What are my options if my cataract surgery caused me to become myopic?

Doctor's Answers 2

Cataract surgery nowadays is also 'refractive surgery' ie, it aims to minimise refractive errors (long/shortsightedness and astigmatism), or perhaps to target a certain refractive error like low myopia depending on the individual patient's preferences.

In this way, cataract surgery aims to achieve something similar to what LASIK does for people who do not have cataracts.

This is possible because cataract surgery replaces the original lens of the eye with a new lens implant, which comes in various focusing powers and can be tailored according to the patient's needs.

The customization/ lens implant selection is based on calculations, which are in turn based on measurements like the length of the eyeball and the curvature of the cornea.

Although a certain post-operative spectacle power may be targeted, sometimes the final achieved spectacle power is different from what was originally planned.

If you had targeted close to zero power but are now myopic, you have a few options.

You should consider several aspects of your situation first.

How myopic are you currently after the cataract surgery? If you are only slightly or mildly myopic, it might be good to leave it alone, especially if you have a monofocal lens implant, because mild myopia helps your near vision. But if you have a multifocal lens implant, mild myopia may negate the whole purpose of having this lens because it makes distance vision blurred. In this case, you might want to consider the various options to clear away this myopia.

Residual myopia can be treated like any other myopia in general. ie you can wear glasses, wear contact lenses, or consider some type of refractive eye surgery.

The possible refractive eye surgeries would include LASIK, a piggyback lens implant, or possibly a lens implant exchange.

Which you should go for depends very much on the factors mentioned above as well as your own individual preferences. Do see an eye doctor for a comprehensive eye examination, and then have a frank discussion with him or her about the risks and benefits, pros and cons of each option.

Photo of Dr E-Shawn Goh
Dr E-Shawn Goh

Ophthalmologist

Post-cataract refractive error is increasingly uncommon nowadays as our lens formulae and surgical reproducibility improve. However, some refractive surprises do occur.

Discuss your options in detail with your attending ophthalmologist, as the usual options to discuss include [1] [2]:

  1. Wearing spectacles/contact lenses to correct the refractive error,
  2. Leaving the refractive error (monovision or mild myopia in the affected eye allows you to see near),
  3. Intraocular lens exchange for a lower power IOL, or
  4. Refractive surgery to correct the residual power.

References:

1. Refractive Errors | National Eye Institute. Nih.gov. Published 2019. Accessed November 26, 2019.

2. Heus P, Verbeek JH, Tikka C. Optical correction of refractive error for preventing and treating eye symptoms in computer users. The Cochrane database of systematic reviews. 2018;4(4):CD009877. doi:10.1002/14651858.CD009877.pub2

Similar Questions

What are the latest advancements in cataract surgery in Singapore?

The key advancements in cataract surgery now is in the field of multifocal lens implants. This lens has been instrumental in allowing patients, in their later years, gain spectacles-independence for both far and near distances. The other significant advancement is in the practice of introducing antibiotics into the eye during cataract surgery thereby significantly reducing the risk of post-cataract surgery infection.

When should I have cataract surgery, and what will happen if my cataracts are not removed?

Cataract surgery is not always an elective procedure. Occasionally, a cataract may progress very rapidly to cause severe visual impairment, as well as acute glaucoma. In these situations, the cataract needs to be removed urgently. In most other cases, cataract surgery is elective because cataract progression is usually very gradual. You should choose to have your cataracts removed when your vision deteriorates to a stage that it affects your quality of life. This is very dependent on each individual, your occupation and activities you like to do.

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Answered By

Dr Claudine Pang

Ophthalmologist

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