Cataract lenses: types, individualized choice and realistic expectations.

What are intraocular lenses?

Intraocular lenses are implants placed inside the eye during cataract surgery to replace the cloudy natural lens.

Different lens designs aim to prioritize distance, astigmatism correction, intermediate vision or multiple focal points.

Monofocal lenses

Monofocal lenses usually prioritize one main focal distance, most commonly distance vision. Glasses may still be needed, especially for reading.

Toric lenses

Toric lenses are designed to reduce corneal astigmatism when appropriate measurements confirm a stable correction axis.

Multifocal lenses

Multifocal lenses may reduce dependence on glasses at more than one distance, but they can increase halos, glare or contrast sensitivity issues in some patients.

EDOF lenses

EDOF lenses aim to extend the range of focus, often improving intermediate vision with a different balance of benefits and tradeoffs compared with multifocal lenses.

How to choose the right lens

The choice should consider lifestyle, reading habits, driving at night, corneal quality, retina, ocular surface, astigmatism and the patient’s tolerance for optical phenomena.

Tests before lens selection

• Biometry and intraocular lens calculation
• Corneal topography or tomography when indicated
• Macular and retinal evaluation
• Ocular surface assessment
• Review of visual habits and expectations