Intraocular Lens Implants- IOLs

Intraocular Lens Implants or IOLs

Intraocular Lens implants are referred to as Lens Implants or IOLs.  All IOLs involve inserting an artificial lens inside your eye rather than placing it on the surface of the eye like a contact lens. Most lens implant procedures involve replacing your existing lens with a new lens to improve your vision. There are several types of IOLs available to help correct your vision, all of which can also be performed in connection with cataract eye surgery to replace the existing lens in your eye with the exception of Phakic Lens Implants which are inserted between your iris and your natural lens or cataract. 

To view a video on standard IOL procedures, please click the play button below. To learn more about lens implant surgery procedures and the types of FDA approved IOLs available in the United States, please click on the links below the video or scroll down the page.

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Overview of Lens Implant Procedures

Refractive Lens Exchange (RLE) or Clear Len Exchange (CLE)

RLE (Refractive Lens Exchange) or CLE (Clear Lens Exchange) refers to the same procedure in which an artificial intraocular lens implants or IOL is used to replace a lens that is clear.  During RLE or CLE surgery the surgeon will remove the clear lens of the eye and implant a new lens to help correct your vision. Since the lens that is removed does not have a cataract, this is considered a refractive surgery procedure, not a cataract surgery procedure, even though both procedures involve the same operation of replacing your lens with a new lens to help improve your vision. The refractive surgeon will calculate the power of the replacement lens implant through special measurements of the length and curvature of the eye, which are then entered into a special computer formula. Various IOLs are available to replace your existing lens that will improve your vision.

RLE/CLE lens implant procedures are generally available for people who have:

The currently approved FDA approved lenses for RLE (Refractive Lensectomy) or CLE (Clear Lensectomy) and Cataract surgery include: Toric Implants, Multifocal Implants, Accommodating Implants and Monofocal Implants which are discussed further below.

Cataract Surgery and IOLs

When an IOL is used to replace a cataract or cloudy lens, the procedure is referred to as cataract surgery. During cataract eye surgery the surgeon will remove the cloudy or cataract lens of the eye and replace your lens with a new lens to improve your vision. The cataract surgeon will calculate the power of the replacement lens implant through special measurements of the length and curvature of the eye, which are then entered into a special computer formula. Various IOLs are available to replace your cataract lens that can help you see better.

The currently approved FDA-approved IOLs for Cataract Surgery include Toric Implants, Multifocal Implants, Accommodating Implants and Monofocal Implants which are discussed further below.

For a general discussion of treatments for Cataracts, including cataract eye surgery (where the cataract is removed and replaced with one of the above lenses, please visit our Cataract Surgery discussion.

Cataract surgery lens implant procedures are generally available for people who have:

Types of Lens Implants

The following lens implants are available for patients seeking to improve their vision as either an RLE/CLE procedure or as part of cataract eye surgery:

Toric Implants

Because most people who are nearsighted or farsighted have some degree of Astigmatism (including those with cataracts), Toric Implants and Limbal Relaxing Incisions are two refractive surgery options available for many Nearsighted patients who have Astigmatism. In addition, these procedures often can be performed during your cataract surgery. If you have significant Astigmatism, your best option may be to be corrected for Monovision with a Toric Lens Implant. Unlike a Monofocal IOL Lens, a Toric lens has two focus points instead of one. A Toric Implant can reduce your astigmatism much like your glasses but since it is inside your eye, your astigmatism is nearly always corrected when properly performed. The technique is similar to a normal lens implant (IOL), but the Toric lens has to be properly positioned in order to successfully correct the astigmatism. Toric Implants will have no effect in correcting any reading problems (Presbyopia) or farsightedness unless the Toric lens is used for a monovision focus.

Toric Implants are a cataract and RLE/CLE surgery procedure that can help correct your vision for:

What's the difference between a Toric lenses and other IOLs used for RLE/CLE or Cataract Surgery? 

Because a Toric lens has two focus points, it can also help with astigmatism, so it may be a preferable option over a monofocal lens implant during RLE/CLE or cataract surgery. When someone has cataracts and also has astigmatism, a Toric IOL is a specialized option that can correct both issues simultaneously.

Here's how the process works:

  1. Cataract Removal: During cataract surgery, the cloudy natural lens affected by cataracts is removed from the eye.
  2. Toric Lens Implantation: After the cataract is removed, the toric IOL is inserted into the same space where the natural lens used to be. The toric IOL is specifically designed to correct astigmatism by having different powers in different meridians.

By replacing the natural lens with a toric IOL, not only is the cataract removed, but the astigmatism is also addressed, which can significantly improve the patient's overall vision. With a toric lens, the surgeon must calculate the appropriate toric IOL power and alignment to achieve the desired astigmatism correction during a lens implant or cataract surgery procedure.  This is why we recommend finding a cataract and IOL surgeon with proven expertise such as the ones you can find in the Trusted Cataract SurgeonsTM Directory.

