Do I Still Have to Wear Glasses After Cataract Surgery?

Bill from Cobourg, Ontario asks Dr. David Lane if it's possible to not to have to wear glasses after laser cataract surgery.
The short answer is “it depends on your eyes”.

Some people are good candidates for not having to wear glasses after cataract surgery, and others are not.

There is an advanced technology intraocular lens (IOL) called a multifocal IOL. This type of implant does allow people to see distance, intermediate, and near without glasses; however, not everyone is a good candidate for this type of lens implant.

For younger people who have an active lifestyle, play sports, or simply do not want to have the bother of glasses, this can be a great option.

If you would like to have a multifocal IOL at the time of cataract surgery, there are several criteria that must be met in order to determine if you are a “good candidate”

Normal cornea (clear window at the front of the eye) must have a regular shape, free of surface disease, and must be moist

No dry eye - dry eyes can greatly affect the quality of vision after surgery. Multifocals may still be an option for people with dry eyes, but the dry eyes must be properly treated beforehand.

Normal Angle Alpha  - this is a measurement that determines how well the implant will be centered in your eye. Multifocal IOLs must be perfectly centered in order to work properly. 

You must be assessed properly with special diagnostic machines, and by an eye care professional to determine if you meet these criteria for a multifocal IOL. 

Furthermore, given that a multifocal IOL works best when it is perfectly centered, it is preferable to have the surgery performed by a femtosecond laser. This allows the opening for the implant to be made perfectly round, and perfectly centered. 

Multifocal IOLs work best when the “glasses prescription” post-operatively is essentially zero. Therefore, all the measurements before surgery must be as accurate as possible. It is possible however, that there could be an unexpected glasses prescription postoperatively, which can make the vision blurry. It is important to have your surgery done at a centre that can fix this type of problem with an excimer laser “touchup”, if needed, to give the very best visual result possible.