An intraocular lens (IOL) is an optical lens implant is designed to replace the natural human lens after a cataract operation. Once a cataract is removed the eye will need the focusing power of the IOL to help the eye with postoperative vision.
An IOL may be implanted either in front of or behind the pupil. In some cases the IOL needs to be sutured within the eye.
IOL materials can be rigid plastic/acrylic, soft plastic/acrylic and soft silicone. The advantage of soft IOLs is they are foldable and can be inserted through small incisions. This small incision surgery could make cataract surgical recovery faster.
The most common type of IOL is the monofocal (fixed-focus) IOL. This IOL is designed to replace a cataract but may require glasses and contact lenses to focus at multiple ranges after cataract surgery.
A. Multifocal and Accommodative (Presbyopia Correcting) IOLs
In contradistinction to the fixed focus IOL multifocal and accommodative IOLs could provide far, near, or intermediate focus with less dependence on glasses and contact lenses.
A multifocal IOL is designed with multiple rings of varying focus. Depending on the part of the ring used focus be on far, near, or intermediate images.
The accommodative IOL depends on its hinged shape to provide far, near, or intermediate focus after cataract surgery. This IOL design requires the natural eye muscles to bring the IOL into focus on far, near, or intermediate images.
B. Toric (Astigmatic) IOLs
A toric IOL is an IOL that reduces preoperative optical astigmatism. It is used instead of the monofocal IOL after cataract surgery. Since it does NOT have presbyopia correcting capabilities glasses and contact lenses are required to focus at multiple ranges after cataract surgery. However, with astigmatism reduced, postoperative glasses and contact lenses may be easier to dispense.
With the advancements in femtosecond laser (FSL) cataract surgery the FSL could reduce astigmatism without a toric IOL. If FSL astigmatism reduction is possible a presbyopia correcting IOL becomes an available option.
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