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Are there some IOL's that prevent you from wearing contact lenses?

I'm confused.  If a problem crops up after an IOL implant are contact lenses an option when looking for a way to correct it?

For instance, if I have trouble with light sensitivity afterwards, could I not just wear contacts with UV protection?

Could I opt to continue to correct astigmatism via contact lenses rather than getting a toric IOL (which carries the added risk of not being rotated into proper position)?

If I hope to see a computer monitor at 25-30  inches for computer programming, but find after surgery I'm seeing at 15 inches, could I wear a contact lens to correct it to 25-30?

Does a multifocal lens preclude you from wearing a contact lens afterwards?

If I get try a monocular or multifocal with emphasis on near to mid range, rather than distance, could I not just wear a contact lens to switch to distance, or mid-to-distance range  on those occasions where I preferred this?

I see so many mentions of where people are told they may need glasses afterwards, so I am wondering if contact lenses would work.  

3 Responses
177275 tn?1511755244
Start off by reading this carefully:  https://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You  ; With a monofocal or toric IOL in your eye you might be able to wear contact lens (CTL) post op although that is very unusual. With a multifocal you likely could not. If you have worn CTL before that might work, because of age most people that have never worn CTL are NOT good candidates post cataract/IOL surgery
7 Comments
Thanks for your reply.  

You wrote: "With a monofocal or toric IOL in your eye you might be able to wear contact lens (CTL) post op although that is very unusual."

Do you mean that it is "very unusual" to _need_ to wear a contact lens post op, or "very unusual" to  _be able_ to wear one post op?

Or perhaps you mean it is unusual for a person to desire to wear one post op.  I took pretty well to monovision near vision contact in my left eye until my vision started getting worse, presumably as my cataract worsened.   But I still took off my contacts at night and wore my normal distance vision glasses for a while before  going to bed , and also wore my glasses to start the day.  Sometimes I would wear my glasses all day (perhaps if alergans were high that day or something was irritating my eyes).   Or it might just feel nice to have binocular distance vision for a while (maybe watching a movie).

Very unusual to wear contact lens after cataract/IOL surgery
Yes, I understand from your original comment that it is very unusual.     My follow up question above asks as to _why_ it is unusual.  There is a big difference in it being unusual because most people find it more convenient to wear glasses for those times they want a change in their vision from nearer  to farther away (or to make a slight adjustment if the IOL didn't hit the mark),  verses it being unusual because it is _ impossible_ to wear contact lenses due to discomfort or the impossibility of being able to see clearly through the contact lens or getting a contact lens to fit.    Can you give me some idea as to what makes it unusual?  thanks
The average age for cataract surgery is mid/late 70's  at that point most people have made their peace with glasses and have no interest in wearing contacts which most don't have manual dexterity to insert/remove and/or their eyes are too dry to wear comfortably.
I have a monofocal IOL in my LE and wear RGP contacts in both eyes for distance correction. Dr. Hagan is correct in my opinion by stating that someone who has never worn contacts and had cataract surgery around age 60+ might very likely find them to be more trouble than they are worth. I am an exception to this by virtue of having worn contacts for decades prior and was very comfortable with going back to them post-surgery.
Thanks Mr P
Thanks for clarifying that for me.  This is encouraging then, because I don't find contact lenses trouble at all.   I was worried there was some "mechanical" reason why they wouldn't work with certain IOLs.
Avatar universal
I too wore RGP contacts for decades prior to cataract surgery in my right eye.
But eye doctors tell me due to dry eye they are no longer recommended so I've adjusted to glasses mainly for correcting my left eye which doesn't need cataract surgery yet - my right eye with a toric monofocal gets 20/25 or better unaided now though.
12 Comments
At 20/25, couldn't you go without a contact lens in your right eye and just wear one in your left?    I assume wearing one in your left was not a problem prior to surgery on your right.  Did the doctor notice dry eye problems with both eyes, or just the right?
I have worn soft contact lenses for many years (and hard contacts before that).  With the soft lenses, I did monovision for years until the multifocal lenses were perfected.

Since I had no problems adjusting to monovision I was hopeful that I could do the same after my surgery since I only needed to have 1 eye done at this point.

Dr. Hagan's post explains that there should not be more than 1.50 diopter difference between both eyes so if you have done monovision before as long as the surgeon targets the correct post-operative refractive error in your operated eye,  a contact lens in the other eye should work for you.  In my case I have astigmatism in my operated eye so I got the monofocal Toric IOL set for intermediate vision since I work in Information Tech and am at a computer most of the day.  My multifocal contact lens in the unoperated eye gives me the near and distance vision I need so both eyes together are monovision.

