Can I Have Cataract or Lens Replacement Surgery If I’ve Already Had LASIK or ICL?

If you’ve had LASIK or ICL surgery in the past and are now developing cataracts, you’re not alone. Many people who chose vision correction in their 20s, 30s, or 40s are now reaching the age where cataracts begin to affect their vision. Understandably, one of the most common questions we receive is: Can I still have cataract surgery?

The short answer is yes—you absolutely can. But there are important considerations that make your case a little different from someone who has never had eye surgery before. At our clinic in Brisbane, Dr David Gunn specialises in cataract surgery for patients with a history of LASIK, PRK, or implantable contact lenses (ICLs), and uses advanced technology to ensure the best possible outcomes.

Let’s walk through what you need to know.

How Lens Surgery Works in Post-LASIK and Post-ICL Eyes

Cataract surgery involves removing the eye’s natural lens after it becomes cloudy and replacing it with a clear artificial intraocular lens (IOL). In patients who have never had eye surgery before, standard calculations are used to choose the lens power. But in patients who have had LASIK or ICL, those calculations are more complex.

• In LASIK/PRK patients, the shape of the cornea has been permanently altered, which makes traditional IOL calculations less accurate and need to be adjusted for.

• In ICL patients, the artificial lens must first be removed before the cataract is removed and replaced with a new IOL.

Dr Gunn uses specialised formulas and imaging systems designed specifically for post-refractive eyes for your unique optical system to improve IOL accuracy.

Can I Still Have a Multifocal Lens?

Yes, in many cases you can still be considered for a multifocal or extended depth-of-focus intraocular lens, even if you’ve had LASIK or an ICL. However, additional testing is required to assess your corneal shape, contrast sensitivity, and visual stability before making that decision.

At our Brisbane clinic, Dr Gunn takes the time to evaluate whether:

• You’re likely to tolerate a multifocal lens well

• Your previous surgery has left any irregularities or dryness that could affect your outcome

• A monofocal, toric, or blended vision plan might offer a better balance between clarity and comfort if so

If you’ve had ICLs, these are removed during the same procedure as the cataract surgery. This adds a layer of technical complexity, but it’s something Dr Gunn routinely performs.

What Are the Risks or Challenges?

While cataract surgery is one of the safest procedures in medicine, there are a few extra factors to consider if you’ve had prior vision correction:

• IOL calculations require custom adjustment to avoid over- or under-correction

• Corneal mapping may be less predictable in LASIK or PRK eyes

• Visual expectations need to be managed carefully—particularly if your original laser treatment was 10+ years ago and some regression has occurred. Older laser treatments could have small or decentered treatment zones and multifocal lenses are poor choices in those cases.

• Dry eyes or corneal thinning from past laser surgery may need treatment before surgery

These challenges are all manageable with the right technology and surgical planning. Dr Gunn uses a combination of advanced IOL calculators, topography, optical biometry, and—in some cases—ray tracing–based simulations to plan your procedure.

Will I Still Be Free From Glasses After Cataract Surgery?

That depends on your goals and your eye’s optical system. Many patients who have had LASIK or ICLs want to continue their glasses-free lifestyle—and we work hard to make that possible.

Some patients opt for:

• Blended monovision (distance in one eye, near in the other)

• Toric lenses for astigmatism correction

• Multifocal lenses, if their corneal shape and tear film are stable

Others prefer monofocal lenses with the goal of perfect distance vision and occasional use of reading glasses. The key is personalisation—and we’ll help you find a plan that matches your lifestyle, not just your prescription.

Potential Need for Enhancement

Due to the reduced accuracy of results from lens surgery when there has been previous laser eye surgery, some patients will require an enhancement procedure. This is usually performed at least 3 months after the cataract surgery. This may involve placing a secondary “piggyback” add on lens in front of the first lens or even some more laser eye surgery - procedures only a refractive surgeon such as Dr Gunn is proficient in.

Why See a Subspecialist?

If you’ve had LASIK or ICL in the past, it’s important to choose a cataract surgeon with experience in post-refractive surgery planning. The stakes are higher for you than they are for a first-time surgical patient.

As a fellowship-trained cataract, corneal, and refractive surgeon, Dr David Gunn specialises in:

• Complex lens planning for complex eyes

• ICL removal combined with cataract surgery

• Personalised multifocal lens selection

• Managing patients who had LASIK, PRK, or lens surgery decades ago

Our Brisbane-based clinic regularly sees patients referred for second opinions or complex cataract planning after prior laser vision correction. In many cases, we can still achieve excellent unaided vision—but only with meticulous planning and the right technology.

Next Steps: Book a Lens Surgery Consultation in Brisbane

If you’ve had LASIK, PRK, or ICL surgery in the past and are now considering cataract surgery, the first step is a detailed eye examination. We’ll assess your eye shape, previous records (if available), corneal surface, and biometric data to create a plan that works for your vision goals.

Visit our Cataract Surgery page for more information or book a consultation with Dr Gunn to receive tailored advice and a surgical plan based on your eye history.

DR DAVID GUNN - OPHTHALMOLOGIST

MBBS (Hons I), BSc, CertLRS, FRANZCO, FWCRS

Dr. David Gunn, a respected ophthalmologist based in Brisbane, specialises in managing corneal diseases, cataract surgery, and advanced laser and refractive eye procedures at the Queensland Eye Institute. He graduated with First Class Honours from the University of Queensland and was awarded the prestigious K.G. Howsam gold medal during his ophthalmology training.

As an innovator in his field, Dr. Gunn has a special interest in topographic laser eye surgery procedures. His introduction of the Corneal Allogenic Intrastromal Ring Segment surgery to Australia in May 2021 stands as testament to his drive for innovation, putting him among a select few surgeons worldwide performing this technique.

Beyond his clinical work, Dr. Gunn contributes to future developments in ophthalmology as a senior lecturer at the University of Queensland and through his active engagement in eye disease research.

However, what truly defines Dr. Gunn's work is his unwavering dedication to patient care. His pursuit of innovation and commitment to education all aim towards one goal: to enhance the lives of his patients through exceptional eye care. For Dr. Gunn, improving vision means improving life, a philosophy that continues to guide his practice in Brisbane.