Q: I had LASIK years ago and have since needed no glasses. I now need cataract surgery and would like to be glasses-free afterward. I heard about different lens implants that might provide me with this option. Am I a candidate for a multifocal lens having had previous refractive surgery?
A: With the advent of successful refractive surgery procedures such as Lasik in the 1990s, many patients were able to achieve independence from using glasses. As this group of patients has aged, cataracts have developed, and these post-refractive patients are now facing cataract surgery from which they have the same high expectation as the Lasik surgery provided – to be glasses-free.
To be successful with a multifocal IOL after Lasik, there are several considerations. First, discuss with your eye surgeon the advantages and disadvantages of multifocal IOLs and the possible need for further correction of residual refractive errors after surgery. Second, discuss realistic expectations for needing or using glasses after cataract surgery. Although the goal is to be glasses-free, your previous Lasik history and current eye health along with your final IOL selection, multifocal or other, may still require you to wear glasses in certain circumstances such as reading fine print.
Calculating the appropriate intraocular lens (IOL) power to use in cataract surgery for those who have had LASIK surgery poses a particular challenge. Ordinarily, IOL power calculations are straightforward and rely on two main measurements, the length of your eye and the curvature of the cornea. In those who have had LASIK, the corneal alterations make it more difficult to calculate the corneal power because the corneal shape has been altered. This makes choosing the exact lens power to implant in the eye to neutralize the patient’s prescription more challenging.
The good news is that cataract surgery has advanced remarkably. Today, patients can choose from a wide variety of lenses along with additional high-precision laser technology that together can provide customized options for enhanced and optimized visual outcomes.
One such high-precision technology used in cataract surgery today is the Optiwave Refractive Analysis System, or ORA. This real-time analysis by the ORA System measures all of the unique optical characteristics of your eye and gives the cataract surgeon a more accurate measurement of your eye’s focusing ability and the lens implant power needed to achieve the best vision. The ultimate benefit of the ORA System Analysis is that it helps confirm for the surgeon that the IOL (intraocular lens) implant in your eye is of the correct power and precisely oriented in cases of astigmatism correcting lenses.
In cases where LASIK has preceded cataract surgery, it is important to have a surgeon who understands all the issues involved. Talk with your surgeon who can help you determine the best options for your cataract surgery and visual needs post-LASIK surgery.