Accommodative IOL: intraocular lens Implant Pros And Cons

Medically reviewed by Alastair Lockwood on 04 March 2021

There are many pros and cons of having an accommodative intraocular lens implant (IOL). An intraocular lens implant is used in surgery for the eye condition known as cataracts and is great because it can improve both near and distant vision after the surgery. This has made cataract surgery more successful in terms of visual outcomes. It is now possible to dramatically improve your vision while having cataract surgery by using a powerful artificial lens.

You can get Crystalens and Toric IOL's, both of which are manufactured by Bausch & Lomb and correct presbyopia as well as refractive errors.

Nevertheless, while these Intraocular lens implants provide a wide range of clear vision, including intermediate vision, reading glasses may still be required for near vision tasks such as seeing small print comfortably.

Other types of Intraocular lens implants include multifocal IOLs and monofocal IOLs. Both multifocal and accommodative IOLs are more beneficial than monofocal IOLs; however, they still have their limitations. An accommodating lens will provide sharper distance vision than a multifocal IOL; however, a multifocal IOL is better for seeing fine print.

What are intraocular lens implants?

Intraocular lens implants are used to replace the eye's natural lens that has become cloudy with cataract surgery. The power of the lens can be chosen to correct for refractive error as well so for example it may be used to treat myopia. These artificial lens implants are tiny and refract light rays entering the eye to help you see. Just like glasses and contact lenses, IOL's come in different focusing powers/ The focussing power is determined by the length of your eye and the curve of your cornea. These are both measured by an ophthalmologist.

Pros And Cons

There are pros and cons of having an accommodative intraocular lens implant (IOL). An intraocular lens implant is used in surgery for the eye condition known as cataracts, with the aim of improving clarity of vision. Nevertheless, while these Intraocular lens implants provide a wide clear vision, including intermediate vision, their focus is fixed, so reading glasses may still be required for near vision tasks such as seeing small print comfortably

Accommodative IOLs aim to improve both near and distant vision after the surgery.

Crystalens are IOLs manufactured by Bausch & Lomb that try to correct for presbyopia as well as refractive errors.

Other types of Intraocular lens implants include multifocal IOLs. Both multifocal and accommodative IOLs are reported to give a greater focussing range than monofocal IOLs; However, they still have their limitations, and some people find them difficult to adapt to. An accommodating lens may provide sharper distance vision than a multifocal IOL; however, a multifocal IOL may be better for seeing fine print.

How long do lens implants last?

Intraocular lens implants are permanent and should last forever. The permanent nature of an IOL means that it is very important to consider your options and be sure of your decision before you proceed with the surgery.

Can an intraocular lens implant be replaced?

An intraocular lens implant can be replaced; however, the necessity of this is rare. This can happen if the power is incorrect or if the IOL shifts out of position from the eye. Nevertheless, both these instances are uncommon. It is not a simple procedure to replace the intraocular lens as the lens is designed to be permanent.

Can an IOL be repositioned?

If the IOL has not fallen into the vitreous cavity, it can be repositioned, but this is best done shortly after surgery. In the longer term the healing process renders manipulation very difficult.

How much do intraocular lenses cost

When considering the cost of intraocular lenses, you have to take into account whether you're after premium IOLs or conventional ones in addition to the cost of the surgery, the type of treatment you need and your prescription.

The average cost of surgery for intraocular lenses in the UK is between £2,495 and £3,495 per eye.

Symptoms of dislocated intraocular lenses

Symptoms of Intraocular lens dislocation include:

• Vision loss
• Unfocused or blurry vision
• seeing the edge of the intraocular lens implant

Intraocular lens dislocation is when the implanted lens becomes displaced towards the vitreous cavity of the eye. It can also decentre from the visual axis without falling into the vitreous cavity. A dislocated intraocular lens is rare and causes changes to vision. If it falls into the vitreous cavity, this can cause traction resulting in retinal detachment, vitreous haemorrhage or both.

What holds an IOL in place?

During the majority of cataract surgeries, the IOL is placed inside a sack-like structure in the eye known as the capsular bag. The capsular bag, which previously contained the cloudy lens holds the IOL in place.

What type of intraocular lens is most popular?

There are many lenses available in cataract surgery, enabling you to improve your vision and choose a lens that is best suited to your lifestyle. A Monofocal IOL is the most popular intraocular lens used in cataract surgery. This lens is designed to give a particular distance vision that is clear and crisp but only at one distance. Therefore, if you opt for a monofocal lens, you may have to wear glasses to have clear vision at other distances. For example, reading glasses may be required for near vision. Different types of intraocular lenses include:

• Toric IOLs-a toric lens used to correct astigmatism.
• Multifocal lens-this type of lens can help to improve your vision at a range of distances.
• Accommodative IOLs- these lenses allow you to focus at different distances by moving or changing shape inside your eye.
• Aspheric IOLs-this IOL mimics the shape of the natural lens and provides clearer night vision than a spherical IOL.

You can also opt to have different lenses inserted into each eye to enable you to see at various distances. This can correct long-sightedness and short-sightedness and is known as monocular vision.

Quick links

A guide to cataracts
A guide to myopia
A guide to retinal detachment