Wearing progressive lenses after cataract surgery is common. However there are a few things to consider before and after the surgery before you buy your glasses.
In this article, you will learn about what you can plan out to have the greatest visual comfort after cataract surgery with your progressive lenses and how the changed lens (intraocular lens) influences your visual experience depending on what model you choose.
The big topics around a cataract surgery are:
- Where do you want to see clearly without your glasses after cataract surgery?
- Do you want the best visual acuity or do you want to be able to see without glasses most of the time? (multifocal intraocular lens).
- After cataract surgery, you need to wait in most cases at least six weeks before your progressive lenses can be ordered.
Now that you saw all the important topics let us dive deeper into the them to build a foundation of knowledge for you to be able to make good decisions.
Where Do You Want to See Clearly Without Your Glasses After Cataract Surgery?
This decision about the cataract surgery and where you want to see clearly without glasses at first has nothing to do with your progressive lenses. It is simply a factor you need to consider. I will give you an example. If you use your tablet most of the waking hours you could decide to see it clearly without glasses.
This would mean you would see perfectly clear after cataract surgery within your arm’s length. Distances bigger than that would be blurry. But of course, this could be corrected with your new progressive lenses. The benefit for you would be to be able to enjoy an unrestricted clear field of view in the reading distance. But as soon as you want to go outside you need to put on your glasses.
This solution is often good if the patient was nearsighted before. Or just spends most of the day reading. If this is not the case for you consider seeing clearly in the distance without glasses. This way you can enjoy an unrestricted clear field of view in the distance and when it comes to looking at things in the reading distance you would benefit from progressive lenses or reading glasses.
One thing should be clear to you. Progressive lenses are made to empower you to see clearly again at all distances. But they are definitely not perfect for reading long hours because of the small reading zones you can only get out of them. So always consider reading glasses in addition to your progressives.
If you choose to have single vision intraocular lenses you choose one distance in which you can see clearly in. This is as I said usually the distance or within your arms length. One option to correct both distances with single vision intraocular lenses is called monovision. With this option, you will have one eye setup for distance vision and one for reading.
Depending on how well your eyes play together the likelihood for getting progressive lenses after you have been corrected with monovision is very minimal. The reason is a side effect that could lead to double vision or headaches.
Do You Want the Best Visual Acuity or Do You Want to Be Able to See Without Glasses Most of the Time? (Multifocal Intraocular Lens)
In the first part of the article, we talked about single vision lenses only in the cataract surgery. However, you can get multifocal intraocular lenses too.
Those lenses empower you to see clearly in every distance. By clearly I mean you will be able to read most things when the lighting around you is good and you will enjoy decent visual acuity. The reason why my description now gets so vague here is the multifocal lens design.
Let us look at an excerpt from the conclusion from a study in which two multifocal intraocular lenses got compared. Although this statement was written for this study only I think it is true that a lot of patients stay dissatisfied because they think spectacle free equals the best visual acuity they can have. When in reality those things are not the same.
… diffractive bifocal IOLs produce high levels of spectacle independence and patient satisfaction. However, a small but clinically significant minority of patients remained symptomatic and dissatisfied with visual results 4 to 8 months after surgery.
Study by Vincenzo Maurino and his team.
It is definitely more of a compromise in terms of visual acuity compared to the single vision intraocular lenses. What you could notice are little double contours or starbursts at night or during the day too. And in most cases, those things can not be corrected with your progressive glasses/ contact lenses in general.
So if you like the idea more of being free of glasses or contacts compared to seeing perfectly clear multifocal intraocular lenses are an option for you. But if you want to enjoy the best contrast and the clearest picture possible do yourself a favor and stay with single vision intraocular lenses.
Here in the picture above you can see an example of the visual experience you can expect from multifocal intraocular lenses. As you can see on the right it says 20/20 vision which is very good. You can be able to read this whole line without a mistake. But obviously, because the characters are not clear it will be a taxing visual experience. But still 20/20 vision.
You can have a similar visual experience by testing out multifocal contact lenses. Depending on your preferences this visual experience can be exactly the right thing for you because you can stay spectacle free most of the time. Or it is just not your thing to compromise your visual acuity overall a little. But test it out before surgery.
After Cataract Surgery, You Need to Wait in Most Cases at Least Six Weeks Before Your Progressive Lenses Can Be Ordered.
In the time after your cataract surgery fluctuations can happen in your needed lens power for your glasses. So you need to wait until it is stable which is in most cases six weeks after the last eye had cataract surgery. The time until both eyes had the treatment can be a little taxing depending on the prescription you had before. Let us say you are myopic.
This means if you decide to have single vision intraocular lenses and you want to see clearly in the distance after surgery the eye that still needs to get the treatment is myopic. So one eye sees clearly without any prescription during this time and in the other eye, you need your old glasses or contacts. This could lead to double vision with glasses due to prismatic side effects.
You can only avoid this during the transitional period with contact lenses.
What Are the Best Progressive Lenses After Cataract Surgery?
There is no difference in normal progressive lenses after or before cataract surgery. The same rules apply to your progressives no matter if the treatment was done or not. If you have two vastly different lens powers after your cataract surgery the best progressive lenses will be those with short lens design. This means you do not have to look down as much to reach full reading support.
With this short lens design the prismatic side effects get reduced.
If you want to have the widest field possible the Add value should be as low as possible while you still can read perfectly clear. In combination with the mentioned lower Add value, you should also choose the longest progressive lens option to get the biggest field of view.
If you want to read more about what clear field of view you can expect in your new progressive lenses read this article here.
Of course progressive glasses, in general, are just one option for you. If you decide to wear just reading glasses because you do feel no need for them in your daily routines this is also totally fine.
I wish you a great day.
