Refractive cataract surgery is a type of eye operation that removes the lens of the eye when it has become cloudy. An intraocular lens (IOL) replaces the original lens, allowing the person to have clearer vision without the use of corrective eyewear. Cataract surgery usually only replaces the lens with an artificial lens, but refractive surgery replaces the cloudy lens with an IOL that also corrects other vision problems such as nearsightedness, farsightedness, or astigmatism. Cataracts are usually a result of the normal aging process, but some people may be genetically predisposed or have a condition that can cause cataracts to form.
Cataract surgery is performed under a local anesthetic, and it is an outpatient surgery. An ophthalmologist will create a small incision on the cornea, and he or she will insert a device that sends ultrasound waves to break up the lens of the eye. The lens will then be dissolved, and the physician will irrigate the eye and remove the remaining pieces. Once this is complete, another small incision is made to implant an IOL.
In the past, different types of IOLs would allow the person to see far distances well, but they would still need glasses or contacts to be able to see things close up or to correct astigmatism. Multifocal lenses are a type of IOL that is used in refractive cataract surgery to improve the person’s ability to see objects in the distance and up close. These types of lenses may not allow the person to see images and colors clearly, and colors and objects appear faded or hazy. This causes many people to require more light to see clearly, and they may have trouble with night-driving.
One type of lens presently used in refractive cataract surgery is the Crystalens®. It is in a class of premium IOLs, also known as presbyopia-correcting and accommodating IOLs. Compared to the multifocal lens, the Crystalens® is a single vision lens that is attached directly to the eye muscles, allowing the lens to move naturally and improve the person’s ability to focus quicker. Also, this type of lens can correct hyperopia, but there is risk that the implantation of the IOL could create astigmatism. Other premium IOLs are available, such as ReSTOR® lenses and Tecnis®, and a person undergoing refractive cataract surgery should consult an ophthalmologist about their options and the advantages and disadvantages of each type of lens.