Cataract

Refractive planning

Refractive planning is the process of choosing which is the best focus for you to aim for, taking into account your hobbies and habits and your previous spectacle (or contact lens) history.

Most patients who have cataract surgery will not have needed glasses until they reach their thirties or beyond, at which point they started wearing reading glasses. These patients will always always choose to be left with as good distance vision without glasses as possible (emmetropia where no glasses are needed to see clearly in the distance). With a standard lens they will be totally reliant on reading glasses for near vision. They may choose to try to improve their near or intermediate vision with a premium lens.

Patients who have been myopic since childhood will still mostly choose to be made emmetropic the state of emmetropia, where no glasses are needed to see clearly in the distance, however, for these patients the loss of the ability to remove their glasses and see things close up may be quite distressing and it takes some thought and some time on their part to work out what solution would be best for them. Approximately 20% of myopic patients in the minus two to minus 6 range choose to remain myopic.

Patients who wear glasses or contact lenses for significant astigmatism will usually elect to be left emmetropic. Unless they have a premium lens or limbal relaxing incisions to correct the astigmatism, they will need glasses to see clearly for all distances.

The above overview of refractive planning is a useful starting point. In reality for many patients it is a fairly simple process, but for perhaps one patient in every five it is a very complex one, and it may take some time to think it over having had preliminary discussions before the best decision is arrived at.

Cataract surgery is rarely urgent; I believe that making the best refractive planning decision for you is a critical part of making sure you are as happy as possible with the outcome of your cataract surgery. You can have as long as you wish to make that decision, I would not operate on you until you are happy with your choice.

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