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Refractive Cataract Surgery Versus Standard Cataract Surgery: How They Differ

Refractive Cataract Surgery Versus Standard Cataract Surgery: How They Differ

Every year, more than 3 million Americans have cataract surgery, making it the most common surgical procedure performed.

Whether you have standard or refractive cataract surgery, it's a safe and highly effective treatment, especially when you have a skilled surgeon like Stephen Khachikian, MD, at Black Hills Regional Eye Institute in Rapid City, South Dakota.

Here's what you need to know about cataracts and the different types of cataract surgery.

How cataracts form

When you have a cataract, the lens in one or both eyes turns cloudy and interferes with your vision. This change occurs slowly over many years as proteins normally found in the lens gradually clump together.

Most people start forming cataracts in their 40s, but then it takes 20 years or longer before the cataract gets large enough to affect your vision. Then you have symptoms such as:

Though cataracts typically affect both eyes, they can progress at a different pace in each eye. As a result, your right eye has different vision and clarity than the left one.

At first, you may only need eyeglasses. But once cataracts reach an advanced stage, there's just one treatment option: cataract surgery. You can choose between standard cataract surgery and refractive cataract surgery.

Two types of standard cataract surgery

Standard cataract surgery can be performed using a scalpel or a laser:


When you have standard cataract surgery with a scalpel, the procedure is called phacoemulsification. During this procedure we apply a local anesthetic and make a tiny incision.

Then we insert a specialized instrument through the opening that uses ultrasound to break up the lens. After removing the pieces of lens, we replace the old lens with a new intraocular lens (IOL). 

The new lens fits perfectly into the same pocket that held your original lens, and the incision heals quickly, so you don't need stitches.

Laser cataract surgery

This is a more advanced type of standard cataract surgery. When using a laser, we begin by making a map of your eye. The map shows the precise contour, size, and location of the lens. This information goes to a computer that programs the laser, ensuring precise removal of the lens.

We may use the laser to soften the lens or ultrasound to break up the lens. Then we remove the lens and insert your new IOL.

About refractive cataract surgery

Refractive cataract surgery follows the same procedure as standard cataract surgery. The difference between standard and refractive surgery is the type of IOL we use to replace your lens. 

During standard surgery, you get a monofocal IOL. These lenses correct vision to a single distance. You can have your near, middle, or distance vision corrected, then you need glasses to correct for other distances.

The lenses inserted during refractive cataract surgery are called premium IOLs. These advanced IOLs correct your near, intermediate, and distance vision.

In other words, this procedure treats your cataracts and corrects refractive errors in your vision. After getting a premium IOL, most patients don't need to use eyeglasses. 

Types of premium IOLs

Though there are several basic types of premium IOLs, you may be able to choose between different brands that are available for each type.

Multifocal IOLs

Multifocal lenses correct far away and close up vision, as well as all the distances between the two extremes. 

Accommodative IOLs

These premium lenses move or change shape, adapting their focus to accommodate different distances.

Toric IOLs

A toric IOL corrects astigmatism. When you have astigmatism, the cornea has an irregular shape that affects your vision at all distances. This lens is customized with different powers in specific parts of the lens.

The type of cataract surgery that’s best for you depends on several variables. But the presence of some eye diseases may prevent you from getting a premium lens.

To learn more about cataract surgery, call Dr. Khachikian, or book an appointment online today.

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