Brief Summary
This video provides a comprehensive guide to selecting the best lens for cataract surgery in 2025. It covers the different visual zones (distance, intermediate, and near), categories of lenses (monofocal, toric, extended range, and unique lenses), and specific lens options available, including new FDA-approved lenses. The video also discusses the differences between basic and premium cataract surgery, astigmatism correction, and the trade-offs between range and quality of vision with different lens types.
- Understanding visual zones is crucial for lens selection.
- Premium lenses offer more independence from glasses but may have additional costs and side effects.
- New lens technologies continue to improve vision outcomes and reduce side effects.
The video introduces the topic of selecting the best lens for cataract surgery in 2025, emphasizing its importance for long-term vision. It promises to cover visual zones, lens categories, and specific lens options, including newly FDA-approved ones. The aim is to inform viewers about making the right lens choice for their desired vision outcomes.
Cataract surgery involves removing the clouded natural lens and replacing it with a clear artificial lens. In 2025, various lenses are available, each offering different vision enhancements, such as focusing at various distances or providing a range of vision. The chosen lens remains stable for life, making the initial selection crucial for achieving desired vision goals.
The three visual zones to consider are distance, intermediate, and near vision. Distance vision is for objects farther than arm's length, like watching TV or driving. Intermediate vision is at arm's length, used for computer screens or car dashboards. Near vision is for close-up tasks like reading or using a phone. Understanding these zones is important when choosing a lens.
Basic cataract surgery is manual, uses a monofocal lens, and is covered by insurance, aiming to improve vision with glasses or contacts. Premium surgery may be manual or laser-assisted, corrects astigmatism, and uses advanced lenses like toric, multifocal, or EDOF lenses, with the goal of reducing reliance on glasses or contacts. Premium surgery involves additional out-of-pocket costs.
Astigmatism is a condition where the eye's shape causes blur at all distances, correctable with glasses, contacts, or during cataract surgery. Correcting astigmatism during cataract surgery is highly recommended for improved vision without glasses. Small amounts can be corrected with a laser, while medium to high amounts require a toric lens.
The different lens types are categorized into single range monofocal lenses, single range toric monofocal lenses, extended range lenses, and other unique lenses. This categorization helps simplify the understanding of available options and their specific benefits.
Monofocal lenses provide good vision at one range (distance, intermediate, or near), with most patients choosing distance. Uncorrected astigmatism requires glasses for all zones, while corrected astigmatism provides good vision in the chosen range. These lenses are covered by insurance and prioritize quality distance vision, but offer minimal range, necessitating glasses for other distances. Common brands include Alcon Clareon and Johnson & Johnson Tecnis.
A digital lens guide is available for free download in the video description, offering a reference for understanding and reviewing the different lens options discussed in the video.
Toric monofocal lenses correct astigmatism, allowing for good vision at a chosen range (usually distance) without glasses. These lenses are suitable for medium to high astigmatism and provide great quality distance vision with minimal nighttime side effects, but offer very limited range. Major manufacturers like Alcon and Johnson & Johnson offer toric lens options.
Extended range lenses offer a good range of vision, including far and some near vision, reducing the need for glasses. Unlike monovision (where one eye is set for distance and the other for near), extended range lenses provide a range of vision in each eye individually. The two main subtypes are multifocal and extended depth of focus (EDOF) lenses.
Multifocal lenses provide the most comprehensive range of vision, including good far, intermediate, and near vision, often eliminating the need for glasses. These lenses have rings that split light to achieve this range, but may reduce vision quality and cause nighttime halos or glare. New additions like the Johnson & Johnson Odyssey lens and the Bausch + Lomb Envy IOL aim to minimize these trade-offs.
EDOF (Extended Depth of Focus) lenses offer a range of vision with good far and intermediate vision, and some near vision, though reading glasses may still be needed for small print. EDOF lenses provide slightly less range than multifocal lenses but with fewer side effects and better vision quality. FDA-approved options include the Vivity and Synergy lenses.
The IC-8 Apthera lens features a pinhole design that enhances vision and provides a range of focus similar to EDOF lenses. It is particularly useful for patients with irregular corneal shapes, such as those with previous RK or keratoconus, as the pinhole effect can offset some of the vision distortions caused by these conditions.
The Light Adjustable Lens is unique because it can be adjusted after surgery to fine-tune vision. This is especially beneficial for patients who have had previous refractive surgery (like LASIK, PRK, or RK), which can make traditional lens calculations less accurate. The adjustability allows for precise correction of any residual prescription, optimizing vision outcomes.
The video concludes by summarizing the different lens options and encouraging viewers to download the free lens guide for reference. It also directs them to a playlist of frequently asked questions about cataract surgery and encourages them to subscribe to the Cataract Companion channel for more information.
