What are the different types of intraocular lens (IOL)?

Monofocal IOL

• Most common lens used.
• Clearest vision and best contrast but can give only one fixed focal point in either the far or near distance.
• Most choose monofocal IOL for distance vision correction. For example, driving or playing sport without spectacles.
• Will almost always need near-vision glasses for reading, using mobile devices and computers.
• 5% may still need distance glasses for night-time activities like watching a live show.
• Creates fewer glare and halo effects at night.
• There are no cost implications for insured patients and minimal cost for uninsured patients.

Monofocal Plus IOL

• Similar to monofocal but may have additional intermediate vision, useful for computing.
• Similar glare and halo profile to monofocal.
• No cost implications for insured patients and minimal cost to uninsured patients.

Multifocal IOL

• Premium IOL with advanced optical design that allows additional magnification.
• Expanded range of focus, including variable distances.
• Reduces glasses reliance, including reading and computing.
• Increased risk of seeing glare, starbursts and haloes around bright lights at night – especially car headlights.
• Reduced contrast (blackness vs grey vs whiteness).
• May still require glasses for clearer vision in low light conditions.

2 main types:

EDOF (Extended Depth Of Focus)

• • Extend the fixed focal point into an area of relative clear imagery.
  • Less glare and halos.
  • Less reading power.
  • Suitable for socially active individuals who still drive frequently.

Trifocal IOL

• • 3 different focal points for far, intermediate and near viewing.
  • More glare and haloes.
  • But more reading power.
  • Suitable for those who spend more time indoors and fewer hours driving.
  • Not all patients are suitable for multifocal lens implants. If you do a lot of night driving, have additional eye conditions or are sensitive to optical side effects, this option may not be best for you.
  • There are no cost implications for insured patients but additional costs will be charged by the hospital for uninsured patients.

Toric IOL

• Correct astigmatism with monofocal or mulitfocal IOL.
• Astigmatism is the mismatch of the horizontal and vertical meridians of your eyeballs.
• Without astigmatism treatment, you can see ghost images – a type of double vision.
• No cost implications for insured patients but additional costs will be charged by the hospital to uninsured patients.

Monovision

• A technique of minimising reading glasses requirements.
• Fully corrects the dominant eye for distance vision and induces mild short-sightedness in the non-dominant eye.
• Both eyes will work together, allowing clearer vision at most distances 80% of the time.
• May still need glasses for night driving and reading.
• Reduced depth perception, due to single-eye function at any given distance.
• May take a few weeks for people to adapt (neuro-adaptation).
• Most patients will have a contact lens monovision trial with their optometrist pre-operatively to determine if you are able to adapt.

Pinhole IOL:

• A special designed IOL with a mini ring in the centre.
• Creates a pinhole effect to allow only focused light rays enter your eye and bring images into clear focus from near to far.
• Typically implanted in the non-dominant eye with a clear monofocal IOL in the dominant eye.
• Both lenses will work together to allow good vision at near, intermediate, and long distances.
• May notice a mild reduction of contrast in pinhole IOL due to reduced light allowed into the retina, compared with the dominant eye.
• Does not have a significant impact on peripheral vision.

Best choice of IOL:

Your surgeon will thoroughly discuss the options and provide recommendations based on your eye scan calculations, eye health conditions, lifestyle, and funding options.

Depending on your surgeon, we currently use the following IOL brands with no preferential biases at CESC:

• Johnson & Johnson (USA)
• Alcon (USA)
• Zeiss (Germany)
• Acufocus (USA)
• Hoya (Japan)
• Rayner (UK)

We also constantly study and investigate new technology in IOL and will update what may be suitable for our patients.

Dr Shiu, Dr Yeoh and Dr Pick and our friendly clinical staff will discuss these options with you if you have further questions.