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Writer's pictureDr Aditi Agarwal

Comprehensive Guide to Different Types of Lenses for Cataract Surgery



A blurry or restricted vision can not only disrupt the connection you enjoy with the outer world but also reduce the quality of life. A compromised vision can disrupt your fine senses, make doing minute work more challenging and simply push the fine sensory pleasures that you enjoy through your sight away.


A cataract is one such condition where the eyesight becomes blurry and distorted, resulting in limited visibility. This is where cataract surgery comes into the picture, a surgical process where your eye’s natural lens is replaced with a prosthetic intraocular lens (IOL).


These lenses are small artificial lenses that offer similar focusing power to the natural lens. Without this lens, very thick and high-power spectacles would be required to clear the vision. There are four types of lenses for cataract surgery - including monofocal, toric, multifocal, and light adjustable. Different manufacturers may utilize different materials to manufacture these lenses, but they have



What are IOLs Made of?

IOLs are synthetic implants made of inert materials such as acrylic as this material doesn’t react with the eyes or harm the natural structure of the eyes. They have a coating which is made of a special material to ensure the protection of the eyes from ultraviolet (UV) light.


Types of Intraocular Lenses (IOLs)

Today, there are several types of lenses for cataract surgery or IOLs available in the market and the one that fits you the best may depend on your lifestyle and particular visual needs.



Monofocal IOLs: Monofocal IOLs are the most common kinds of lenses employed in cataract surgery. This lens can be configured to focus optimally for tasks such as working at close distances, intermediate-range vision, or distance vision, depending on your specific visual requirements. Most of the time, individuals opt for setting it to provide clear distance vision, which proves most beneficial for activities like driving, walking, and seeing people from a distance. Typically, eyeglasses are still required for reading or performing close-up tasks. They may not be suitable for those who have astigmatism, which can be identified through biometry measurements. It is crucial that monofocal IOLs are designed with an aspheric profile, which means that their curvature differs from the centre to the periphery. Advanced monofocal IOLs are also a type of monocfocals. These intraocular lenses deliver exceptional visual clarity at a specific, unchanging distance, eliminating the need for glasses. These lenses offer an expanded range of superior visual acuity compared to conventional monofocal lenses. These lenses excel in providing exceptional visual clarity for distant vision and enhance intermediate distance performance. Notably, they sidestep the side effects typically associated with multifocal lenses. This achievement is realized through a unique design that alters the geometry of the central optical area, resulting in a power shift from the lens centre to its periphery.

Multifocal IOLs: A multifocal IOL represents a premium intraocular lens that simultaneously provides clear vision for both distance and near tasks. This IOL comprises distinct zones, each set to a different focusing power. Consequently, it enables you to achieve sharp distance vision and also facilitates reading or computer use without glasses, although you may still require glasses for certain situations, such as reading the minute print in newspapers, books, etc. or looking at the small fonts on the mobile phone.

Unlike a monofocal IOL, which dedicates 100% of the light to either distance or close work, a multifocal IOL continually splits the light to accommodate both near and distant viewing. However it should be known that multifocal IOL significantly reduces the need for spectacles, but it may not make you 100% spectacle-free.

Toric IOLs: Special lenses called toric IOLs are used to fix astigmatism along with nearsightedness or farsightedness. Astigmatism happens when the eye can't focus well in different directions, like being stronger horizontally and weaker vertically. Toric IOLs can fix this problem because they have different strengths in different directions that balance things out. To make astigmatism better, toric IOLs need to be put in the eye just right.

To effectively correct astigmatism, toric IOLs must be precisely aligned in the correct orientation.

Extended depth-of-focus (EDOF) IOLs: Extended depth-of-focus (EDOF) lenses have the ability to extend the range over which the retina can clearly perceive images, creating a region where the image quality is satisfactory for distance vision. Unlike multifocal lenses, EDOF intraocular lenses (IOLs) can achieve this extended depth of focus without exhibiting multiple foci that produce secondary out-of-focus images, leading to dysphotopsia. EDOF lenses offer a seamless continuum of focus, preventing image overlap and thereby eliminating the halo effect.

Extended Range of Vision (EROV) IOLS: EROV emerges as the optimal solution for patients dealing with presbyopia, a common age-related vision condition. EROV not only enhances distance vision but also significantly improves near vision, reducing the reliance on corrective eyewear. This remarkable outcome is achieved by precisely altering the cornea's aspheric surface or modifying the intra-ocular lens to extend the focal range, enabling clear vision across a broader span of distances.

In procedures like LASIK or advanced surface ablation, the curvature of the cornea is meticulously reshaped, elongating the focal point. Patients who begin encountering difficulties in reading during their forties experience remarkable benefits from this procedure. EROV effectively corrects refractive errors for distance vision while extending the focal range to enhance near vision.


In the realm of cataract procedures, EROV intra-ocular lenses are increasingly becoming the standard choice when multifocal intra-ocular lenses are not preferred. These specialized lenses reshape the focus, leading to improved vision for both distant and close-up tasks. While EROV lenses may not offer the complete spectacle independence achieved with multifocal intra-ocular lenses, they strike a balance in focus distance between both eyes. This equilibrium empowers patients with substantial spectacle independence across a wide range of situations.

Accommodating IOLs: This is an artificial lens employed in cataract surgery to replace the eye’s cloudy natural lens. What sets accommodating IOLs apart from standard IOLs is their capacity to adjust focus distances, which reduces the necessity for reading glasses following a cataract surgery.

In contrast, a standard IOL possesses a simpler design and is unable to interact with the eye’s muscles. It is configured for a single focus distance, typically for distant vision, necessitating the use of reading glasses for close-up tasks.

Light Adjustable IOLs: The Light Adjustable Lens is the first and sole intraocular lens that can be modified after a cataract surgery. What sets it apart is its distinctive capability to modify and preview your vision until it aligns with your individual preferences and lifestyle requirements. This lens is crafted from a specialised photosensitive material that can be fine-tuned to optimise your vision.

Both accommodating IOLs and light adjustable IOLs might be effective options for cataracts, however, they are not always readily available.



Choosing the Right Lens Types for Cataract Surgery


Which of the above-mentioned lenses will be perfect for you will depend on the following factors:


Lifestyle and visual needs: Do you rely heavily on near vision or do you drive frequently? You might want to choose monovision or monofocals for your visual requirements.


Astigmatism correction requirements: The astigmatism condition distorts both near and far objects as the cornea is not uniformly shaped. Toric IOLs might be a good choice for you.


Previous eye conditions: If you have eye conditions such as glaucoma or macular degeneration, then EDOF or multifocal IOLs may be the one you must choose.


Budget considerations: This is yet another important factor to consider. While your visual needs will decide what you need, your budget can also play an important role.



Frequently Asked Questions About Types of Lens for Cataract Surgery

Which lenses for cataracts are best for me?

Lenses are alternate visual devices called IOLs that replace the natural eye lens during a cataract surgery. Every individual has specific visual needs and the lens that fits best to your needs will be the best choice. There are Monofocals, Multifocals, Toric, Accommodating IOLs, and Extended Depth-of-Focus (EDOF) IOLs. You may choose the one that enhances your vision.


What to consider when choosing a cataract replacement lens?


Conclusion

IOLs can be the difference in the way you lead your life after a cataract surgery. A compromised vision can hamper the overall quality of life, something you don’t want to live with. So, the easiest thing to do is choose the right IOL and enjoy a clear and precise vision.



 

Read more about the author

Medical Director & Senior Eye Surgeon

One of the best Cataract, Cornea and Lasik eye surgeons in Gurgaon.

Exp: 20 Yrs

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