Cataract Surgery: What Lens Options Are Available?

Biometry for lens calculation

During biometry, the eye is precisely measured: The length of the eyeball, the curvature of the cornea, and other parameters are determined with modern devices (contactless via laser or ultrasound). This data is necessary to calculate the optimal strength of the artificial lens that will replace your natural lens.

The more accurate these preliminary examinations are, the more precisely the new lens can be selected. This is an important prerequisite for sharp vision after surgery.

Tip: Plan enough time for the ophthalmological preliminary examination. Due to pupil dilation, you will be temporarily sensitive to glare and should not drive yourself until the effect wears off. It’s best to bring an accompanying person or use public transportation for the journey home.

What lens options are available for cataract surgery?

During cataract surgery, the clouded lens is replaced with a clear artificial lens. Various lens implants are available for selection, which can be used according to the patient’s needs:

• Monofocal lenses (spherical and aspherical intraocular lenses)
• Monofocal-Plus lenses
• EDOF lenses
• Multifocal lenses
• Toric lenses

Monofocal lenses (standard): Distance or near focus

These classic lenses offer a fixed focus either for distance or near vision. Typically, the monofocal lens is optimized for distance vision. Patients can then see sharply at distance again but usually need reading glasses for near vision.

Monofocal intraocular lenses are distinguished between spherical and aspherical lenses.

Spherical lenses do not have constant refractive power toward the periphery of the lens. This means that light hitting the eye at the lens periphery is not imaged exactly on the retina but slightly in front of it. This imaging error leads to contrast loss, but the optical phenomenon can also be used to slightly increase the focus range. If you depend on good vision in poor lighting conditions (e.g., driving at dusk) or if maximum contrast vision is important to you, an aspherical intraocular lens can be implanted.

Monofocal-Plus lenses (extended visual range)

These advanced single-vision lenses enable an extended visual range. Compared to standard monofocal lenses, they provide more sharpness in the somewhat nearer range. This makes some daily activities at arm’s length possible without glasses. Monofocal-Plus lenses retain the advantage of clear imaging without significant light phenomena and are a good option for anyone who wants a bit more flexibility than with a standard lens.

EDOF lenses (extended depth of focus range)

EDOF lenses have an extended depth of focus range. They create a continuous focus from distance through the intermediate range to a limited near range. This enables, for example, sharp distance vision and computer work, often even reading large print, while a weak reading glass may still be needed for very small near text.

The advantage of EDOF lenses is that compared to multifocal lenses, they cause fewer halo effects or glare effects at night while still offering a high degree of independence from glasses.

Multifocal lenses (distance, intermediate and near range, advantages and disadvantages)

These multifocal lenses (often designed as bifocal or trifocal lenses) enable sharp vision at distance, intermediate, and near ranges. The great advantage is the prospect of living practically glasses-free. You can both drive and read without glasses.

However, multifocal lenses also have disadvantages: Due to the division of light into multiple focus areas, light halos around light sources or reduced contrast vision can occur, especially at night. Not every patient is suitable for a multifocal lens; thorough consultation is important to weigh the advantages and disadvantages.

Toric lenses (for corneal astigmatism)

All mentioned lens types are also available in toric versions for patients with corneal astigmatism. A toric lens corrects the irregular corneal curvature, so that existing astigmatism is also compensated after cataract surgery. For someone with corneal astigmatism, a toric artificial lens can significantly reduce dependence on glasses, as otherwise even after surgery, glasses would be needed for astigmatic correction.

Choosing the lens

The choice of lens depends heavily on your individual visual habits and preferences. Lifestyle, profession, and hobbies play a major role: Do you read a lot or work in an office? Or do you drive a lot or exercise very regularly? The desire for complete freedom from glasses or the willingness to possibly accept slight visual disturbances like halos also influences the decision.

We provide individual consultation to select the appropriate lens based on your visual habits and expectations.

If you enjoy wearing glasses, for example, it usually makes no sense to use a specialty lens. Often this actually reduces the resulting visual quality with glasses compared to a simpler lens design.

Important questions you should answer are:

• When does wearing glasses bother me?
• What things in my daily life do I like to do without glasses?
• Do I drive a car in difficult weather (glare, dusk, rain/snow)?
• General medical evaluation and possible preliminary examinations

Do you have further questions about cataract surgery or would you like to schedule a consultation appointment? Our team at FIRST SIGHT Eye Clinic directly at Zurich Main Station is happy to help you.

We offer you comprehensive, individual consultation – from choosing the optimal lens implant to aftercare – so that you can go into your cataract surgery well-informed and reassured.

Further Information

Everything about cataract surgery: Procedure and surgical techniques

After cataract surgery: Follow-up care and care

Cataract symptoms: Recognizing signs

Freedom from glasses after cataract surgery: Lens options and aftercare

Cataract causes: Recognizing and preventing risk factors