Monovision cataract surgery helps to correct your vision by implanting lenses which have different focusing distances. That means your cloudy, natural lenses are replaced by intraocular ones, which are called IOLs. Your doctor will give you several choices to consider for this procedure, including the type of lens that you’ll use, the surgery you prefer, and what implant technique is useful for your condition.
When you have a successful surgical intervention, then this procedure could help to reduce your dependency on glasses afterward. It works to correct your vision by giving each eye the specific lens distance needed to provide clear vision. Your brain automatically adjusts the visual inputs when focusing on near or far objects, which allows you to have high-quality vision at all ranges without a corrective device.
Anyone who does not like to wear bifocals or is unable to do so for some reason may be a good candidate for this medical intervention. If you love the outdoors, play sports, and cannot or do not like to wear contacts, then you will want to review the pros and cons of monovision cataract surgery.
List of the Pros of Monovision Cataract Surgery
1. There are four different types of lenses to consider.
When you decide that monovision cataract surgery is your best option, then there are four common styles of lenses from which to choose that each can provide you with a unique set of benefits.
- Fixed-focus monofocal lenses will give you better vision at a distance, so you might still need reading glasses. You can also use one lens for near-sighted items and the other for far-sighted objects.
- Accommodating monofocal lenses can shift from near to far vision at the response of your ciliary muscles. This product gives you a feeling that is similar to what you experienced before the cataract issues occurred.
- Toric lenses can help you to deal with an issue of astigmatism.
- Multifocal lenses provide you with different areas for distance, which your eyes and brain eventually figure out to give you clarity.
2. You will experience an improvement in your contrast vision.
The monovision cataract surgery is one of your best options if contrast vision is what you need. It is suitable for driving and most of your other activities once the healing process is complete. If you develop cataracts prematurely, then this procedure can help to restore your eyesight to approximately what it was before the issue occurred. Although it may be challenging to do lots of close work with this combination of lenses, you may find that the need to wear glasses or contacts can virtually disappear.
3. If you are on Medicare, then your cost might be fully covered.
If you and your doctor decide that the standard monofocal lenses are your best option, then there is an excellent chance that they will be fully covered by your healthcare insurance. Medicare covers this cost, as do most private insurance plans. You may have discounts available for any premium lenses that you might need as well. That means you can experience an immediate improvement to your vision after you go through the recovery period of your surgery.
4. Colors seem to be more vivid and crisp after the surgery.
When you have the current lenses placed as part of the monovision cataract surgery, then the first thing you may notice after you can see again is that there is better crispness and vividness to the colors that you see. Although there will be some blurriness issues at first, especially for items at an extreme distance or very close, you can achieve better clarity between those two boundaries. That’s why a majority of people who decide with their doctor to proceed with the surgery are satisfied with the results.
5. This option works well if you have presbyopia.
Presbyopia occurs when you have farsightedness as a result of a loss of elasticity in the lens of the eye. This issue typically occurs with individuals who are approaching middle age, usually about 40-45, or the elderly who have had reasonably good vision up until then. Because the lens shape no longer changes like it once did, you will find it more of a challenge to read items that are closer to you, so you begin to hold them further away.
Monovision works to correct this issue by altering one of your eyes to account for close items, allowing the other to remain the same to handle your vision at a distance. Although this can result in a loss of the binocular effect, it can be helpful when there is a need to avoid glasses.
List of the Cons of Monovision Cataract Surgery
1. There is a recovery period that you will need to manage.
After the monovision cataract surgery, you will spend about 60 minutes in the recovery room as the anesthesia wears off. Your doctor might give you a clear shield or bandage to place over the eye. You cannot drive home by yourself. Once you return to where you live, your goal is to reduce the risk of infection by using eye drops several times each day while keeping water out of your eye.
You’ll be able to watch television and read about 24 hours after the surgery. You’ll also need to return to your doctor the day after the surgery, a week after, and then a few weeks after that.
2. The cost of the surgery is high, even with insurance covering a portion of the cost.
Your insurance coverage will usually provide you with a benefit that covers monofocal lenses, but you will still need to pay at least $1,500 for each toric lens. If you choose a specialized lens of a different type, they can be as high as $3,000 each. You will then have whatever co-pays and deductibles apply to your outpatient visit for the actual surgery too. When you compare this expense to what the cost of a decent pair of glasses is today, the price of this intervention might be too high for some individuals.
3. There can be some issues with haziness and bright lights with this option.
If you require crisp, detailed vision, then the monovision cataract surgery is not the best option for your needs. Most people experience blurriness in their vision after this procedure, which is an issue that corrective lenses might not be able to fix if the outcome is bothersome. That’s why most doctors who perform this procedure will recommend that you try out monovision with contact lenses first to see if you can adjust to the difference before having a more permanent solution.
If you opt for the multifocal lenses instead, then you may encounter distortions with bright light. Some people report seeing halos in their vision at night with this issue because there is more glare to manage.
4. You might still need to wear glasses after the surgery.
Most people who have monovision will typically wear glasses for driving, especially during the nighttime hours. You might also want to consider have them available if you are in an unfamiliar area. Your near vision is protected in low-light conditions with this surgery, so there is still a benefit to consider there. If you decide to pursue near-distance or long-distance vision only, then you’ll require glasses to improve the other end of the spectrum.
Some people find that they also need to have brighter lights available to them if they wish to have an extended period of reading. Even when there is an excellent refractive result after the procedure, you might want to plan on having a higher intensity of light in your home to manage your daily activities without discomfort.
5. Some people do not adjust well to monovision.
Even though a lot of people do eventually get used to monovision, some struggle to adjust well to the outcome of their surgery. The brain can struggle to process the different information that it receives from both eyes, which means you could end up with vision problems which are worse than they were before. If you want more of a guarantee of success, then accommodative or multifocal lenses are the better option. About 85% of people who receive a multifocal IOL discover that there isn’t a need for glasses at either distance.
If you and your doctor decide that a reversal is your best option to correct this disadvantage, then you might be stuck waiting for up to 3 months to ensure that there is an adequate chance to heal. It can also take that long for the brain to adjust to its new normal.
6. Monovision does not allow for stereo acuity or depth perception.
Physicians rarely perform a monovision cataract surgery on patients who must have a high level of stereo acuity. If you are at a high risk for falling or do not get around very well, then the changes to your depth perception could be enough that it creates disorientation. Anyone who needs to have these vision elements for their work, including police officers, truck drivers, and pilots are not good candidates for the procedure. Certain hobbies, such as tennis or golf, could be problematic as well.
Conclusion of the Monovision Cataract Surgery Pros and Cons
Monovision is not a new concept. Some people even have this setup provided to them naturally, helping them to avoid presbyopia without the need for an intervention. The problem is that most surgeons are not providing this as an option – and some aren’t even talking about it. Ray Radford wrote in The Ophthalmologist in 2015 that in a room of about 100 surgeons, less than 5% had routinely discussed this option for their patients.
There are also several risks to consider with this intervention, but that could be said for any medical procedure.
The pros and cons of monovision cataract surgery show us that it is one way to achieve the best possible range of vision without creating unwelcome aberrations. The outcome may require some time to adjust, but over 90% of patients have a successful experience with it.