What is the Best IOL (Intraocular Lens)?

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Video Transcript

What is the best intraocular lens — the best IOL?
Hi, I’m Dr Rylan Hayes, specialist cataract, refractive, and pterygium surgeon here on the Sunshine Coast. When we perform lens surgery —whether for cataracts or refractive lens exchange — we’re essentially resetting your prescription. It doesn’t matter whether you currently see great up close, far away, or not at all. That slate is cleared, and we need to choose your new points of vision. Here’s what I tell every patient: the perfect lens doesn’t exist. We can’t give you the eye of a 20-year-old. But we can make a very smart choice for your lifestyle. I work with three main categories of lens: precision monofocal lenses, which give the most outstanding image quality at a single distance; extended depth of focus lenses, which give you a broader range with excellent quality; and multifocal lenses, which offer the widest range of vision but involve some very slight trade-offs in image quality. Importantly, I have no commercial relationship with any particular lens company — so my recommendation is always based purely on what suits your eye and your life. I’d love to sit down with you and work out the right lens.

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Video Transcript

What is an intraocular lens or an IOL?
Hi, I’m Dr. Rylan Hayes, specialist cataract, refractive, and pterygium surgeon. An intraocular lens is a crucial part of lens and cataract surgery. After we remove your natural lens, the eye’s focusing power is reset, and we have to choose where you want your vision. And the way we do that is with an intraocular lens. Everyone gets one of these. This is one that’s been blown up probably 20 times bigger than real, and that’s implanted in your eye, and then we choose which power we put in to help with your focus. Here is a real one. That’s how big it is.

What is the Best Intraocular Lens (IOL)?

The question of which intraocular lens is “best” is one of the most common — and most nuanced — questions in modern ophthalmology. The honest answer is that no single lens is best for everyone. The right IOL is the one matched to your eye, your visual demands, and your lifestyle.

Why your current prescription doesn’t determine which lens you need

When cataract surgery or refractive lens exchange (RLE) is performed, your natural crystalline lens is removed and replaced with an artificial intraocular lens. This process effectively resets your prescription. Whether you currently see well at distance, up close, or neither — that relationship with your natural lens is reset, and your new visual starting point is determined by the IOL chosen.

This makes IOL selection one of the most important decisions in the entire surgical process.

The three main categories of IOL

1. Monofocal (Precision) IOLs

Monofocal lenses focus at a single distance — wherever is most important to the individual. They produce the most pristine, high-contrast image quality of any IOL category. The trade-off is that glasses are likely to be needed for near and intermediate tasks after surgery. Some patients are very happy with this arrangement, particularly if they’ve worn glasses comfortably for years.

Examples: Johnson & Johnson Vision Tecnis DCB00, Rayner RayOne, Alcon Clareon, Zeiss Asphina, Bausch + Lomb enVista.

2. Extended Depth of Focus (EDOF) IOLs

EDOF lenses extend the visual range beyond a single focal point. They offer significantly more range than a monofocal — particularly for intermediate distances (computer screens, dashboards) — while maintaining better contrast sensitivity and fewer halos than a multifocal (but more than a monofocal). Glasses may still be needed for fine print.

Examples: Rayner EMV, Alcon Vivity, Johnson & Johnson Vision PureSee.

3. Multifocal IOLs

Multifocal lenses divide incoming light between multiple focal zones — typically distance, intermediate, and near — giving the widest range of spectacle-independent vision. For many patients they deliver excellent freedom from glasses for most daily activities. The trade-offs to be aware of: some patients notice halos or starbursts around bright light sources (particularly at night), and contrast sensitivity may be slightly reduced in low light conditions. These trade-offs to minimise glasses are well tolerated by most patients understanding and accepting of their decision, but you need to consider if you will accept this personally.

Examples: Bausch + Lomb enVy, Johnson & Johnson Vision Odyssey, Alcon PanOptix Pro, Rayner Galaxy.

No commercial bias — ever

Dr Hayes works professionally with a number of lens manufacturers but holds no commercial disclosure or financial relationship with any particular company. This means every lens recommendation is made purely on the basis of what is best for your eye and your lifestyle.

Key Takeaways

• No single IOL is best for everyone — the right lens depends on your eye anatomy, lifestyle, and visual goals
• Lens surgery resets your prescription regardless of your current vision
• The three main IOL categories are monofocal (single distance, highest image quality), EDOF (broader range, excellent quality), and multifocal (widest range, some trade-offs)
• Dr Hayes holds no commercial lens bias — recommendations are based purely on your individual needs

Want to find out which lens is right for your lifestyle?

Book a consultation with Dr Rylan Hayes at The Vision Surgeon, Maroochydore.

References

• American Academy of Ophthalmology. Intraocular Lenses — Preferred Practice Pattern. aao.org
• de Silva SR, et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016.
• Mencucci R, et al. Extended depth-of-focus IOLs: a review. J Cataract Refract Surg. 2021.