Different intraocular lenses (IOLs) can be implanted to achieve customized results based on your visual goals.
Monofocal for distance. The standard IOL is a one focus lens. This option is typically covered by medical insurance. The most common visual goal is best distance, and this requires glasses for clear vision at intermediate and near.
Monofocal for near. The standard IOL can be calibrated for near, and this requires glasses for clear distance vision. Patients who have been naturally myopic, or nearsighted, may prefer this option because they have always seen well at near without glasses.
Astigmatism correction. Astigmatism causes details to appear more ghosted or smeared. Depending on the amount, it is common that an eye that has astigmatism before surgery will still have astigmatism after surgery. Mild amounts may not require correction. Surgical astigmatism management is considered an elective upgrade and is not covered by insurance. Out of pocket expenses can be $3,000 to $6,000 (total for both eyes). If medium or full astigmatism is not addressed surgically, glasses will likely be necessary to see the most clearly for distance, intermediate and near.
Monovision or Blended vision. One eye will be focused for distance and the other for near or intermediate vision. This allows for relatively good vision at both distance and near without much need for glasses. Depth perception at distance may be compromised, so glasses may be required for certain tasks like driving. Reading glasses when print is very small or in dim lighting may be necessary. This uses the standard IOL, and is most successful for patients who have already spent years with this approach in contact lenses.
Multifocal. This lens splits light and is designed to allow each eye to see well for distance, intermediate, and near depending on the specific lens. There is a risk of halos and glare with these lenses, especially in artificial light. Patients that are very motivated to be free of glasses often feel some glare is acceptable. This is considered an elective upgrade by insurance and is typically $7,000 to $8,000 out of pocket (total for both eyes). A leading design is the Alcon PanOptix
Extended depth of focus. This lens is designed to allow each eye to see well for distance and intermediate. These lenses bend light more than split light, so there is some risk of halos and glare with these lenses, though less than with a multifocal lens. Mild (+1.25) reading glasses will likely be required for near work and reading. This is also an elective upgrade in the $7,000 to $8,000 out of pocket range (total for both eyes). The Alcon Vivity is a leading IOL in this category.
