What type of lens

[Pattywhite1000]

I am 52 years old. I have cataracts in both eyes and plan to have surgery. I have been wearing contact lenses for nearsightedness for 35 years now and am used to them. I am trying to decide whether to  get a replacement lens that that will give me the distance vision ( I will then need reading glasses) or close vision ( I will need glasses/contacts for distance).  I am inclined to getting a new nearsighted lens which is what I am used to and get contact lens for the future since do enjoy the luxury of reading, sewing, reading in bed, etc without any reading glasses. Yet a farsighted lens seems very tempting (not to need any correction for distance). It seems to me most cataract patients prefer the farsighted lens. Is that true? Will I be sorry later on in life that I am stuck with contacts or glasses for distance? Will I be able to wear contact lenses  later on in life? I really do not like wearing eyeglasses , for distance or for reading.  Contact lenses i dont mind so much. I am not interested in the multifocal lens and  think I might not  like the monovision lens (one eye distance one eye close)  because I tried wearing a contact lens in only one eye for a day to get a feel for that.. Does it make sense to go with what I am used to or am I giving up an opportunity?

[John C Hagan III, MD, FACS, FAAO]

Plano but its important to understand that distance is 20 feet or further. Looking at somethinbg 6, 10, 12  feet away will be blurry and need glasses that will need to be the progressive-no/line bifocals to see at these variable distances up to 20 feet.
JCH MD

[flossy93]

Thank you for the correction, Dr. Hagan.  

If a patient having cataract surgery wishes to have the surgeon aim for perfect distance vision after a cataract is removed, what should we ask the surgeon for?  Thank you!

[John C Hagan III, MD, FACS, FAAO]

"Plano" means no correction in lens (i.e. 'window glass"). It does not specify what the eye sees with "plano" nor by itself say what distance the test is done.

OS= 20/20 Distance = plano would tell you left eye sees 20/20 at 20 feet or further with no farsighted/nearsighted/astigmatism correction needed

JCH MD

[flossy93]

Please do read through Dr Hagan's blog post about selecting a replacement lens for cataract surgery.  It covers a lot of ground and will help outline your options.

That said, the ultimate choice is still up to you.  It's good you are thinking of the options now and weighing the pros and cons, as you will live with the results for many years.  

Without knowing how nearsighted you are now, I don't know if you would be a later candidate for additional surgery.  But one option you do have is to go for slightly-undercorrected final vision now with the cataract-replacement implant (like the -1.25 to -1.5D range mentioned by Dr. Hagan), and see how you like it.  

With slightly undercorrected vision, you can wear either glasses or cheap, disposable contact lenses when you need sharp distance vision.  You would also have the option to later on have LASIK or another cornea procedure that would correct your slight nearsightedness to perfect 20/20 distance vision, if you decided that's what you wanted after trying the alternative.

If you have the implanted lens power calculated for 'plano' (I think this is the technical term for '20/20 distance vision' rather than 'farsighted' as you described), you will ALWAYS need reading glasses for crafting, computer use, reading, etc.  Only you can decide which outcome is more valuable to you.  

Also, be aware that the more nearsighted you are now, the more difficult it is to calculate the exact correct power of replacement lens you will need.  For folks like me who are highly myopic, I think cataract surgeons rarely try for 'plano' or 20/20 vision, in case the calculation is off a bit and the patient ends up farsighted (where nothing is clear at any distance).  Shooting for the patient to end up slightly nearsighted, where that could be corrected with thin glasses, cheap contacts or later LASIK surgery, is the more typical approach for severely myopic patients, I think.

Good luck weighing your options; I hope your surgery goes well and that you are pleased with the outcome!

[John C Hagan III, MD, FACS, FAAO]

Either go to Dr. Hagan's blogs or look under Today's Pulse on this page and read the article about "Considering cataract surgery: It answers your questions.

http://www.medhelp.org/user_journals/show/841991/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You

JCH MD