Cataracts, clouding of the lens that adjusts to help people see objects close up and far away, develop with age. Over half of all people 80 and older have cataracts or have had cataract surgery, according to 2009 data from the National Eye Institute. Cataract surgery improves vision in 90 percent of cases. Options for cataract surgery mostly involve choosing the type of lens that's implanted, although there are also several options for cataract removal.
Surgical Options
Phacoemulsion was the most common type of cataract surgery performed in 2010, the National Eye Institute reports. The surgeon creates a small incision in the eye, then breaks up the cataract with ultrasound, and suctions out the pieces. A new lens, inserted through the incision, remains permanently in the eye. Extracapsular surgery involves a longer incision into the cornea and removal of the lens in one piece. Most incisions don't need suturing, and those that do rarely require that sutures be removed. Most people choose to have light sedation for cataract surgery, although local anesthesia to numb the eye only can also be given.
Monofocal Lens Options
Monofocal intraocular lenses, or IOLs, remain the most common lens replacement in cataract surgery, according to the Emory Eye Center. Monofocal IOLs help with distance vision, but don't correct astigmatism, an abnormal curvature of the cornea or help with near vision. Monofocal lenses, like contact lenses, come in different powers to improve the patient's vision after surgery, and can be chosen to improve either distance, near or intermediate vision, but not all three, ophthalmologist David Change, M.D. explains. Toric IOLS can correct astigmatism, but patients will still require glasses for close-up vision.
Multifocal Lens Options
The increase in intraocular lens options represents one of the biggest changes in cataract surgery. Lenses that improve near, intermediate and distance vision, much like bifocals or trifocals, are a recent development in cataract lens replacement, but are not without problems. Most people with cataracts also have presbyopia, a problem seeing close-up that also develops with age as the lens stiffens and is not able to readily change shape. Artificial multifocal lenses improve presbyopia and eliminate the need for reading glasses, but cost more than monofocal lenses and can have significant side effects.
Multifocal IOLs can result in poor night vision, glare and halos, and vision that's less clear than the vision restored with monofocal IOLS. All About Vision reports that in 13 to 15 percent of presbyopia correcting lens placements, additional surgical procedures such as LASIK, which reshapes the cornea, are necessary.
Accommodating Lenses
Accommodating lenses shift slightly to adjust for near and distance vision, All About Vision reports, and can improve vision in people with presbyopia and may produce fewer halos and glare than multifocal lenses. Accommodative lenses, which correct well for distance and adjust moderately for near and intermediate tasks, cost more than monofocal lenses, according to Emory Eye Center.