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Transcript
Full transcript of “Cataract Surgery Lenses Options - MD Explains BEST Lens Choice in 2026”. Click a timestamp to open the video at that moment. Need another video? Use the YouTube transcript generator.
0:00 what is the best lens to pick during cataract surgery the lens that you choose for cataract surgery is really going to set your vision up for the rest of your life today's video we're going to go through the best lenses in 2025 to get you the best results during cataract surgery we'll talk about the different zones of vision you can aim for during cataract surgery the different categories or types of lenses to choose from and we're even going to get down to the specific lenses that are available including a couple new lenses that are really exciting that were just FDA approved going into 2025 so if you our loved one is getting ready for cataract surgery in 2025 this is the video to watch this is going to let you know what lens you should choose to get the results you want for your vision before we jump into it my name is Brad CG I'm a board certified cataract surgeon this is
0:45 the Cataract companion YouTube channel it's a channel I made to help answer questions about cataract surgery to make patients more confident so they can get their best result with that let's jump into it so real quick cataract surgery is a procedure where we remove the clouded natural lens from your eye that's what a cataract is and we replace it with a clear artificial lens now in 2025 there's a lot of different lenses available to choose from and those different lenses can do different things for your vision like get you in focus for far for up close or give you a range Vision the lens that you choose during cataract surgery typically will be very stable for the rest of your life it's really important to pick the right lens for your vision goals the first time around because it's a one-time opportunity to set your vision up for the rest of your life now before we talk
1:30 about the different lens types it's important to understand what I consider the three different visual zones that you can aim for during cataract surgery so the first is your distance Vision And when I say distance Vision it means anything that's further than about arms length away so this is the vision that you're going to use when you're watching TV when you're driving the car when you're doing activities outside are generally your distance vision is what you're using when you're getting around the neighborhood or getting around the house the next zone of vision is your intermediate Vision now intermediate vision is actually right about at that arms length intermediate vision is the vision you're using when you're working on the computer screen or looking at the dashboard in a car the third zone of vision is your near Vision now this one makes sense that's your vision up close
2:16 pretty much everything arms lengthen in this is what you use when you're reading when you're looking at your phone or looking at a menu in a restaurant so keep those visual zones in mind they're going to come up over and over again as we start to get into the different lenses now now generally speaking there's really two types of cataract surgery you can have you can have basic cataract surgery basic cataract surgery or traditional is manual it's done by hand it uses a single range or monofocal lens and that's the only type of surgery that insurance or Medicare will cover with basic cataract surgery the main goal is to improve your vision when you're wearing your glasses or when you're wearing your contacts the goal of basic cataract surgery is not to get you out of the glasses or contact there's also Al premium cataract surgery premium
3:02 cataract surgery may be done manually or it may be done with a laser but it always involves correcting a stigmatism it also may involve the use of an advanced or premium intraocular lens this includes lenses like toric lenses multifocal lenses or extended depth of focus or eoth lenses the goal of Premium cataract surgery is to improve your vision but also to make you less reliant on glasses or contacts after surgery some portions of Premium cact surgery continue to be covered by insurance but there's always going to be some additional out-of-pocket cost to either pay for the use of the laser or to pay for the use of those premium or specialty lenses now you heard me just mention the term astigmatism and that's a big point of confusion during cataract surgery this video isn't going to be a
3:48 deep dive on a stigmatism and cataract surgery I actually already made a video that explains a stigmatism in cataract surgery so check that out if you're still confused but quickly a stigmatism relates to the shape of the eye it's a condition where your eye is a little bit steeper going one way and flatter going the other basically what you need to know is that a stigmatism causes blur at all ranges of vision a stigmatism can be corrected by glasses contacts or it can be corrected at the time of cataract surgery to give you better Vision when you're not wearing your glasses I highly recommend correcting a stigmatism during cataract surgery it's a serious no-brainer to me there's almost no downside to it and to find out more reasons why check check out that video on astigmatism and cataract surgery I'll go into it there during cataract surgery
4:34 if you have a small amount of astigmatism it can be corrected with the use of a laser making some relaxing openings on the very front of the eye if you have a medium to high amount of a stigmatism we actually have to put that astigmatism correction into the lens that's what a toic lens is it's an astigmatism correcting lens with a lot of that background out of the way now let's jump into the different lens types so to make things simpler we'll bucket our different lens types into four categories so first is our single range monofocal lenses second we have our single range toic monofocal lenses third we have our extended range lenses and fourth are some other unique lenses that don't really fit into the other categories so starting first with our single range monofocal lenses this is a lens that can get you good Vision in one