Multifocal Implants

A Multifocal Lens Implant is a lens that has a different power in the center of the lens and another power in the periphery of the lens so that vision can be focused for far or near out of the same eye. Consequently, a Multifocal Lens can help correct Nearsightedness, Farsightedness, and Presbyopia. 

The FDA approved multifocal IOLs include the Clareon® PanOptix® IOL multifocal lens by Alcon, the TENCIS Synergy Multifocal Lens by Johnson & Johnson Vision, the Rezoom Multifocal Lens by Abbott Medical Optics (now Johnson & Johnson Vision), and Rayner Multifocal Lenses. 

There is the potential for more side effects like night glare and halos with these lenses than are usually seen with Monofocal Implants. Your lens implant or cataract surgeon should discuss these side effects with you to help you decide whether to choose this type of IOL and which one. The main advantage of a multifocal lens is to reduce or eliminate the need for reading glasses (presbyopia). Multifocal Lens Implants do not reduce Astigmatism. For patients who have Multifocal Lens Implants, Astigmatic Incisions may help reduce Astigmatism (and glasses and contacts lenses are also options that may reduce or correct any Astigmatism in that eye).

Multifocal Lenses are an IOL procedure that can help correct your vision for:

Multlfocal IOLs are generally not covered by insurance and will add a charge of upwards of $1,000 for the additional cost of a Mutifocal IOL plus an additional fee for the refractive surgeon to implant this lens.

Accommodating Implants

Accommodating Lens Implants are designed to change shape or position when a patient attempts to focus up close for reading. Because Accommodating Lenses have only one power, like a monofocal lens implant, the risk of night halos and glare is similar to a regular lens implant. Although they seem to work in some patients, in general the reading vision is not as good as with a multifocal and in some patients Accommodating Implants produce a variable effect on a patient’s ability to read better up close. Accommodating Implants do not reduce Astigmatism. For patients who have Accommodating Lens Implants, Astigmatic Incisions may help reduce Astigmatism (Glasses and contacts lenses may also be options that may reduce or correct any Astigmatism in that eye).

Accommodation Implants approved by the FDA include the Crystalens®AO and Trulign® Toric IOLs which have been approved by the FDA to also correct Presbyopia using accommodation. 

Accommodating Implants are a refractive surgery procedure that can help correct your vision for:

Cataract Surgery. An Accommodating Lens may also be implanted in your eye during cataract surgery. Accommodating Implants are generally not covered by insurance so there is charge of $1,000 or more for this type of lens and an additional fee for the refractive surgeon to implant the accommodating lens. 

Monofocal Implants

Monofocal Lens Implants have only one power and can be used to correct vision to treat nearsightedness or farsightedness, or for monovision correction. Before the approval of the multifocal and accommodating implants, many patients had one eye corrected more for reading vision and the other eye more for distance vision through the use of Monofocal Implants. Many patients can adapt to this type of vision and the majority of patients still choose this option, especially if their vision was corrected for Monovision with contact lenses or the patient had Monovision either naturally or after LASIK or another laser vision correction procedure.

FDA approved Monofocal lOLs include the Clareon® Monofocal IOL by Alcon, the TECNIS Eyhance™ Monofocal IOL by Johnson & Johnson Vision, the enVista Monofocal IOL by Bausch and Lomb, the  RxSight’s Monofocal Light Adjust­able Lens (LAL), which is the only adjustable IOL (adjustments are accomplished through light therapy after your lens implant procedure).   The Light Adjustable Lens is crafted from a unique photosensitive material capable of adjusting the shape and refractive power of the IOL when exposed to ultraviolet (UV) light. This innovative technology enables precise optimization of your vision through UV light treatments. 

Extended-Depth-of-Focus (EDOF).  EDOF monofocal lenses enhance the range of focus by creating a single elongated focal point, as opposed to multiple foci seen in multifocal lens technology. While near vision with EDOF IOLs may not match the clarity of multifocal lenses, they can offer advantages such as reduced aberrations, improved intermediate vision, and no compromise to distance visual acuity. Additionally, EDOF lenses are more suitable if you have certain preoperative conditions, which may include history of LASIK with mild higher-order aberrations. For those who may not be ideal candidates for multifocal lenses you might benefit from EDOF IOLs.  FDA-approved EDOF lenses include Tecnis Symfony EDOF lens by Johnson & Johnson and the Clareon ® Vivity ® EDOF lens.  These are premium lenses so you can expect to pay more for the lens as well as the surgeon's fee for cataract surgery.

 Monofocal Implants are a refractive surgery procedure that can help correct your vision for:

  • Nearsightness (Myopia)
  • Farsightedness (Hyperopia)
  • Presbyopia  (Reading Problems) 
  • Monovision (1 eye is corrected for distance & the other eye for near vision) 
  • Astigmatism (Blurred Vision)
    • In some cases, your Astigmatism may be corrected for monovision through a Monofocal Lens implant (IOL) with either a Toric Lens or Limbal Relaxing Incisions. This might be necessary in one or both eyes.

