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Topic Overview

For cataracts

A cataract—a clouding of the lens of the eye—blocks the normal passage of light through the eye.

Surgery for cataracts involves removing the natural lens camera.gif of the eye that contains the cataract camera.gif and either replacing it with an artificial lens called an intraocular lens implant (IOL) or compensating for its absence with eyeglasses or contact lenses.

The most common replacement is an IOL. Before having surgery, review with your doctor the advantages and disadvantages of each type of replacement lens. A variety of IOL types are available. Your doctor can help you choose the type that may work best for you.

An IOL is placed inside the eye during surgery. Corrective glasses may be needed after surgery for reading and close work. But they are not as thick and heavy as traditional cataract glasses.

Studies are being done to find the age at which children can benefit from an IOL. If your child needs cataract surgery, talk with your eye specialist (preferably a pediatric ophthalmologist) about what current studies are showing about the use of IOLs in children.

For nearsightedness, with or without cataracts

If you have cataracts and you are nearsighted, you may be able to have cataract surgery and get an IOL to help treat both issues. The chance of having retinal detachment after the surgery is higher than if you were not nearsighted, though. Talk to your doctor about all the pros and cons of cataract surgery.

If you don't have cataracts but you are nearsighted, there are two ways that IOLs may be able to help treat the nearsightedness:

  • When the surgeon replaces the eye's natural lens with an IOL, it's called "clear lens extraction."
  • When the surgeon does not remove the eye's natural lens, the IOL implants are called "phakic intraocular lenses" or "implantable contact lenses." These IOLs are placed in front of the natural lens, either in front of or behind the iris.

Cataracts that begin in the center of the lens (nuclear cataracts) are the most common cause of nearsightedness getting worse in adults.

Types of IOLs

Most people choose distance-vision IOLs over near-vision IOLs, and they use glasses for sharp near vision. But some people choose IOLs that provide better near vision for reading, and they use glasses for distance vision.

If you are having the lenses in both eyes replaced, your doctor may recommend monovision. With monovision, the IOL in one eye provides for better near vision, and an IOL that gives better distance vision is implanted in the other eye. Many people who try monovision can adjust to it. But it's not an option for everyone. 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.

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