Cataract Surgery- Hard Lens vs Soft Lens


I had laser surgery due to hemorrhaging blood vessels in my eyes. A complication of the laser surgery is cataracts, so I now need cataract surgery.

If you had the complication of cataracts due to this surgery, did your doctor use hard or soft lens to replace your natural lens?


I too have cataracs as resul of long ago lasers. I look forward to hearing advice. I hope to wait awhile until it gets real bad. Unless, others think it better to do sooner. Thanks for post.



1. Cataracts occur in everyone. Just like gray hair, some people get it early in life and some later in life.

2. Patients with diabetes, as a whole, get cataracts earlier in life.

3. While laser can theoretically cause cataracts (though it would be difficult), it is not uncommon to develop diabetic retinopathy and cataracts at the same time.

4. In most cases when cataracts are removed, a intraocular lens is placed inside the eye - the intraocular lens is (nowadays) made of soft, foldable acrylic or silicone based material which allows the IOL (intraocular lens) to be inserted into the eye through a smaller incision (hole), and thus, facilitates faster healing. Once inside the eye, the lens unrolls into its normal shape.

I am not sure if this is what you mean by hard or soft lens?

Contact lenses are placed on the outside of the eye and are usually referred to as either hard or soft. They, too, can sometimes be used instead of placing an IOL inside the eye.

Hope this was helpful.


Randall Wong, M.D.Retina Specialist


Dr. Wong,
Thank you for the information.
For the past year, I have been treated for diabetic retinopathy/macula edema. My retina specialist has been telling me that having the cataract in my left eye removed would improve the vision in that eye (I also have one in my right eye). My left eye has a cyst which refills with fluid between Lucendis treatments. My vision in that eye is about 20/100.
The issue he keeps mentioning is that I would need to coordinate the cataract surgery with Lucendis injections at his office: one injection two weeks before and one two weeks after.
What puzzles me is everyone I've spoken to about cataract surgery talks about different types of lenses: some are monofocal, some multifocal. I wonder if I need to think about paying extra for a special lens. My vision in that eye is so wonky anyway.


I am having injections of Avastin, one week prior to my cataract surgery.

I would pay extra for the best lens available to give me an advantage in my sight. What are our options in lens, that is my question.

Best wishes, Tina


Dr. Wong

Great to hear from you on the cataract surgery and thank you!

The cataracts occurred in my eyes three to four weeks after the laser surgery was preformed to seal the hemorrhaging in both of my eyes. My retina surgeon, prior to the surgery informed me that cataracts were a common complication of this partial laser surgery. So, now a month after the laser surgery, I am scheduled for cataract surgery.

The cataract specialist said, he would use traditional hard lens for my implants instead of the silicon or Teflon soft lens because if I need future laser surgery, the laser would glue the soft lens to my eyes.

Do you know if soft lens are an option for me? Has anyone whose had this type of laser surgery received soft lens implants or only hard lens implants?

I look forward to your reply, Tina


I can only tell you my personal experience.

I wanted to wait to have the cataracts removed but the retina surgeon and the cataract specialist, advise me otherwise. Because the cataracts are obstructing the view of my retinas. This obstruction prevents the retina surgeon from detecting the condition of my blood vessels, so we do not know if are still hemorrhaging. These facts renders me having no options except to have the cataracts removed.

I would consult with your retina surgeon and your cataract specialist to get their opinion on waiting.

Best of luck to you!


Hi Tina!
I am scheduled to see a cataract surgeon in 2 weeks. It looks like we are both wondering about the kind of lens that would be used.



I'm a little wary of the explanation linking laser and cataract formation, but okay, so you've got cataracts.

The issue with the "soft" or silicone lens is that, in the highly unlikely event, you would need silicone OIL to help fix a retinal detachment, the silicone oil and the silicone implant may bind to each other (glue?).

The fact that you are already under care for your eyes, makes it highly, highly unlikely your diabetic retinopathy will get out of control and cause a retinal detachment.


Randall Wong, M.D.Retina Specialist,Fairfax, VA.



I forgot to say that, with regard to the resultant vision, there really is no difference between the hard or "soft" IOLs. Perhaps, due to a larger size, the hard IOL may have a tiny advantage.

At our office, we use the silicone or acrylic in almost everyone...diabetic or otherwise.


Randall Wong, M.D.
Retina Specialist
Fairfax, VA



Monofocal- presently the gold standard. Usually calculated so that you can see clearly for distance. You will need to use reading glasses. This is still the most common type of IOL used.

Multifocal - these lenses allow you to see both at distance and near. The Crystalens and Restor have different advantages, but I'll save discussion for your eye doctor.

In any case, your ultimate distance and reading vision will be dependent upon the health of your macular...not the type of lens which is implanted.


Randall Wong, M.D.
Retina Specialist
Fairfax, VA



Do I need to ask for IOL or is that standard?
The cataract specialist said, the soft lens, if I need additional laser surgery,this particle laser would glue the soft lens to my eye. What is your opinion?

Your answers have been exceptionally helpful.
Thank you! Tina



It is standard.

The part about the laser/glue/soft lens......have him/her explain better.

I think they were attempting to advise you about the "in the event of developing a retinal detachment requiring oil..."


Randall Wong, M.D.

Retina Specialist

Fairfax, VA


Thank you, Randy, for getting back to me. You have been extremely helpful and have relieved my worries and stress. I will ask the doctor for clarification about the soft lens and the laser.

Again, thank you, Tina


So, I should not have to ask for IOL?


Dr. Wong,
Thank you for joining this discussion. I now have a better grasp of what to expect. Since I may need additional laser treatment, the discussion about soft and hard lenses has also been helpful. My retina surgeon told me that getting the cataract removed would make his job easier because the cloudy lens makes it difficult for him to see into my eye. I was wondering how he would be able to work with a plastic lens in the eye. Then, I was wondering if the plastic lens would "glue" to the eye from the laser!
Thanks for clearing up some of the issues!


Should not have to ask for IOL. I would dare to say it's standard of care. There are a few exceptions, such as, if you are extremely, extremely near-sighted and have a prescription of about -20. In this situation, vision is actually better without an implant. There are a few diseases which might preclude placing an IOL.


Randall V. Wong, M.D.
Retina Specialist
Fairfax, VA 22031



Glad to be so some help.

Get the cataract removed, let your retina specialist better examine and treat you and move forward!

Stay well.


Randall V. Wong, M.D.
Retina Specialist
Fairfax, VA 22031


Amanda, you and I are in the same boat. Keep me posted on how it goes for you.


Randy, I agree with Amanda, your imput has been invaluable.
Thank you, again, Tina