Best Cataract Choices Decision Tree: What are my choices in Cataract Surgery

What is the Best Cataract Surgery in the World: 
Until about March 2005 in the US, patients and eye surgeons did not have a wide range of choices for cataract surgery, in particular implant choices. The only real choice was a Monofocal implant (or IOL=intraocular lens). Monofocal IOLs helped patients for 1 distance only, most often distance vision, but patients often (close to 95%) need glasses for intermediate and reading vision as removing the lens of the eye (ie, cataract surgery), takes away one’s ability to accommodate completely. 

In 2005, a revolution occurred in IOL implant options. The first multifocal implant was introduced called the Restor. For the first time, patients had a chance to be glasses free for distance, intermediate, and reading. 

Since then more choices have emerged, each with their positive and negative aspects.

In 2012, the FDA approved the Femtosecond Laser to aid in Cataract Surgery. This now adds another choice each patient and surgeon must make for surgery, which is a good issue to have.

Below is a flow chart to think about when deciding on what type of surgery to have, what implant to have, and, if astigmatism is present, how best to correct corneal astigmatism.

Remember that this is the best time in the history of humanity to have the diagnosis of a cataract and cataract surgery. As innovations and choices in cataract surgery become available, surgery risks decrease and happy patients with excellent vision without glasses increase.

Sandra Lora Cremers, MD, FACS

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