Best Cataract Lens After LASIK Surgery

October 13, 2025

How does prior LASIK surgery affect cataract surgery?

Cataract surgery is one of the most frequently performed medical procedures in the United States. Many patients who once chose LASIK are now reaching the age when cataract surgery becomes necessary. This naturally raises the question: does prior LASIK make cataract surgery more challenging? And if so, why does it matter?
 

What is LASIK? 

LASIK is a procedure that is done on the cornea to help correct nearsightedness, farsightedness, or astigmatism. LASIK uses two different lasers to re-shape the cornea, resulting in improved vision for more than 99% of patients. However, later in life, when patients develop cataracts, this earlier corneal alteration can create new challenges. 
 

How does prior LASIK surgery affect cataract surgery?

A history of LASIK doesn’t make the actual cataract surgery harder, what becomes more difficult is the calculation of the intraocular lens (IOL) power used for surgery. 

Why does this matter? A couple quick things we have to understand. 

First, a cataract is a cloudy lens just beneath the surface of the eye. Everyone will get cataracts if they live to be wise enough.

Secondly, in old school cataract surgery they would just take the cataract out. The problem? The patient would have to wear thick coke bottle glasses after surgery. Remember the cataract is a cloudy lens, but it also has a prescription. So, if you do cataract surgery where you just take the cataract out, then you would be removing a prescription, ultimately, you would have to wear thick glasses after surgery. Eventually in the early 60s they figured out instead of wearing thick glasses, you could implant a lens (IOL) with a prescription. 

One of the most important questions in cataract surgery is how do you calculate the intraocular lens power that each patient needs. It’s dependent on two things – the length of the eye and the curvature of the eye. And what affects the curvature of the eye… LASIK. 
 

Cataract Surgery after Refractive Surgery

Eye doctors use special post-LASIK formulas to calculate the lens power that will be used for cataract surgery. Even using special lens formulas for post-LASIK eyes, the chance of hitting the target, can be as low as 50% (defined by +/- 0.5D of emmetropia). 

Multiple studies have shown the difficulty of power calculations in patients with a history of cataract surgery.  For example, a notable myopic shift has been seen in some post laser vision correction eyes with extremely long axial lengths. 
 

Best Cataract Lens after LASIK surgery

Typically the best lens for a patient who has had cataract surgery is a lens that is adjustable. Meaning that after surgery if a patient ends up with a little farsightedness, near sightedness, or astigmatism, you could adjust the power of the lens to account for the unpredictability of LASIK. 

We now have that in the light adjustable lens. The light adjustable lens is a lens placed at the time of cataract surgery. The patient lets the eye heal for a month and then you can adjust the power of the lens afterwards with the light using photochemistry. 
 

Cataract Surgery after LASIK monovision

Light Adjustable Lens is the best lens for any patient who has a history of monovision LASIK. With the light adjustable lens you can recreate monovision and potentially even improve it. 

 

Success of Cataract Surgery after LASiK

The overall success of cataract surgery depends on the type of cataract surgery performed and the expectations of the patient. You want to make sure you fully understand the current state of your eyes, the exact type of surgery you are getting, and the post-operative expectations. Some patients need to wear glasses, some patients need a PRK treatment after surgery, and some need light treatments after surgery. 

A recent published paper showed great success of cataract surgery after LASIK with the newest light adjustable lens. The procedure was effective with a majority of patients seeing 20/20 or better after surgery. (1)

  1. Wong CW, Folden DV, Pineda R. “Visual Outcomes of a Second-Generation, Enhanced UV-Protected Light Adjustable Lens in Cataract Patients With Previous LASIK and/or PRK.” Clinical Ophthalmology. 2023;17:3793-3802.
    Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10637228/

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