There are two types of IOLs, hard and soft, depending on the material used to make them. Hard IOLs have been used in clinical practice for a long time and their clinical results have been fully validated. They are inexpensive, but the surgical incision at the time of implantation is large, usually around 6 mm, requiring sutures, and the postoperative wound healing time is long, which can cause greater astigmatism of surgical origin. Soft IOLs are characterized by foldability, so the incision at implantation is small, usually at 2-3 mm, which does not require sutures, and the postoperative vision recovery is fast, causing less surgical astigmatism, but the price is relatively high. Currently, soft IOLs are mostly used clinically.
In order to meet different clinical needs, many new types of IOLs have been introduced in recent years, including aspheric lenses, blue filtered lenses, lenses for astigmatism correction, etc. These new high-end IOLs undoubtedly provide patients with more choices. However, there are still many misconceptions when choosing an IOL, such as “expensive is good” and “new must be perfect”.
Individualized selection can meet the needs of patients. Compared to the measurement of the prescription of glasses, the calculation of the prescription of IOLs is much more complicated. Before performing cataract surgery, the refraction, corneal curvature and axial length of the operated eye must be measured, and the surgeon then selects the appropriate IOL formula based on the patient’s data.
The choice of IOL is based on the patient’s financial situation, lifestyle and requirements.
For example, for those who often need to read books and newspapers, an IOL that can cause a certain degree of myopia (near-focus) is suitable; for elderly women who are mainly engaged in housework, usually cooking and stir-frying, playing mahjong and watching TV, a medium-distance IOL (medium-focus) can be placed; for those who want to go out frequently, a distant IOL (far-focus) can be placed. Multifocal IOLs can solve both near and far vision, but the price is relatively high.