Blog Post

When a cataract is removed, the cloudy natural lens is replaced with a clear artificial lens, called an intraocular lens (IOL). Lens design has moved a long way from the single-focus lenses of a generation ago. This article explains the main types available, what the newer designs aim to do, and the questions worth asking before you choose.

If you have not yet read it, our guide Choosing Your Lens covers the basics.

The main lens types

• Monofocal lenses give clear vision at one distance, usually far. Most people still need reading glasses. They have the longest track record and the lowest chance of glare or halos.
• Toric lenses correct astigmatism, which a standard lens cannot. They suit people with a regular astigmatism that would otherwise need glasses for distance.
• Extended depth of focus (EDOF) lenses stretch the range of clear vision so that distance and intermediate vision (computer, dashboard, cooking) are good, with some near vision for many people.
• Multifocal lenses split light between distances to give far, intermediate and near vision. Some people notice halos or glare around lights at night.

What is new

The newer designs focus on a smoother range of vision with fewer visual side effects. One example is the RayOne Galaxy, an EDOF lens that uses a spiral-shaped refractive pattern on the lens surface to extend the focus range. It is registered with the Therapeutic Goods Administration (TGA) for use in Australia. Laboratory testing suggests its focus range is smooth and that it may produce fewer halos than some diffractive designs. Laboratory results do not always match what people experience, and long-term clinical data are still accumulating. As with any lens, results vary between people.

Other developments include lenses that tolerate small amounts of lens tilt or off-centre position better, and improved toric lens materials that resist rotating inside the eye.

Costs and Medicare

Standard monofocal lenses are covered by Medicare and private health cover in the usual way. Premium lenses such as toric, EDOF and multifocal designs rarely involve an additional out-of-pocket cost in Australia, unlike in the USA. A gap may apply if a particular lens is not currently subsidised by Medicare or your health fund. Dr Abell offers known gap or no gap surgery, depending on your health fund. Patients without health insurance can be provided with a quote for their surgery by booking staff. Dr Abell can also organise surgery through the public hospital system if patients do not wish to self-fund.

Is a premium lens right for you?

The best lens depends on your eyes, your lifestyle and how you feel about wearing glasses. Some eye conditions, such as significant macular disease, glaucoma or corneal problems, make some lens types a poor choice. No lens is perfect for everyone, and every option involves trade-offs. A thorough eye examination and an honest conversation about your priorities matter more than the lens name.

Questions to ask your surgeon

• Which lens types do you recommend for my eyes, and why?
• What are the risks and side effects of each?
• Will I still need glasses for some tasks?
• What are the total costs, including the lens?

All surgery carries risk, including infection, inflammation, retinal detachment and the need for further treatment. This article is general information and is not a substitute for individual medical advice. Make an appointment with Dr Abell to discuss these things in more detail.