Cataract Surgery- Hard Lens vs Soft Lens


Thanks, your help, knowledge and advice is priceless. You have cleared up so many questions and concerns for me.


Best of luck, Tina! It's great we can keep in touch !


I was reading this thread as I'm going to be having my chataract fixed in a few months here I'm just starting to go in for testing in the next month to find the right lens.
My question is if I do have more vitrectomys in the future, will that cause a cataract on the new IOL? I wouldn't want to pay for the expensive one only to find it clouds over in future because of more surgeries. Do cataracts even form on acrylic/silicone IOLs?


I have read that sometimes clouding can occur after a cataract is removed. I think a laser surgery can correct it if it happens.


The normally clear tissue which holds the implant almost always gets cloudy with time. A Yag laser (different type of laser used to treat diabetic retinopathy) can open up the cloudy tissue and restore vision.

I wrote this article on Posterior Capsular Opacification.

Hope this helps!

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


Thanks Dr. Wong, that is really good to know. Every time I read one of your posts here I feel I gain some great information and insights.


You are welcome. Have a great weekend.



thank you for info.may I ask if a intraocular lens may give any problems later as inflammations or pain, should I be careful in some way? Thank you for answer.


Intraocular lenses, in general, do not cause any inflammation or pain. They have been used for over 35 years and are considered standard of care.



thank you so much most appreciate it. what a relief .


thanks so much Dr Wong, have a good day


It looks like I am a little late for this conversation
Maybe I don’t even belong here since I don’t have diabetes
I was just curious about this hard lens
Why is it called hard lens ? Is this for cataracts or something else ?
As far as I know the lens can’t be too hard because it has to be folded so it will go through a small opening


This was reply from MD.
"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."

My experience:
I had cataract surgery in both eyes, both with IOL lenses. One about 20 years ago, the 2nd 5 years ago.


Thanks for the reply
I thought by the name of the topic when it says cataract surgery that means something you put inside the eye not on the outside

How does that work for cataracts ?
If you place a contact lens on the outside you still have the cloudiness so I don’t see how that would help
What does the contact lens have to do with surgery ? Can’t a patient put in a contact lens?

Leaving that aside I did a search on the hard lens and I found a video where they placed a hard lens in a patient with small pupils Looks like the hole for the lens is twice as big as the normal IOL Maybe that depends on the pupil size otherwise I don’t see why anyone would choose a hard lens and I certainly would not think to put a lens on the outside at least not for cataracts

Just out of curiosity which IOL did you get ?
The monofocal or the multifocal ?

I am trying to decide which one to get but I can’t seem to find any detailed information on them
I was trying to find out for the monofocal IOL what is the smallest distance where you can see well without glasses ?
They say it’s good for distance vision which includes driving but there is no real measurement so anyone can determine what they mean by distance Is it 100ft ? 10 ft ? 2 ft ?

Does that mean that you can see the stop sign but not the dashboard ?


My first one, 20 years ago, I don’t recall any choices or discussion regarding IOL that was inserted. This was on my eye with partial vision, due to scarring, many lasers, and a vitrectomy. The cataract surgery provided some improvement, mostly for reading.

My other eye was more recent, but again I just relied on doctors recommendation. He asked several questions, and told me what he recommended based on discussion. I did not research various options. Sounds like you have researched beyond my recall of options offered to me. I assume mine is monofocal, but don’t remember discussing, or those terms were not used.
However in each eye, improvement was minimal, even after YAG laser, due to permanent damage of significant laser treatments, with older technology in 1980s.

Good luck with your decision.


I think you are probably right that there was not many choices so many years ago so it’s probably monofocal
I am guessing that based on the discussion that you may not benefit for distance vision if you do a lot of reading or close up work

I am trying to research as much as I can and it’s still hard to choose and even so the doctor may recommend something else
This is a lifetime decision so I might as well get the best one since i’;s not going to be easy to exchange it

At first I wanted to get the Cristalens which uses the eye to focus but after the evaluation the doctor did not even mentioned it as an option so after I asked about it he said it’s not worth it because it can get stuck in a certain position so I would be back to monofocal vision so I can cross that off the list

Now I am looking at multifocals and trying to determine which has the least amount of glare at night the tecnis symfony or the restor activefocus

Otherwise I would have to go with the monofocals and maybe do a monovision where you have a different focus in each eye to extend the clear vision range