Cataract Surgery

Custom Cataract Surgery refers to performing additional procedures at the time of cataract surgery and/or implanting an intraocular lens (IOL) that can reduce the dependence on glasses or bifocals. The vast majority of patients who choose Custom Cataract Surgery report that they can read a book, work on a computer, drive a car and play tennis or golf with an increased freedom from glasses.

Patients who undergo a cataract procedure, and who have nearsightedness or farsightedness, can have these refractive errors corrected with the implantation of a standard “monofocal” intraocular lens and achieve good distance vision without the need for glasses. However, there will be a need for reading glasses to improve near vision.

The two conditions that Custom Cataract Surgery address are astigmatism and presbyopia.

Astigmatic Correcting IOLs


Sometimes the surface of the cornea is shaped more like a football, with both steeper and flatter curves. When the surface of the cornea has an uneven curvature, vision becomes blurry. This common irregularity is called corneal astigmatism. Astigmatism causes distorted vision because images are not focused at one spot on the retina to provide clear vision.

A person who has both a cataract and corneal astigmatism will not regain high-quality distance vision after cataract surgery unless the astigmatism also is corrected.

Treatment Options

There are several surgical options your surgeon may choose to treat astigmatism, such as LASIK laser vision correction, astigmatic keratotomy (AK), limbal relaxing incisions (LRI) or, if you are undergoing cataract surgery, there is an IOL available that will correct astigmatism called a “toric IOL.” Your surgeon will recommend the option that is best for you.

Presbyopia Correcting IOLs


Presbyopia is a condition that develops in everyone over age 40. It causes difficulty seeing up close unless aided by bifocals, trifocals or reading glasses. This age-related condition is believed to be caused by a hardening of the lens inside the eye, making it difficult for the eye’s muscles to change its focus.

Treatment Options

Patients who undergo cataract surgery, and who receive standard monofocal IOLs, will experience reduced near vision just with presbyopia because these IOLs have only one focal point for distance. These patients will likely need glasses for intermediate and near vision. By choosing a “multifocal” or “presbyopia-correcting IOL”, patients may enjoy a decreased dependency not only on glasses or contacts for distance vision, but also on reading glasses or bifocals for near vision.

If you are considering cataract surgery, you may be a candidate for Custom Cataract Surgery with a presbyopia correcting IOL that can provide a full range of vision. Depending on the technological features of these IOLs, they may be described as “Accommodating IOLs”, “Apodized-diffractive IOLs” or “Mutlifocal IOLs.” Each of these lenses has advantages and disadvantages. Which one, if any, is best for you depends on the unique characteristics of your eye as well as your expectations for lifestyle needs. Only you and your surgeon can decide whether a multifocal lens is right for you.

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