Tips to choose the right artificial lens after cataract surgery

A cataract is the clouding of the eye lens. Of the various reasons — trauma; drug-induced issues like local and systemic use of steroids; and congenital, developmental, and systemic conditions like diabetes, and arthritis — ageing is the most common cause of cataract formation. The symptoms of cataract are blurry and foggy vision, sensitivity to bright sunlight, lamps or headlights, double vision, poor night vision, and changes in the way one sees colour, said Dr Sanjeev Taneja, ophthalmolog, Apollo Spectra Delhi, Karol Bagh.

Surgery for cataracts involves removing the natural lens of the eye that has become clouded. “The lens may be replaced with an artificial lens called an intraocular lens implant (IOL), placed at a position as close to the normal physiological position of the natural lens. One may wear eyeglasses or contact lenses to compensate for the missing lens,” Dr Taneja said.
“A variety of IOL types are available with the aim of reducing your dependence on glasses after the surgery. IOLs can be made with different focusing powers, like prescription spectacles or contact lenses. Before having surgery, review with your doctor the pros and cons of each type of replacement lens. Your doctor can help you choose the type that may work best for you, depending on your age, visual requirements, and other coexing eye conditions,” Dr Taneja elucidated.
Some types of IOL to consider are
Monofocal IOLs
This type of intraocular lens is designed for either near or dant vision. If you have this type of IOL implanted in your eye(s), you may not require glasses for a particular working dance. “For example, it is common for IOLs to be chosen to provide better dance vision than near vision. Then glasses are used for sharp near vision and require no glasses or minimal glasses for dance,” Dr Taneja mentioned.
Multifocal Trifocal IOLs
This type of intraocular lens design provides correction for both near and dance vision, the virtue of having rings for different focusing powers and both near and far objects can be in focus at the same time. “Your brain must learn to select the visual information it needs to form an image of either near or dant objects, so multifocal IOLs may require some adjustment. A person may adjust better to multifocal IOLs if they are placed in both eyes. This type of lens is not an option for some people. It may be considered a premium lens, so it might cost more than a monofocal IOL,” Dr Taneja noted.
IOLs can be made with different focusing powers, like prescription spectacles or contact lenses (representative image) (Photo: Getty Images/Thinkstock)
EDOF IOLs
Extended depth of focus lenses are lenses that provide clear vision for dance, and at the same time provide nearly clear near vision, better than monofocal, but less than multifocals/trifocals. “One may still require reading glasses but less than what is required with monofocals. They score over multifocals, as they do not give any glare of halos, because they lack the different focusing rings,” Dr Taneja mentioned.

Toric IOLs
This is a type of monofocal IOL that helps correct astigmatism. It may be considered a premium lens, so it might cost more than a monofocal IOL.
According to Dr Taneja, most people choose dance-vision IOLs over near-vision IOLs, and use glasses for sharp near vision. “But some people choose IOLs that provide better near vision for reading, and they use glasses for dance vision. If you are having the lenses in both eyes replaced, your doctor may also recommend monovision. With monovision, the IOL in one eye provides for better near vision, and an IOL that gives better dance vision is implanted in the other eye. Many people who try monovision can adjust to it, but it’s not an option for everyone,” said Dr Taneja.
He mentioned that one drawback of monovision is that each eye must work “more independently”.
“This can cause problems with depth perception. You may have to adjust your gaze more often to allow one eye or the other to see properly. So like any tailor-made situation, even IOLs can be customised according to the patient’s needs and treating ophthalmologs’ guidance. Monovision though a practical concept is not very popular. So proper counselling needs to be done, before proceeding,” said Dr Taneja advised.
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