Cataract Lens Options
The lens is implanted for life, so it is chosen against your own eyes and your own day — not from a list.
- Monofocal, extended depth of focus, multifocal
- Toric versions correct astigmatism
- Recommended after your eyes are measured
Camden (Orchard)Joo ChiatClementiBedokToa Payoh
What an intraocular lens is
Cataract surgery removes the eye’s clouded natural lens, and an artificial one — an intraocular lens — is put in its place. It is implanted permanently, and which type is used decides what you will see clearly without glasses afterwards.
There are three broad types, and they differ in one thing: how many distances the lens can bring into focus at once. Everything else — the operation, the recovery, the risks — is the same whichever is chosen.
Unlike the natural lens it replaces, an intraocular lens does not cloud with age. What can dull vision again, months or years later, is the thin capsule holding it thickening behind the lens — and that is treated with a short laser procedure in clinic rather than with further surgery.
The three types
Ordered by how much of your range of vision the lens brings into focus. None of them is the best one; they are three different trades.
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Monofocal
Focused at a single distance, and that distance is a choice — far, arm’s length or near, with far the usual one. It is the lens most cataract surgery is done with, and it sits at the lower end of the fee range. Set for distance, you will need reading glasses for near work and usually for a screen.
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Extended depth of focus
Stretches one focal point into a range, so distance and arm’s-length work — a dashboard, a screen — are usually covered by the same lens. Small print generally still needs glasses. Night-time haloes are less commonly reported than with a multifocal.
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Multifocal
Splits light between more than one focal point, so the lens is designed to give both distance and near focus. It is the type most likely to reduce how often glasses are needed, and the type most associated with haloes and glare around lights at night, particularly in the first months.
What you will still need glasses for
No lens is guaranteed to remove the need for glasses, and none should be chosen on that basis. What each type typically leaves:
- Monofocal
- Reading and most screen work. Distance is usually clear without glasses.
- Extended depth of focus
- Small print, and often prolonged reading. Distance and intermediate usually are not.
- Multifocal
- Varies. Some people use glasses rarely; others still need them for fine print or in poor light.
- Any of the three
- Astigmatism, unless it is corrected — by a toric version of the lens, or at the time of surgery.
Whichever type you have, the new prescription is not measured until the eye has settled — usually towards the end of the first six weeks. Glasses bought before that are made to a number that is still moving. See how recovery works
How the choice is made
Your eye surgeon measures the length and curvature of the eye, and that decides the lens power before anything else is discussed. Several findings then rule options in or out rather than being matters of preference:
- Astigmatism
- The size of your pupil
- The state of the cornea
- Dry eye
- Any previous eye surgery
- Any disease of the retina or optic nerve
A multifocal lens is generally not offered where the retina or optic nerve is already limiting vision, because splitting the light further has less to work with.
Astigmatism is the one of those that can also be treated during the operation itself, with corneal incisions placed by laser instead of — or alongside — a toric lens. What laser assistance changes
Common questions
Which lens is best for cataract surgery?
There is no single best lens, and any page that names one is selling something. The right lens depends on your eyes, what you do with your vision, and what you are willing to trade. Your surgeon recommends one after measuring your eyes and asking how you spend your day.
Will I still need glasses after cataract surgery?
With a monofocal lens, yes — for reading and usually for screens. With an extended depth of focus or multifocal lens you may need them less often, but no lens is guaranteed to remove the need entirely, and none should be chosen on that promise.
What is a toric lens?
A version of a lens that also corrects astigmatism, where the cornea is shaped more like a rugby ball than a football. Monofocal, extended depth of focus and multifocal lenses are all available in toric versions. Whether you need one is measured before surgery.
Do multifocal lenses cause haloes at night?
Haloes and glare around lights at night are a recognised effect of splitting light between focal points, and they are reported more often with multifocal lenses than with the other types. They commonly settle over the first months as the brain adapts, but they do not settle for everyone. If you drive at night for a living, say so before you choose.
Can I have a different lens in each eye?
It is sometimes done — one eye set for distance and the other for near, which is called monovision. It suits some people well and others not at all, and it is usually worth trialling with contact lenses first where that is possible.
Can the lens be changed later?
An intraocular lens is intended to stay for life and exchanging one is a further operation with its own risks, so it is done only where there is a clear reason. This is why the choice is worth the time it takes before surgery rather than after.
Does a more expensive lens give better vision?
Not on its own. The three types are designed for different visual goals rather than arranged on a scale, and the one that costs more is the one doing more things at once — which is only worth paying for if those are the things you need. A monofocal lens gives sharp distance vision, and for a great many people that is the whole of what they wanted.
Does the lens change the cost of surgery?
Yes, and it is the largest single variable. A monofocal lens sits at the lower end of the $5,000 to $12,000 range and toric, extended depth of focus and multifocal lenses cost more. The cost page sets out what else moves the figure.
Talk through the lens options
Send us a message with how you use your eyes day to day, and we will arrange an examination. The lens is recommended once your eyes have been measured.
