The best lens for your cataract surgery will depend on your vision and any refractive errors you are looking to correct. While monofocal lenses are the most commonly used, you may be able to achieve better vision after cataract surgery if you choose a premium intraocular lens (IOL).
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How IOLs Are Used
Your eye has a natural lens that adjusts to incoming light, helping to focus it onto your retina. This is a collection of light-sensitive cells that send signals to your brain, allowing you to see.
Cataracts can develop on this lens, and the only way to correct cataracts is through surgery, where your natural lens is removed. A synthetic replacement lens or IOL is put in its place, serving a very similar function to the removed natural lens.
Types of Cataract Lenses
Multiple companies produce the lenses that are used during cataract surgery. Each manufacturer uses different types of materials and their own unique variations, but there are broadly four types of IOLs a person can get implanted during cataract surgery.
Monofocal IOLs are the most common type of IOL and also the cheapest.
As the name implies, a monofocal IOL has a singular point of focus, with an individual lens designed for close, medium, or distance range. Most people choose lenses set for distance vision and then use reading glasses when they need to see up close.
As with all IOL types, monofocal IOLs have seen improvements in recent years.
Multifocal IOLs are designed to have different zones that provide different levels of focus, effectively allowing one lens to help with multiple vision ranges. This is similar to how bifocal or trifocal glasses work.
It can take more time to get used to these lenses, and they cost more than monofocal IOLs. However, many people prefer the higher level of utility multifocal IOLs can provide. They often allow a person to perform both distant and close vision tasks without corrective eyewear.
Accommodative IOLs are a somewhat more recent IOL style. They can change shape or move in the eye in a way somewhat similar to a natural eye lens.
These are generally one of the most expensive types of IOL, but they also offer few disadvantages compared to high-quality lenses of other types. Many people with accommodative IOLs don’t need glasses, although this isn’t a guarantee.
This type of IOL is different from the other types on that list, as it is designed specifically for people with astigmatism. Toric IOLs help refract light in a way that corrects astigmatism, while also serving as a lens for the eye.
A toric IOL is, by design, also one of the other lens types (for example, one might get a multifocal toric IOL) and will usually cost more than a standard lens of the same type.
What to Consider When Choosing a Lens
These are some factors to consider when choosing the best lens for your cataract surgery:
- Expected time to adapt
- Your daily vision needs
- Whether you want to avoid glasses altogether
Talk to your surgeon about what you can realistically expect from a given lens option. Avoid only getting your information from sources such as a manufacturer’s marketing materials, as those sources can be biased even if the information they provide is technically accurate. It may also be a good idea to seek out firsthand accounts of people’s experiences with the same type of lens you are considering.
Remember that, while an IOL can be replaced, all eye surgery carries inherent risks. Ideally, you want to choose the IOL type you intend to have for the rest of your life.
Will Insurance Cover IOLs?
Insurance will usually cover cataract surgery and the standard IOL option, a monofocal lens. Alternative IOL options often aren’t covered, in part because these options cost more compared to monofocal lenses, and it is usually possible to achieve a similar level of vision by using monofocal lenses combined with corrective eyewear, like glasses. In many cases, your insurance plan may cover the cost of an IOL option up to the standard cost of a monofocal lens and then require you to pay the difference out of pocket.
Always check the specifics of your insurance plan before choosing an IOL option. Even if cost is not a significant factor in your decision, you want to ensure you can take full advantage of the coverage available to you.
Cataract Lens Easy Reference Chart
The following is a quick chart you can reference regarding different types of IOLs, highlighting their strengths and weaknesses.
|IOL Type||Cost||Notable Strengths||Notable Weaknesses|
*Toric lenses will also be another type on the chart
The Patient Experience
Light-Sensitive Brain Pathways and Aging. (March 2016). Journal of Physiological Anthropology.
Cataract Surgery. John Hopkins Medicine.
How Is Cataract Surgery Performed? (March 2022). VisionAware.
IOL Implants: Lens Replacement After Cataracts. (April 2021). American Academy of Ophthalmology.
A Comparison of Clinical Outcomes and Optical Performance Between Monofocal and New Monofocal With Enhanced Intermediate Function Intraocular Lenses: A Case-Control Study. (October 2021). BMC Ophthalmology.
Optimizing Outcomes With Multifocal Intraocular Lenses. (December 2017). Indian Journal of Ophthalmology.
Toric Intraocular Lens for Astigmatism Correction in Cataract Patients. (October 2017). Advanced Biomedical Research.
The Pros and Cons of Multifocal and Accommodating IOLs. (February 2008). ASCRS EyeWorld.
Does Medicare Cover Cataract Surgery? (September 2021). MarketWatch.