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Cataract Surgery patient information leaflet

Glasses after cataract surgery

Most people still need glasses after cataract surgery. The chance of not needing glasses after cataract surgery depends on many things. These include your personal vision requirements, the presence of any astigmatism and the choice of lens implant (monofocal, toric, multifocal, or monovision). This would be explained to you by the surgeon.

Most people having cataract surgery already have different distance and reading glasses prescriptions. They can be separate glasses, bi-focals or vari-focals.
If cataract surgery (using a monofocal lens implant) corrects focus without glasses in both your eyes for distance, then you should still expect to need reading glasses for near focus.

At the cataract assessment clinic visit, precise measurements are made of the length of your eye and the curve of your cornea. The measurements will be compared with your distance glasses or contact lens prescription. They are used to calculate a lens implant for you, according to your preferred outcome.

The measurements must be made without any influence from contact lenses, if you use them. This is why it is important to remove contact lenses at least two weeks before the assessment visit.

It is also important to tell the person who makes your measurements, on the day of assessment, if you have already had cataract surgery in either eye, or if you have ever had corrective laser eye surgery.

You should decide in what situations you don’t mind wearing glasses or contact lenses and discuss this at the clinic. You should take as much time as you need to consider this, even if it means you cannot decide on the day. Talking about this with your own optician can help if you remain unsure.

Lens implants can be made to most prescriptions so it is possible to correct long or short sight at the time of cataract surgery. Special lens implants (toric), which correct astigmatism, are not routinely available in the NHS, so you are likely to still need glasses for both distance and close up if you had astigmatism before your operation. Similarly, special lens implants (multifocal), which correct the need for glasses of any sort, are even less routinely available, so you will still need reading glasses if you have a lens implant which focuses your distance vision.

The eye changes shape as it is healing and any spectacle prescription will alter during this time. You will be ready for an update of your spectacles four to six weeks after your operation, when the healing has settled sufficiently.

If you are very keen to read with the eye that has just had surgery with a distance focus implant, you can buy an off-the-peg pair of reading glasses at minimal cost from a high street chain. You will not harm your eyes by using an old pair of glasses or an approximate glasses prescription.

To be completely free from glasses or contact lenses after cataract surgery a compromise has to be made. One eye can be focussed for near and the other eye focussed for distance. This is called monovision, with a monofocal lens implant in each eye. With both eyes open, one or the other eye will always be blurred.

Alternatively, a multifocal lens implant can be used but, as stated above, these are not routinely available in the NHS. These lenses are not like bifocal glasses (where you choose which element to look through for best focus) because they simultaneously give the eye a focussed image when viewing near objects (from the near lens element) with a blur from an out of focus image (from the distance lens element) on top of it, and vice versa when viewing distant objects. Glare and haloes are the result, which can be bad enough for patients to ask for multifocal implants to be removed.

Sometimes cataract surgery reveals pre-existing astigmatism of the cornea, which had been neutralised by the cataract. This scenario results in a need for glasses or contact lenses to correct astigmatism after cataract removal when they were not needed before.

It is important you are aware that the calculations used to choose a lens implant are not accurate for all eyes. They assume that all eyes are put together in the same way, when they are not. This means that the preferred glasses prescription (e.g. no glasses needed for distance focus) is not achieved in about five cases in every 100. Also, cataract surgery can change astigmatism, sometimes for the worse.

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