Is it necessary to wear glasses after cataract surgery?

Is it necessary to wear glasses after cataract surgery?

The answer to the question "Is it necessary to wear glasses after cataract surgery?" can be given as "sometimes it may be necessary." Firstly, no matter how meticulously we plan, the power of the lenses implanted in the eye during cataract surgery is based on measurements, mathematical calculations, and some estimations of these formulas. It is possible to have a slight deviation in these calculations.

Additionally, each person's eye may respond differently to the surgery, causing slight changes in the refractive power during the healing period. Therefore, it may not always be possible to achieve perfect zero distance vision after cataract surgery; the primary goal is to restore vision to a non-seeing eye.

Even if it requires glasses, achieving 100% vision is one of life's greatest gifts. We, eye surgeons, are among the luckiest groups of doctors; have you ever thought about which branch of medicine can provide an 18-year-old's function to a patient in their 70s or 80s?

With successful cataract surgery, if there are no other problems in the eye, it is possible to achieve vision similar to that of an 18-year-old. Reaching this level without glasses makes cataract surgery one of the most successful treatments in the history of medicine.

In a successful surgery, the distance vision prescription is obtained below one diopter, and in most patients, it drops below 0.50. Intermediate and near distances are a different issue. Even if distance vision is corrected to zero, seeing intermediate and near distances requires an extra lens due to the laws of physics.

What types of lenses are used in cataract surgery?

As you can see in the other sections of my page "Lenses and Implants in Cataract Surgery" and in the videos on my YouTube channel, many different intraocular lenses are used in cataract surgery. All these lenses are actually implanted in the eye to provide distance vision without glasses. However, by using multifocal or extended depth of focus (EDOF) lenses, or by adjusting different prescriptions between the two eyes, it is possible to see intermediate distances (such as computer and phone distances) and even near distances without glasses, and to read books without glasses.

Types of intraocular lenses used in cataract surgery:

• Monofocal lenses,
• Monofocal + lenses,
• Bifocal lenses,
• Trifocal lenses (smart lenses),
• EDOF lenses (extended depth of focus lenses),
• Toric astigmatism-correcting lenses.

Cataract Surgery with Monofocal Lenses

When monofocal lenses are used, if all calculations and measurements go as planned or as expected, there is no need for distance glasses, but near vision can be achieved with +2 diopter glasses. It is not possible to read a book or see the phone without glasses.

Another application of monofocal lenses is to set the distance vision to -2 diopters myopic. In this case, 2 diopter glasses are used for distance, but near vision is zero, and near can be read by removing the distance glasses. As the name implies, monofocal lenses focus the optical system of the eye either on distance or near; therefore, glasses are needed either for near or distance.

The only exception here is that it is possible to make the patient glasses-free by setting one eye for distance and the other for near; however, in this monovision application, one eye will see near and the other will see distance clearly, so it is not possible to see all distances glasses-free with both eyes.

Cataract Surgery with Multifocal Lenses

Multifocal lenses used to be bifocal, but now all quality manufacturers have switched to producing trifocal smart lenses. Trifocal lenses, if the calculations match the expectations, can provide glasses-free vision for distance, intermediate, and near, allowing you to see the computer and phone and read books without glasses. However, as you will see if you read the pages on smart lenses in detail, although these lenses provide glasses-free vision, they cause some light scattering at night.

Cataract Surgery with EDOF (Extended Depth of Focus) Lenses

Additionally, the latest technology EDOF lenses, or extended depth of focus lenses, provide glasses-free vision for distance and intermediate without causing light scattering at night. With these lenses, if one eye is slightly adjusted to be myopic, glasses-free vision can be achieved for distance, intermediate, and near.

The Use of Toric Astigmatism-Correcting Lenses in Cataract Surgery

Another point is the patient's astigmatism in the cornea, the outer layer of the eye. This astigmatism can create a need for glasses after surgery; therefore, in all the lenses mentioned above, if necessary, toric lenses that correct astigmatism can be used to achieve glasses-free vision for distance, intermediate, or near. Using toric lenses in the presence of astigmatism is a necessity, so consult your doctor about this.

What should be done to avoid wearing glasses after cataract surgery?

Achieving glasses-free vision can be ensured by performing high-quality measurements with high-tech devices, having an experienced doctor, using high-quality materials in surgery, and using the best quality lenses, but there is never a guarantee of reaching 100% zero. Various factors such as different healing profiles for each individual and deviations in measurements due to advanced cataracts can cause a slight prescription to remain after surgery.

At this point, unexpected prescriptions after surgery can be fine-tuned with surgical methods like laser surgeries, without the need for lens replacement.

In conclusion, with well-performed measurements, in an experienced center, and with the approach of an experienced surgeon, ninety out of one hundred patients can achieve glasses-free vision in modern cataract surgery. For the remaining patients, if necessary, small fine adjustments can be made with lasers to achieve the goal of glasses-free vision.

When are glasses prescribed after cataract surgery?

If there is a need for glasses, an adjustment can be made about a month after the surgery.