5:21 range of vision you can choose to aim for your distance intermediate or near Vision most patients choose to aim for their distance vision Vision some patients who have always been nearsighted are able to see up close may choose to keep that near vision and aim for the close Vision however the majority of patients do choose to aim for the distance Vision now if you have some astigmatism that's not corrected at the time of cataract surgery you'll still need glasses for all three zones of vision if you fully correct the astigmatism using something like the laser then it should give you good Vision in one range knowing you'll need glasses for the other two now the single range monofocal lens is the only type of lens that's covered by Insurance are Medicare every other type of lens we're going to talk about is going to have some additional out-of-pocket cost if
6:08 you choose it for cataract surgery now as you can see there's a lot of different lenses that fall into this category some of the more commonly used ones in the United States include the Alcon claron lens and the Johnson and Johnson technus lenses now with these single range monofocal lenses as expected you can see well at one range of vision whether you choose to aim for your distance Vision or for your near Vision how well you see without glasses in that range will be determined by how much astigmatism you have if you correct the astigmatism or if you have little to no astigmatism then you should see well at that one range without glasses but you'll still need glasses for the other two zones of vision now these single range lenses prioritize all of the light into that one zone of vision so really if you're aiming to get your absolute
6:53 best quality distance Vision then the single range lens is what's going to give you that best quality distance vision Vision the trade-off with this is because it's prioritizing quality over quantity of vision you'll have very little range of vision if you aim for the distance Vision with a single range monofocal lens you're absolutely going to need glasses for everything arms lengthen in for that intermediate and near Zone that's because these lenses don't provide much range of vision at all it's very minimal now when looking at visual side effects all lenses can cause some Halo or glare or sometimes some nighttime symptoms but the single range monop vocal lenses caus the least amount of those nighttime symptoms now before we go any further in the video I do want to mention that I've actually made a digital copy of this lens guide
7:39 if you go down to the video description and click the link that's there you can have that copy sent to your email it's a great form to have to reference during the video or to reference back to after you've watched the video if you want to look back at something in the future our second category of lens is our single range toic monofocal lens now very similar to that last category we talked about this is a single range lens meaning you have to choose to aim for either your far or your close Vision again most patients aim for their distance Vision as mentioned earlier in the video these toic lenses have a stigmatism correction built into the lens if you have a medium to high amount of astigmatism and you want to correct it at the time of cataract surgery a toric lens is the way to do that since you're fully correcting the astigmatism with that toic lens you can expect to
8:26 see well in that zone of vision that you aim for if you aim for your far Vision you should have good far Vision Without Glasses just needing them for up close vice versa if you aim for your close Vision you should have good near Vision but you'll need glasses when you're looking at a distance again most of the major US manufacturers make these toic lenses with the Clarion and technus being some of the most common ones that I see in practice similar to the non-toric version of the single range lens these lenses are going to have really great quality distance Vision they're going to have minimal nighttime or visual side effects but they come with the cost of not having much range to the vision really you get very minimal range at all that leads us to our next category of lenses which is our extended range lenses in contrast to our
9:12 single range lenses an extended range lens can get you a good range of vision where you're seeing far but also seeing some up close without needing glasses now there's really two main subtypes of extended range lenses and we're going to talk about both of them the first is a multifocal lens and the second subcategory is an extended depth of focus or eoth lens now before we jump into the specifics of these two categories I do want to highlight that an extended range lens is different from something called monovision so monovision is a setup where you can have one eye for far and one for up close to get some range of vision when you're using both eyes together extended range lenses are different each eye is individually getting a range of vision where both eyes are seeing far intermed
9:59 mediate and some up close so our first subcategory of extended range lenses is our multifocal lenses now multifocal lenses give you the most range of vision with a multifocal lens you can expect to have good fire vision good arms length computer vision and good up close reading Vision as well really most patients with multifocal lenses don't need glasses hardly at all including reading glasses with the exception of sometimes for very small or pill bottle print they may still need a small pair of readers as you can see there's a lot of multifocal lenses on the market now including some new additions to the market that we're really excited about in the past I've used a lot of panoptics lenses and a lot of synergy lenses with great results patients very happy with that range of vision these multifocal
10:46 lenses as you can see have rings on the lens and those Rings split the light to give that range of vision now as with anything in life there's no free lunch to get that increased quantity of vision or that increased range Vision you do give up a little bit of the quality of the vision you also will have more side effects with your vision particularly with your nighttime vision where you should expect to see some Halo or glare around lights at night most patients notice those side effects it's only a small percent of patients that are actually bothered by them as with anything your brain gets used to them and tunes them out with time now all of the advances with these multi focal lenses are situations where they're trying to minimize some of those trade-offs where you're keeping that great range of VIs without having as many side effects or
