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With vision like this can I have normal cataract surgery and will I have to wear glasses afterwards?

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Hi. I am an Optometrist. I don't do cataract surgery, but do co-manage it with Ophthalmologists. Things can go wrong with cataract surgery, but most patients are really happy after they have the procedure. 20/400 is not usually considered "really" nearsighted. Do you know what your prescription is? 20/400 means that you can see the big E on the top of the eye chart, but that's about it with your glasses off. Anyway, assuming you are about 20/400, that should not cause you to have a problem with cataract surgery.
Now days, there are different types of cataract surgery. The traditional type removes the lens and replaces it with a lens that will eliminate most of your distance prescription but you will need glasses for reading or near tasks. If you are willing to spend about twice as much as traditional surgery, you can get a multi-focal replacement lens. This is a lens that would give you both distance vision and near vision. There are also procedures that can remove any astigmatism you might have. To remove the astigmatism they combine cataract surgery with Lasik or a surgical procedure called AK.
Even if you decide to go the less expensive traditional route, seek out a surgeon that does these different procedures. That way you are more likely to get a very experienced surgeon. Hope that helps.
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