Below you will find a summary and an informational video for the four major types of intraocular lens options for patients at River City Eye Associates.

1. Light-Adjustable Lens
Video: Cataract Surgery: Light-Adjustable Lens
The Light-Adjustable Lens (LAL) by RxSight is the most advanced lens option available at River City Eye Associates and the only intraocular lens whose power can be customized after cataract surgery. Unlike all other IOLs — whose prescription is permanently fixed at the time of implantation — the LAL contains photosensitive molecules that respond to UV light delivered by a device called the Light Delivery Device (LDD). In the weeks following surgery, Dr. Hager uses this device to perform a series of brief, painless in-office light treatments that adjust the lens power — including spherical correction and astigmatism — based on how the eye has actually healed. Once the target vision is achieved and confirmed, a final lock-in treatment permanently stabilizes the lens. The LAL is particularly well-suited for patients with significant astigmatism, patients who have had prior LASIK or corneal surgery, and anyone who wants the highest available precision in their cataract surgery outcome. Patients must wear UV-protective glasses at all times between surgery and lock-in to protect the lens from unintended light exposure. For more detailed information about this unique lens option, please visit our LAL page.

2. Multifocal Lens
Video:
Cataract Surgery: Multifocal Lens
Multifocal intraocular lenses are premium IOLs designed to provide functional vision at more than one distance — typically both distance and near — reducing or eliminating the need for glasses after cataract surgery. This is achieved by incorporating multiple focusing zones into the lens, allowing the eye to see at various distances without changing the lens power. Multifocal lenses are an appealing option for patients who are highly motivated to achieve spectacle independence for most daily activities. However, they are not appropriate for every patient. Some individuals experience increased glare, halos, or reduced contrast sensitivity with multifocal lenses — particularly with nighttime driving — and this trade-off must be discussed carefully during the consultation. Multifocal lenses are also less predictable in eyes with pre-existing corneal irregularities, macular disease, or significant astigmatism. Dr. Hager will review your candidacy honestly to ensure the lens choice aligns with realistic expectations.

3. Toric Lens
Video:
Cataract Surgery: Toric Lens
Astigmatism is caused by an irregular curvature of the cornea — shaped more like a football than a basketball — which causes light to focus at multiple points rather than a single sharp point on the retina, resulting in blurred or distorted vision at all distances. Standard monofocal lenses do not correct astigmatism; patients with significant astigmatism who receive a standard lens will typically still require glasses for distance vision after surgery. A toric intraocular lens is a specially designed IOL that incorporates astigmatism correction directly into the lens implant, reducing or eliminating distance glasses dependence for patients with astigmatism. Toric lenses must be aligned to a precise axis in the eye during surgery to be effective. For patients with significant corneal astigmatism who want the best possible uncorrected distance vision, the toric lens or the Light-Adjustable Lens (which can refine astigmatism correction post-operatively) are the most appropriate options.

4. Monofocal Lens
Video: Cataract Surgery: Monofocal Lens
The monofocal lens is the standard intraocular lens covered by Medicare and most medical insurance plans. As its name suggests, a monofocal lens has a single focal point — meaning it is optimized for one distance. Most patients choose to have their monofocal lens targeted for distance vision, which means glasses will still be needed for intermediate and near tasks such as computer use, reading, and phone use. Even for distance, many patients find that glasses improve sharpness and clarity for demanding tasks like nighttime driving, though functional unaided distance vision is often achievable in good lighting conditions. Alternatively, the lens can be targeted for near vision, which requires glasses for distance. It is important to understand that no lens implant eliminates the need for glasses entirely — the monofocal lens is a reliable, well-proven option that significantly improves vision impaired by cataracts, but most patients will wear glasses for at least some activities after surgery. For patients who are comfortable with that expectation, the monofocal lens is a time-tested and effective choice.