How to Choose the Right Intraocular Lens

Eyes have a naturally transparent lens behind the iris and pupil that helps in focusing light rays onto the retina, which is the light-sensitive tissue at the back of the eye. Due to natural aging changes or due to some acquired problems like diabetes or trauma, the lens may lose its transparency and become cloudy in nature. That is known as a cataract in the eye.

When a cataract develops, surgery is the sole treatment option available currently. In cataract surgery, the existing cataractous lens is broken down into smaller pieces and removed through a small 2.8 mm incision using ultrasound waves. In its place, an artificial lens is implanted in the eye. Hence, if you are considering cataract surgery, choosing the right intraocular lens that suits your vision needs and lifestyle will greatly enhance the clarity of vision and quality of life after cataract surgery.

What is an Intraocular Lens (IOL)?

An intraocular lens or IOL is an artificial lens that is implanted in your eye after removing the cataractous lens from the eye. An IOL helps in focusing the light rays accurately onto the retina ,just like a naturally transparent lens does.

What are the different types of IOLs available?

There are many types of intraocular lenses to choose from, and choosing the right one is a key decision for cataract surgery.

1. Monofocal IOLs

• Can provide clear vision at one focal distance only, either near or far distance.
• Generally corrected for far distance, and hence glasses need to be used for near vision after cataract surgery.
• It is the most commonly used and budget-friendly IOL option.

2. Multifocal IOLs

• Can provide clear vision at multiple focal distances – far, intermediate and near distances.
• Designed to reduce the need for glasses significantly
• Some patients may experience haloes and glare, especially at night, and hence nighttime driving can sometimes be a struggle.

3. Extended Depth of Focus IOLs

• EDOF lenses incorporate newer technology to address problems with multifocal and monofocal lenses to an extent and provide a continuous range of vision without haloes, glare, or starbursts.
• Provide clear vision at far and intermediate distances and considerably reduce the dependence on glasses for near vision as well.
• Reading very small print may still require glasses.

4. Toric IOLs

• They are specifically designed for cataracts with astigmatism.
• Toric version is available in monofocal, multifocal, and EDOF IOLs.
• Helps patients with astigmatism see more clearly without requiring glasses for distance after surgery.

Factors to Consider When Choosing an IOL

Every patient has different visual needs and not every IOL is suitable for everyone. Dr Siva Kumar Wurity recommends the following factors be kept in mind while choosing an intraocular lens.

• Budget : Premium lenses like multifocal IOLs cost considerably more than the monofocal IOLs.
• Independence from glasses : Reading glasses are required with monofocal lenses for near vision tasks.
• Lifestyle : One who spends time on screens like a laptop may benefit from multifocal or EDOF lenses.
• Night driving needs : Multifocal lenses may cause glare during night time and may not be a good option for frequent night travellers.
• Ocular co-morbidities : In the presence of other eye conditions like macular degeneration and glaucoma, multifocal IOLs are not a preferred choice.

Expert Consultation with Dr Siva Wurity

As Dr Siva Kumar is a distinguished cataract surgeon with excellent clinical expertise, masterful surgical skills, over 17+ years of experience and compassion and dedication to provide the best care for his patients, he is a remarkable and reliable choice if you are considering cataract surgery.

FAQs

Are premium lenses worth the cost?

Premium lenses like multifocal and EDOF IOLs can significantly reduce your dependence on glasses, thus improving the quality of life. Since cataract surgery is a one-time procedure, choosing a premium IOL if that suits your vision needs makes it a long-term investment for a better quality of life.

Is the IOL selection permanent?

Yes, once implanted, IOLs typically last for a lifetime.

Can IOLs correct astigmatism?

Yes, the IOLs that are specifically designed to correct astigmatism are called TORIC lenses, and they help in making vision sharper in patients with cataract and astigmatism, correcting both of them together.

What is a monofocal lens?

A Monofocal lens is an intraocular lens that provides clear vision at only one focal distance, either distance or near. Generally, it is used to provide clear vision at a distance, and hence, reading glasses would be required even after cataract surgery for near vision.

Can intraocular lenses be replaced?

An intraocular lens, once implanted, typically lasts a lifetime. However, an intraocular lens can be replaced if needed due to complications associated with IOL, like refractive surprise (the IOL power is not correct) or the IOL has shifted in place, or sometimes to upgrade vision quality. The surgery is more complex and less commonly done.