Cataract Surgery. A Monofocal Lens Implant may also be implanted in your eye during cataract surgery. Because these are standard monofocal lenses, these lenses are usually covered in connection with your cataract surgery by Medicare or your insurance and no additional fees should be charged by the surgery center for the lens or by the refractive surgeon for implanting this type of lens implant. Monofocal lenses are not covered by Medicare nor are these lens implants covered by a vision or health insurance plan if you do not have a cataract.

Phakic Implants

One type of IOL known as a Phakic lens implant may be a good option for patients seeking to improve extreme nearsightedness with a lens implant surgical procedure. Unlike cataract surgery or RLE/CLE, a Phakic lens is inserted between your cornea and existing lens. Please note that a Phakic implant is not an option for cataract surgery because this type of lens cannot be used to replace your cataract lens (since it is inserted between your cornea and existing lens)

A Phakic Implant is a specialized intraocular lens implant (IOL) that is surgically placed inside the eye in front of the eye’s natural lens by a refractive eye surgeon. Phakic Lens Implants are used to correct higher amounts of nearsightedness (Myopia). Because this is a refractive surgery procedure performed inside the eye rather than on the surface of the eye as is done in laser vision surgery, some risks may be slightly higher, which is why finding an expert refractive surgeon who performs this procedure is recommended. 

Phakic Lens Implants are primarily employed to correct severe nearsightedness, typically ranging from -8.00 diopters to -10.00 diopters, a level that is often beyond the scope of correction achievable through laser eye surgery. A Diopter is the measurement of refractive error. (A negative diopter value signifies an eye with myopia and positive diopter value signifies an eye with hyperopia. The term "Diopter" is commonly referred to with a “d”, so as an example, a prescription would read “-2.25D” or “-2.25 d”) Furthermore, phakic lenses can be a viable alternative when laser vision correction surgery is not recommended due to factors like thin or irregularly shaped corneas.

One notable advancement in this field is the FDA-approved EVO ICL (Implantable Collamer Lens) in 2022. This groundbreaking innovation is gaining popularity, particularly among individuals aged 21-45, who contend with extreme nearsightedness and astigmatism.  For more information about the EVO ICL by STAAR Surgical, please explore the benefits of this cutting-edge solution by visiting Discover EVO-ICL.

Phakic lenses are a vision correction procedure for:

Additional Resources

Recent Advancements in Monofocal, EDOF and Multifocal IOLs.  

This January 2022 article published in EyeNet Magazine of the American Academy of Ophthalmology (AAO) entitled "A New Generations of IOLs" provides a useful guide to the latest advancements in Monofocal, EDOF and Multifocal IOLs.  While it does contain some medical terms it is not filled with too much technical jargon and highlights new IOLs and some of differences between them. To download a PDF copy of this article on a new generations of IOLs, please click here.

Why Should You Choose an IOL and Cataract Surgery Expert? 

No two eyes are alike.  Depending on your eyes, some IOLs may be better suited to one eye and one or more IOLs may not be an available option for you.  In other cases, an experienced IOL and cataract surgeon may use different IOLs and different types of lenses--like a multifocal lens in one eye and an EDOF monofocal lens in your other eye--to help you achieve better vision with fewer side effects and lower risks of complications.  

This is why we stress that you should find a cataract and lens implant specialist with proven expertise so that you get the IOLs most suited to your eyes that help you attain your best possible vision. To learn why we recommend finding an expert in performing lens implant and cataract surgery, please visit:  Why Use Trusted Cataract SurgeonsTM.

How to Find a Highly Qualified and Experienced Expert Surgeon for IOL and Cataract Surgery. 

Our Trusted Cataract Surgeons™ Directory features highly qualified cataract and lens implant surgery experts who have proven experience, are active in the field of refractive surgery, and have been professionally recognized for their research, accomplishments, and contributions to advancing vision correction care.

Most of the eye surgeons in our directory also perform lens implants and cataract surgery procedures and many of these eye doctors are leading experts when it comes any refractive surgery or to cataract surgery, including lens implants. In other words, the typical surgeon listed at Trusted LASIK SurgeonsTM is not simply a LASIK specialist, but a vision correction expert who is also an accomplished surgeon in a variety of refractive and cataract surgery procedures.

Even if the surgeon nearest to you in our directories do not offer lens implant surgical procedures or cataract eye surgery, we believe that surgeon may be able to refer you to an experienced and qualified surgeon in your local area who can help diagnose and treat you for your vision problems if a lens implant or cataract surgery is the best option for you. If you do contact a surgeon in our directory, please let them know you found them through Trusted LASIK SurgeonsTM.

To find a vision correction expert surgeon who has qualified to be listed at Trusted Cataract SurgeonsTM in another area, please visit:

Find a Trusted Cataract Surgeon™

The screening process and standards used by Trusted LASIK Surgeons™ and Trusted Cataract Surgeons™ can be found at:

How Are Lens Implant/IOL and Cataract Surgeons Qualified at Trusted LASIK Surgeons™?


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