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Which lens should I choose for cataract surgery?

During cataract surgery, the cloudy natural lens is replaced with a clear artificial lens, called an intraocular lens or IOL. It sits inside the eye for life, and you cannot feel it. Choosing the type of lens is one of the main decisions before surgery. This guide explains the three types used at ReNew Vision Eye Hospital, so you can talk it through with our eye surgeon. For an overview, see cataract surgery in Vasco, Goa.

What does the artificial lens do?

Your natural lens focuses light on the retina. When it is removed, the artificial lens takes over that job. Its power is chosen for your eye from the lens power test, which measures the length of your eye and the curve of your cornea. Read the lens power test. The type of lens decides at what distances you see clearly without glasses.

Monofocal lens: the standard choice

A monofocal lens has one focus. It is usually set for distance, so that you can see faces, the TV and the road clearly. For close work such as reading, your phone or sewing, you then use reading glasses. Some people also need a light spectacle power for distance to make vision fully sharp.

Monofocal lenses are the lens most people receive. They give good-quality vision with few side effects at night, and they suit most eyes, including eyes with other conditions. Some people choose a different plan with monofocal lenses, such as setting one eye for distance and the other for near (called monovision). This does not suit everyone, and your surgeon will discuss whether to try it.

Toric lens: for astigmatism

Astigmatism means the cornea is curved more like a rugby ball than a football, so light focuses unevenly. A standard lens does not correct this, so a person with significant astigmatism would still need spectacles with a cylinder power for clear distance vision.

A toric lens has astigmatism correction built in. It must sit at an exact angle inside the eye, so the eye is marked and measured carefully before surgery. Rarely, a toric lens turns from its position and needs to be adjusted. A toric lens corrects astigmatism for distance; you will usually still need reading glasses.

Multifocal lens: for distance and near

A multifocal lens is designed with zones or rings that focus light at more than one distance, so that you can see far and near with less need for glasses. Many people use them for most daily tasks, but there are trade-offs:

• Some people see haloes or glare around lights at night, which can matter for night driving.
• Contrast can be a little lower, especially in dim light.
• The brain may take weeks or months to adapt.
• Some people still use glasses for fine print or long reading.

A multifocal lens may not suit you if you have macular degeneration, diabetic changes in the retina, glaucoma with nerve damage, an irregular cornea, or other eye disease, or if you drive a lot at night. It is usually planned for both eyes. Your surgeon will tell you if your eye is not suitable.

Which lens is right for me?

There is no lens that is right for everyone. The right lens is the one that suits your eyes and your life. Think about these questions before the consultation:

• What do you do most: reading, phone, sewing, cooking, driving, fishing, office work?
• How much does wearing glasses bother you, and for which tasks?
• Do you drive at night, for example on a long route home or a night shift?
• Do you have astigmatism? Your spectacle prescription and the lens power test will show this.
• Do you have diabetes, glaucoma or another eye condition?
• What fits your budget? The fee differs between lens types; see what decides the cost.

Our eye surgeon examines your eye, tells you which lenses are suitable, and explains the fee with each. You then choose with your family, without pressure.

Will I need glasses after cataract surgery?

Most people still use glasses for some tasks. With a monofocal lens set for distance, reading glasses are usually needed. Toric and multifocal lenses can reduce the need for glasses, but no lens can promise that you will not need them. Your new spectacle power is checked a few weeks after surgery, once the eye has settled, and the spectacles can be made at our Vision Correction Centre in the same hospital.

Does the lens wear out?

No. The artificial lens is designed to last a lifetime and does not need changing. Some people, months or years later, develop clouding of the capsule behind the lens, which blurs vision again. That is not the lens wearing out; it is treated with a quick YAG laser. Read YAG laser after cataract surgery.

To discuss lens choices for your eye, book a cataract check-up at ReNew Vision Eye Hospital, Vaddem, Vasco. Call or WhatsApp 072489 88039; the eye OPD is open Monday to Saturday, 4 pm to 7 pm.

Questions patients ask

Which lens is right for cataract surgery?

There is no single right lens for everyone. A monofocal lens suits most eyes, a toric lens suits eyes with significant astigmatism, and a multifocal lens suits some healthy eyes. Your surgeon advises which lenses suit your eye.

Can a multifocal lens remove the need for glasses?

It can reduce the need for glasses for many tasks, but it cannot promise you will not use them. Some people still need glasses for fine print or in dim light, and some notice haloes around lights at night.

What is a toric lens?

A toric lens is an artificial lens with astigmatism correction built in. It is placed at an exact angle inside the eye, so that distance vision without a cylinder power in your glasses can be sharper.

Can the lens be changed later?

The lens is meant to stay for life. In rare cases a lens has to be repositioned or exchanged, which needs another operation. That is one reason the choice is planned carefully before surgery.

Can I feel the artificial lens in my eye?

No. The lens sits inside the eye, behind the iris, where there is no feeling. You will not feel it when you blink or move your eyes.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.