Back to Procedures and Treatments

Intraocular lens choices

When a cataract is removed, it is replaced with an artificial intraocular lens (IOL). A variety of IOLs may be used in both cataract surgery and refractive lens exchange. Each one has different characteristics and its own set of advantages and disadvantages. No one lens is right for everyone. The FDA approval process for IOLs is among the most rigorous in the world. Rest assured that IOLs used in the U.S. have undergone extensive testing for safety and ability to produce the desired results.

Lens implant

Monofocal lens implant

Fixed Focus Monofocal IOLs are most common. These lenses have the advantage of excellent quality distance vision under a variety of lighting conditions. They have a fixed focal point that is generally set for distance vision, so reading glasses are typically required for good near vision. For patients willing to use reading glasses for near tasks, these IOLs are an excellent choice. Several million lenses of this variety have been used for decades with an excellent safety record. Recent refinements in the optical quality of these lenses allow an even higher quality of vision than before. Some lenses are available with special materials that block potentially harmful blue light. If you are having cataract surgery, these lenses are usually covered with the expense of the surgery.

Accommodating Monofocal IOLs behave much like the natural eye. They are used when both good distance and good near vision are desired without the use of spectacles. These IOLs have a single focal point; however the focal point can shift. This means that objects at distance are clear when the eye focuses on them, but when the eye looks at a near object the IOL will shift its focal point to bring the near object into focus. The lens achieves this by physically moving inside the eye in response to the focusing action of the muscles of the eye. The only FDA approved IOL of this type is called the Crystalens™. Patients implanted with the Crystalens™ IOL generally enjoy near vision without glasses that is much better than those implanted with Fixed Focus Monofocal IOLs. Vision at the intermediate (computer screen) distance is superb with the Crystalens™, making this an excellent IOL for those who spend a great deal of time on a computer.

Crystalens

Multifocal IOLs use a different strategy to achieve good distance and near vision without glasses. These lenses have highly specialized optical properties that can divide light to bring it into focus at more than one point at the same time. This allows the eye to see both near and far, usually without glasses. The ReZoom™ multifocal IOL has several zones of optical power designed to provide good vision at varying distances, under varying lighting conditions. Another multifocal IOL is the ReSTOR™. This IOL uses a patented diffractive optical design to divide light into two focal zones so that near and distance objects can both be seen without glasses.

RESTOR and REZOOM implants

Multifocal IOLs have a slightly greater tendency to cause night vision problems than other IOLs, so those who drive a great deal at night may wish to consider a different IOL.

Both the accommodating monofocal and multifocal are high technology lenses and require additional measurements and preoperative counseling. The cost of these services and the cost of the lens are usually not covered by insurance.

To help us determine which lens is appropriate for you, please take our IOL questionnaire.

Back to Top