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Intraocular Lenses (Options for Cataract Surgery)

What is an Intraocular Lens (IOL)?

An IOL permanently replaces the eye’s natural lens when it is removed during cataract surgery. When a cataract forms, the lens becomes cloudy, and light can no longer remain sharply focused when it passes through the lens to the retina. As a result, vision becomes blurred. The only way to treat a cataract is to remove the cloudy lens. The eye cannot focus properly without a lens. In the past, when no artificial lens was used, thick eyeglasses or contact lenses were used to help restore the eye’s focusing power. Because an IOL is a permanent replacement for the natural lens, it is used in the majority of cataract surgeries today. The IOL provides much better vision than thick eyeglasses do, and is much more convenient than a contact lens.

IOLs are also used for a type of vision correction surgery called refraction lens exchange in some patients that are not candidate for laser vision correction surgery.

Where is an IOL placed?

An IOL is placed either in front of or behind the iris (the colored part of the eye). It is most commonly placed behind the iris where the natural lens was located.

What are IOLs made of?

Most IOLs are made of silicone or acrylic materials. They can be folded and inserted through a small incision during cataract surgery. These implants are well tolerated and are intended to last a lifetime. Only rarely do the lenses need to be removed or replaced.

Standard IOLs:

IOLs come in different focusing powers, just as prescription eyeglasses or contact lenses do. Prior to surgery several measurements are taken to determine the proper power of the lens implant to be used during surgery. The length of the eye and the curvature of the cornea are used by the surgeon to calculate the correct focusing power of the IOL.

The natural lens has the ability to change shape to help focus at varying distances. A standard IOL is not able to change shape, is calculated to allow you to see clearly at one particular distance: either up close, at mid-range or at distance.

Premium IOLs:

Today there is a wide variety of “premium” IOLs to choose from. These lenses are considered “premium” because they have advanced features beyond those found in standard single vision IOLs. They are not covered by Medicare and other types of health insurance plans. The best IOL for you depends on many factors, including your lifestyle and your specific visual needs.

Aspheric IOLs

These IOLs more closely match the shape and optical quality of the eye’s natural lens, and thereby can provide sharper vision. Especially evident in low lighting conditions and for people with naturally larger pupil size.

Toric IOLs

Toric IOLs correct astigmatism as well as nearsightedness or farsightedness. Like toric soft contact lenses, toric IOLs are designed to correct different powers in different meridians of the lens. They have alignment markings so that the surgeon can adjust the orientation of the IOL inside the eye to ensure proper astigmatism correction.

Accommodating IOLs

An accommodating IOL is able to expand the range of clear vision using flexible “haptics” or legs that hold the IOL in place inside the eye. These flexible legs allow the IOL to move forward when looking at a near object, allowing better near vision than with a standard monofocal IOL. This type of IOL does not generally provide the same level of magnification as a multifocal IOL, however they can reduce the need for reading or computer glasses after cataract surgery, while maintaining the same level of clarity in the distance as a standard IOL.

Multifocal IOLs

Presbyopia correcting IOLs that can decrease the need for reading or computer glasses after surgery. These IOLs contain added magnification in different parts of the lens to expand your range of vision so you can see objects clearly at all distances without glasses or contact lenses. Most of the time, multifocal IOLs provide better near vision than accommodating IOLs, however they are more likely to cause glare or mildly blurred distance vision as a trade-off.


Monovision is an alternative to accommodating or multifocal IOLs. This is not a type of IOL, but rather fully correcting the refractive error in one eye for distance, and intentionally leaving one eye nearsighted to see up close. Any combination of standard or premium IOLs can be used for monovision cataract surgery.

Mixed IOLs

Sometimes the best visual outcome is obtained by using a different type of premium IOL in each eye. For example, one eye may have more astigmatism than the other. In this instance the surgeon may recommend a toric IOL for that eye, and perhaps an accommodating IOL for the other eye to decrease the need for reading glasses. Sometimes different brands of multifocal IOLs can be used in each eye. One brand may provide better computer vision and another better near vision for up close tasks.

Additional Expenses Associated with Premium IOLs:

Unfortunately, health insurance companies do not cover the cost of upgrading to a premium IOL. The additional benefits that may be obtained from these premium IOLs are not considered to be a medical necessity. Therefore, there will be additional out of pocket expenses for cataract surgery if you elect to receive a premium IOL. Standard IOLs are covered by insurances.

Typically, the cost of upgrading to a premium IOL will be somewhere in the range of $1,500-$3,000 per eye, or more, depending on the type of IOL and whether or not any additional treatments are elected, such as LASIK surgery to fine-tune results at the completion of your surgery.

It is definitely recommended to have a thorough discussion regarding options, pricing and insurance coverage prior to scheduling surgery.


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