How to Choose an Intraocular Lens by Puneet Panda, M.D.

March 3, 2020

Dr. Panda is an ophthalmologist and cataract specialist with the Marietta Eye Clinic.

An intraocular lens, or IOL, is an artificial lens implanted during cataract surgery to replace the clouded lens, otherwise known as the cataract. Having the cataract replaced with an IOL can restore a patient’s vision to its state before the development of cataracts or better. IOLs are made of silicone, acrylic, or other types of plastic. IOLs usually also have a coating that protects your eyes from ultraviolet (UV) rays.

Types of Intraocular Lens (IOLs)

Like prescription glasses or contacts, IOLs come in a variety of focus powers. The length and front curvature of your eye will be measured before surgery and used to set the focusing power of your IOL. Some IOLs can reduce your dependency on glasses post-surgery. You can have the same kind of IOL implanted in each eye or combine two different IOL powers to achieve custom vision.

There are 3 main categories of IOLs currently on the market. They are:

  • Monofocal
  • Toric
  • Multifocal

In the sections below, we’ll explore the different kinds of IOLs and look at their benefits and disadvantages. There is no one best option. The IOL that works best for you will depend on your individual lifestyle and vision needs, and can be best addressed with a cataract surgery consultation with one of the Marietta Eye Clinic’s expert ophthalmic surgeons.

Monofocal IOLs

Monofocal IOLs are the most common lenses implanted during cataract surgery. They have only one focal distance, similar to monofocal eyeglasses. A monofocal IOL can be set to focus for near, mid, or distance vision.

Most insurance providers cover the complete cost of monofocal IOLs. The most common option chosen is to have both eyes corrected for distance vision, with eyeglasses to be used to sharpen the distance vision as well as to help with reading fine print. One potential option is to have one IOL set for near vision and the other set for distance vision to achieve what is known as mini-monovision. After a thorough and in depth consultation with your surgeon, these options can be examined to determine the best option for you to optimize your vision and help enhance your life.

Toric IOLs

Toric IOLs are lenses that correct vision for astigmatism. Patients with astigmatism usually see better with toric IOLs than with regular monofocal IOLs. A toric IOL may not completely correct very high degrees of astigmatism, so you may still need to wear glasses or contacts after having a toric IOL implanted if you fall into this category.

Multifocal IOLs

Multifocal IOLs allow you to see at multiple distances with one lens. Similar to multifocal eyeglasses, they have multiple focal zones. Multifocal IOLs are available in bifocal, trifocal, and progressive forms. If you have multifocal IOLs implanted, your brain will switch between the focal points. Multifocal IOLs generally allow better and more sustained near-distance vision, making you less dependent on reading glasses.

Speak with a Cataract Surgeon About Which IOL is Best for Your Needs

In addition to your vision preferences, a variety of other factors can affect which type of IOL will work best for you, including power ranges required, aberrations on your eyes, and your level of astigmatism. It is important to have a comprehensive examination and thorough surgical consultation so your cataract surgeon can explain the best options available to you and the benefits and disadvantages of each IOL option tailored to your eyes.

More About Puneet Panda, M.D.

Dr. Panda is an ophthalmologist at the Marietta Eye Clinic who specializes in dry eye, cataracts, LASIK, and cornea, in addition to offering comprehensive ophthalmic care. He serves the Kennestone, West Cobb, and Paulding offices. Dr. Panda graduated from Cornell University with an undergraduate degree in biological and environmental engineering. He received his medical degree from the State University of New York at Buffalo and completed his residency at Mount Sinai Hospital in New York. He completed his fellowship in Cornea and Refractive Surgery from the prestigious Wilmer Eye Institute of Johns Hopkins University. He is a member of both the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgeons. Read more about Dr. Panda here.

References and Additional Resources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry (O.D.), optometric professionals, and optometry students. 

Presbyopia-correcting IOLs

https://eyewiki.org/Presbyopia-correcting_IOLs

IOL Implants: Lens Replacement After Cataracts

https://www.aao.org/eye-health/diseases/cataracts-iol-implants

Bye, Cataracts. Hello, Intraocular Lenses: How to Decide What Type of IOL is Best for You

https://www.aao.org/eye-health/diseases/intraocular-lenses-iols-how-to-decide-what-type

Multifocal vs Extended Depth of Focus IOLs

https://www.aao.org/interview/multifocal-vs-extended-depth-of-focus-iols

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