I just posted the current outcome of my surgery:  https://www.medhelp.org/posts/Eye-Care/Acrysof-Toric-IOL-in-one-eye-and-Multifocal-Contact-lens-on-unoperated-eye/show/3041277#post_14414668.  Hope this helps you.
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Thank you for responding, stone1.  My eyes (LE cataract and astigmatism)  and my concerns are very similar to yours.  I have been studying computer programming for a career change, and then my vision started to be a problem and a drag on my study efforts.  I feel like 25 inches would be a good distance for me LE monovision.   My question was as to whether there was an issue with wearing a contact lens in my LE after the operation was even possible, not just inconvenient.  I see a response by Dr Hagan in your post that you linked which makes me uncertain again because *that* response does seem to indicate some sort of conflict between a toric IOL implant and a contact lens.  I'll read it over again later.  Of  course, ideally, the doctor nails the prescription of the IOL and the surgeon rotates it just right so it gives the intended vision.  But seeing as this does not always happen, it would be nice to know you could possibly wear a contact lens to correct it to the intended vision.

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Dr. Hagan explained that since the IOL is aspheric and contact lenses are spherical it won't work wearing the lens on the operated eye.

The better course is to use a multifocal contact lens in the unoperated eye and pick a really good surgeon.  I did a lot of research and got a second opinion before choosing a surgeon.  

The surgeon should have done a minimum of 500 cataract surgeries (Dr. Hagan let us know if you sgree with that) and don't be hesitant to ask a surgeon you are considering that question.
I don't agree with minimum of 500 cases.   Some surgeons are mediocre even after 5000 cases and others are extra competent the first case they do. Don't forget that even a surgeon with 10,000 cases when a new IOL or new procedure comes out he/she will be doing their first case.   Some things do stand out:  board certification by Am Board of Ophthalmology, membership in top level organizations Am College of Surgeons,  Am Acad of Ophthal,  ASCRS.   involved in research, publishing in medical journals,  lecturing to other physicians, a really outstanding reputation in the community.  This sort of information can be had on the internet easily.  Don't over-value what the surgeon says about themselves on their website. That is best case scenario and often an infomercial.
Understood though you would hope that the more experience doing cataract surgeries a surgeon has the better.  My surgeon has an outstanding reputation in my area so I felt that I was in good hands but I agree that everything you mention is important so everyone considering this surgery should do their research.
One thing I have talked about before is 'co-management' and people that are under the care of an optometrist.   Optoms often send all their patients to the same Eye MD surgeons.  These surgeons are often chosen because they always are willing to 'co-manage'. That means the optoms do most of the post-op care and they split the surgical fee and capture the glasses RX.  Patients of usually not told of the sub rosa financial arrangement.  Ideally the patient can do their own research and find the surgeon they  feel most qualified, feel most comfortably with.   So if people are referred to an eye surgeon for cataract surgery a legitimate question for the optom is "do you co-manage with this surgeon?"  If so do you ever refer to surgeons better qualified that don't comanage?
More great info!
This is something that should be disclosed but rarely is.  In Missouri we tried to pass a law that would require it. The optoms and the eye MDs that work with them killed it.
When I googled aspheric IOL I found the following on allaboutvision.com, which if I understand correctly is opposite to what sstone1 posted:

      "Aspheric IOLs

Traditional intraocular lenses have a spherical optical design, meaning the front surface is uniformly curved from the center of the lens to its periphery. Though a spherical IOL is relatively easy to manufacture, this design does not mimic the shape of the natural lens inside the eye, which varies in curvature from center to periphery. In other words, the eye's natural lens is aspheric ("not spherical").

Why is this important?

A spherical intraocular lens can induce minor optical imperfections called higher-order aberrations (HOAs), which can affect quality of vision, particularly in low-light conditions such as driving at night.

Premium aspheric IOLs, on the other hand, match more closely the shape and optical quality of the eye's natural lens, and thereby can provide sharper vision — especially in low light conditions and for people with large pupils."

This seems to indicate  that the contact lenses you are used to wearing would be actually find a fit with aspheric IOLS that more closely approximates the fit with your natural lens.

At any rate, it addresses my concern that there may be other factors to consider about the possibility of wearing a corrective (or perhaps a UV protecting) contact lens on IOL implanted eye beyond inconvenience or learning a new behavior (for someone who has never worn contacts).  
177275 tn?1511755244
This is the post:  Dr. Hagan explained that since the IOL is aspheric and contact lenses are spherical it won't work wearing the lens on the operated eye.

I did not say that contact lens are spherical, they make toric contact lens.       All modern IOLs are aspherical but that does not mean they are aspheric in the center;  only toric IOLs correct for corneal astigmatism.
2 Comments
So a soft contact lens can be worn on an eye that has a aspheric toric IOL?
With a monofocal or toric IOL in your eye you might be able to wear contact lens (CTL) post op although that is very unusual. With a multifocal you likely could not   AS I SAID BEFORE.   YES
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