Which option should I choose?
Whenever the lens of the eye must be removed because it is cataractous, the focusing power of that lens must be replaced to restore clear vision to the eye. This can be done with an intraocular lens implanted at the time of surgery. The other options to restore vision used in years past were thick cataract glasses or contact lenses.
Intraocular lens implant
Intraocular lens implants restore the eye’s vision essentially the same as before the cataract developed, with no noticeable magnification. Also, the side vision is normal. Furthermore, by taking special measurements prior to surgery with an instrument called a biometer, usually the lens implant can be focused so many patients can see well enough to do normal activities at home without glasses. After lens implant surgery, regular glasses are usually prescribed to fine-tune distance vision for driving, with a bifocal for reading.
Intraocular lenses are implanted inside the eye at the time of surgery. They require no handling or cleaning. Older types of lens implants occasionally dislodge or cause chronic inflammation of the eyes, sometimes making it necessary to remove the lens implant. This is extremely rare with modern small-incision, no-stitch cataract surgery, and posterior chamber intraocular lens implants. In fact, as will be discussed later, this type of surgery and lens implant is so successful, we recommend it for nearly all cataract patients.
Before intraocular lenses were perfected in the 1970s, patients had to wear thick cataract glasses or contact lenses after their cataract surgery. With cataract glasses, several months were usually required to adjust to the distorted vision. All objects were magnified 30% with the cataract glasses and also appeared to be 30% closer than they actually were. This resulted in many accidents and spills during the adjustment period. The side vision was quite limited with cataract glasses, and there were blind areas in the side vision which were quite difficult to adjust to.
Contact lenses are the third method of restoring focus to the eye after cataract removal. These lenses float on the surface of the cornea and restore nearly normal vision with fairly normal side vision. However, “extended wear” lenses require fairly frequent removal for cleaning or replacement. Contact lenses occasionally fall out and must be replaced. Studies show after five years only one-third of patients will be able to continue wearing the contact lenses and must resort back to the thick cataract glasses after cataract surgery.