your primary eye care doctor likely referred you to an eye surgeon, but too often, you were surprised to be asked a medical decision question with little or no objective background.
Generally, most people have their regular eyecare with their primary eye care provider, their optometrist or optometric physician. We are your best source of information about when to have cataract surgery, and by whom. And as true vision specialists, your optometrist is best trained to guide you through the process with good clear vision afterwards.
There are several choices in “intra-ocular lens implants”, to replace your natural crystalline lens that became cloudy or brownish over the years. When that natural lens is removed, the replacement is a small plastic lens, much like a small contact lens. I should add that most people think a laser is used to remove the cloudy lens, in reality it is ultrasound that dissolves your natural lens. While the actual procedure can take as little as 10 minutes, your decision will likely be your vision choice for life.
We most often recommend the “standard” distance vision implant. This simple lens is designed with a vision prescription built in to give you the sharpest distance vision. This is also the least expensive choice, because Medicare generally covers the cost. About 2 weeks after the procedure, your optometrist can prescribe your new glasses…..fine tuning any residual prescription needed for driving, and giving your excellent near vision for reading.
Some surgical offices recommend some version of “multifocal” lenses to give you both distance and near vision without glasses. While this sounds ideal, in reality many patients do have some near vision afterwards, but complain about distance vision blur or haloes around lights. The risk is you could be one of those unhappy people after surgery, and only then realize that your implant cannot be easily changed.
The newest option, and most expensive, is an implant that can have the prescription altered by exposing the implant to certain wavelengths of light! This seems amazing, but again, in reality, we see little need for this “changeability option” for the vast majority of people. In my experience, vision prescriptions change very little after cataract surgery. And to this day, most people find that their post-cataract glasses give very sharp driving and reading vision…..and are easy to change if ever needed.
Because most people have a budget, please be aware that these last two options cost more. Usually several thousand dollars more. These additional costs are not covered by Medicare and generally must be paid by the patient. Your primary eye care doctor of optometry has no financial interest in your surgery and is your best source of un-biased guidance on your vision.