11:31 without having reduction in the quality of your vision on that note there's a couple new additions to the market that look really exciting The Odyssey lens has just been approved by Johnson and Johnson and is starting to roll out at the end of 2024 and into 20125 I personally have just started putting these lenses in eyes and have seen some really happy patients there's also the Envy iol which is made by BOS and LOM which is the newest multifocal to be FDA approved and should be rolling out in 2025 now as we discussed the benefit of these multifocal lenses is that really you can expect to have that full range of vision without needing glasses looking at the distance Vision you do give up some quality of the distance Vision to get that quantity or that range of vision your distance Vision won't be quite as good as it would be if
12:16 you did a single range lens however considering you have a cataract going in depending on how bad that cataract is there's a good chance your distance vision is going to be better after the surgery than it was before even if you choose one of these multifocal lenses as mentioned these multifocal lenses have the most and the best range of vision that we can currently get during cataract surgery however they do come with the trade-off of having some of those nighttime side effects like Halo and glare you should expect to have some of that in your vision if you think it's going to really bother you I would not recommend a multifocal lens now our second category of extended range lenses is our extended depth of focus our eoff lenses eof lenses give some range of Vision with an E off lens you can expect to have good far Vision good arms length
13:04 computer vision and some up close Vision although you should still expect to need reading glasses for smaller print up close e off lenses have slightly less range of vision than multifocal lenses but they come with the benefit of having less side effects and less reduction in the quality of your vision compared to a multifocal lens you get slightly less range of vision but slightly better quality of vision there's only two FDA approved eolf lenses the vividy and Synergy lens both of which have been around for a few years these are some of my most commonly implanted lenses because they give a great range of vision without having too many side effects there's some other lenses like the iance and the Aspire lens that sometimes are called eof lenses now technically these lenses were not approved as eof lenses studies show they
13:52 do give some range of vision but not quite as much as the FDA approved eoff lenses they probably belong somewhere between the sing single and extended range categories as an in between with e off lenses as mentioned you can expect good far Vision good computer arm length and some close Vision knowing you'll still need reader some of the time for up close the distance Vision quality is better than a multifocal and slightly less than a single range lens the range of vision is intermediate not quite as much as a multifocal but definitely considerably more than a monofocal lens and there's less visual side effects than with a multifocal lens probably a little bit more than with the monofocal lens but typically not too much e off lenses can be a great option if you want some range of vision without having too
14:37 many visual side effects coming with it and finally jumping into our fourth category which is really just a catchall other unique lenses these are some lenses that are very unique compared to whatever else is out there and really deserve a category of their own the first lens to mention is the ic8 AP Thea lens now this lens as you can see actually has a pinhole built into the optic on the lens so that you're looking through a pinhole with your vision if you've ever been at an eye doctor and they're testing your vision and then they flip those little holes in front of you and all of a sudden things are much more clear well that's the effect that this lens has on the vision now that pinhole can give a little bit of a range of vision probably somewhere close to what an eoff lens gets it also can be particularly useful in patients who have a regularly shaped eyes like patients
15:25 who've had RK in the past or patients who have catonis because that pinhole kind of offsets some of the negative effects of those conditions and the last lens to talk about in this category is the light adjustable lens now this lens has been out for a couple years now it's been getting a lot of Buzz nationally and for good reason the light adjustable lens is unique compared to all other lenses for cataract surgery in that it can be adjusted after the surgery if it needs to be to fine-tune the vision traditionally with cataract surgery at the pre-operative appointments we take a lot of measurements of the shape and size of your eye and from those measurements we determine what strength of lens to put in the eye if we're aiming for your distance vision during catac surgery then we're trying to get your eye to be very close to having zero
16:10 prescription our calculations nowaday are actually very accurate we can get there about 80 to 90% of the time but about 10 to 20% of the time for whatever reason people's eyes don't follow averages and they're can still be a little bit of prescription left with the light adjustable lens if that's the case the lens can then be adjusted to account for that little bit of prescription to fine-tune or fine focus the vision this lens can be an especially great option and patients where those calculations aren't quite as accurate for their eye that includes patients who've had lasic PRK RK or any type of refractive surgery in the past previous refractive surgery makes our traditional calculations we do for cataract surgery a little bit less accurate so I hope this video has been helpful giving you a breakdown of the different lenses during cataract surgery
16:57 how you can think about them in approach them if you haven't already scroll down to the video description and click that link to have a hard copy of this lens guide sent to your email for free and make sure to go over to the channel page there you'll find a playlist of frequently asked questions in this playlist there's dozens of frequently asked questions about cataract surgery there are short questions with short specific answers if you have a specific question about cataract surgery there's a good chance I may have already answered it there while you're on the channel page make sure to subscribe this is the Cataract companion Channel where my only goal is to help you get your best cataract surgery result I'll see you next time
