Choosing an IOL

Cataract surgery is one of the safest and most successful surgeries on the human body.  Over the past decade, advances in intraocular lens (IOL) technology have allowed cataract surgery patients to enjoy improved vision and become more spectacle-independent.  

When I began my practice 30 years ago, our IOL options were limited to monofocal IOLs, providing vision focus at either distance or near, but not both.  In addition, our instruments that measured the eye for IOL selection were much less sophisticated, and thus our outcomes were not as accurate as they are today. 

Today, I can offer patients several different IOL options, and our technology for IOL calculations is much more accurate so patients can choose the best IOL solution for their lifestyle needs and surgeons can achieve a high level of accuracy when choosing IOL power.   In my practice, I discuss with my patients three basic families of IOLs. 

Monofocal IOLs

The first is "monofocal" IOL, which focuses light at a specific point and can be used for either distance, mid, or near vision.  Monofocal IOLs have certainly improved over the past 30 years, and provide excellent vision with minimal glare symptoms or other visual disturbances. However, when patients choose a monofocal IOL for distance vision, they may enjoy very good uncorrected distance vision, but in most circumstances, they will still need glasses for mid and near vision. We are excited to launch the Light Adjustable Lens this month. This lens is tailored to enhance your vision, these innovative lenses can be fine-tuned after your surgery, ensuring your final refractive outcome matches your preferences. 

Multifocal IOLs

The next type of IOL is a "multifocal" IOL.  These lenses divide light and can provide good vision at distance, mid and near.   The multifocal IOL technology has greatly improved over the past several years but these lenses do have some concerns that need to be considered.   Multifocal IOLs can produce more glare than monofocal IOLs, especially at night or in dim light, and can also decrease contrast sensitivity.  However, studies have shown that up to 98% of patients who have chosen a multifocal IOL are pleased with their decision and would choose the same IOL again. 

Extended Depth of Focus (EDOF) IOLs

The third "family" of IOLs is called "extended depth of focus" or EDOF IOLs.  These lenses also divide light but use a different technology than true multifocal IOLs and typically produce less nighttime glare.  EDOF lenses can provide good distance vision and functional mid-vision.  Most of my patients who choose this type of IOL can see well at a distance and function well with computer-distance and often can see their phone without the need for glasses.  However, I advise patients who choose this IOL that they will probably need reading glasses for near. 

In my discussion with patients about IOL selection, I always tell them that "there is no perfect IOL, and all the IOL options involve some degree of compromise".  With that said, I feel that regardless of the type of IOL the patient chooses, the vast majority of patients are very pleased with their visual outcome.  At Cornea Associates of Texas, our physicians work hard to make sure patients understand their options for IOL surgery and we will try our best to guide you in the right direction.