• Will IOL Eliminate Need for Glasses?


    Question:

    I have astigmatism (abnormally shaped cornea, which distorts vision) and have been nearsighted all my life. I now have developed cataract in one eye. When they place an IOL in my left eye will it give me the kind of vision I had with spectacles? Or will they only correct up to my naturally shortsighted vision?


    Answer:

    This is a complicated situation so allow me some latitude to give you a long answer.

    When we replace a cataract in one eye (the other not being ready yet) with an intraocular lens, we must consider the refractive condition (eyeglass measurements) of the fellow eye. The final desired refractive condition of the operated eye must be close enough to the un-operated eye to prevent double vision. Nearsighted and farsighted spectacle lenses affect the size of the image seen by each eye. Nearsighted eyeglasses make images look smaller while farsighted spectacle lenses make images look larger than the size of an image that doesn’t require eyeglasses. If the operative eye power doesn’t match or nearly match the non-operated eye, the patient will likely see double, unless they wear a contact lens in the un-operated eye all of the time. So to the first part of your question, the amount of correction of your nearsighted cataract eye will be impacted by the degree of nearsightedness of the eye without the cataract.

    As to the second part of your question regarding your astigmatism, there are several ways to assist you. Intraocular lenses are made that correct most amounts of astigmatism. These specialty lenses usually come at an additional out-of-pocket cost to the patient as most insurance companies and Medicare consider them to be cosmetic (an option that is not required) as one could just wear eyeglasses and live with the astigmatism. Another option is adding an additional step in your cataract surgery (astigmatic keratotomy) to attempt to reduce your astigmatism, but it generally is less precise than the intraocular lens approach.

    I urge you to fully discuss all of your concerns with your ophthalmologist to make certain that you understand all of these conditions.


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