Should You Pick Standard or Premium Lenses When Having Cataract Surgery?

A cataract is a clouding of the eye’s natural lens. The lens is a structure tucked deep inside the eye that helps us focus our vision on objects near and far. Natural lenses start out clear when we’re young, but they can cloud over as we age. 

Cataract removal involves removing the eye’s clouded natural lens and replacing it with a clear artificial lens called an intraocular lens (IOL). Below, we review some of the options you may have when selecting an IOL.

How does cataract surgery work, and why do you need intraocular lenses afterwards?

During cataract surgery, your natural clouded lens is removed. The lens is then replaced with a clear artificial lens — an intraocular lens — in order for the eye to see its best.

Once an IOL is placed in your eye, it can’t be changed without additional surgery.

What types of intraocular lenses (IOLs) are available?

As you prepare for cataract surgery, you’ll discuss IOL options with your eye surgeon. Several different types of IOLs are available.

What is a standard IOL?

Standard IOLs are included in the cost of cataract surgery with most medical insurance plans. They are high quality and come in different strengths. Your surgeon will work with you to determine what strength you need.

These lenses are monofocal (also called single-focus) IOLs. They give the sharpest focus at one particular distance — usually a far distance that is helpful for driving. When you want to see up close for reading, or at a middle range for using a computer, you’ll need to wear glasses. 

People with astigmatism are likely to need glasses all the time after cataract surgery if they choose standard IOLs.

What is a premium IOL?

Premium IOLs are designed to offer some freedom from glasses after cataract surgery. They use advanced technology to correct for eye irregularities and help you focus better up close. 

There are several different types of premium IOLs: 

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Toric IOLs

Toric IOLs are single-focus lenses designed for people who have astigmatism.

Accommodating IOLs

Accommodating IOLs use your eyes’ own muscles to adjust their focusing power and allow you to see clearly at closer distances. 

While these lenses often work well at first, they can sometimes become less effective over time and have been linked to other problems — like tilting or clouding — that could require additional procedures. 

Multifocal IOLs

Multifocal IOLs contain more than one focusing power within each lens (similar to bifocal glasses but without any line or distortion). 

They are designed to help you focus on the far distance, at middle range (for using a computer screen), and up close (for reading) without needing any glasses.

Multifocal IOLs work well in daylight. In the dark, they can make you see halos around lights. This can cause glare and interfere with night vision. 

Extended depth of focus IOLs

Extended depth of focus (EDOF) IOLs are similar to multifocal IOL but with less focusing power — and fewer side effects. 

Glare and halos aren’t as big of a problem with EDOF lenses, but their focusing power isn’t as strong, either. In addition to giving you good distance vision, they can help you focus at a middle distance (to see a computer screen), but you’ll still need glasses for reading. 

Choosing between standard and premium IOLs for cataract surgery

You’ll want to work closely with your eye surgeon to select your IOLs. There are many factors to consider.

Why choose a standard IOL?

Standard IOLs are less expensive, reliable, and don’t come with many side effects — but most people will still need to wear glasses to see clearly at closer distances.

People choose standard IOLs when they:

• Want the least-expensive option

• Prefer to avoid side effects like glare and halos around lights

• Don’t mind wearing glasses

• Have other eye conditions, like dry eye, glaucomaglaucoma, or macular degeneration, that could interfere with the precise technology used in premium IOLs

Why choose a premium IOL?

Premium IOLs offer the possibility of freedom from glasses, but they are more expensive and come with a higher risk of side effects. 

People choose premium IOLs when they:

• Don’t have other eye problems 

• Don’t mind the extra out-of-pocket cost

• Strongly dislike wearing glasses

Monovision is another option to consider

Keep in mind, premium lenses aren’t the only way to get both near and far focusing power with IOLs. If you need cataract surgery in both eyes and choose standard lenses, it is sometimes possible to correct one eye to see better at a distance and the other eye to see better up close. This inexpensive solution is called monovision. 

While monovision can work well for some people, others find it difficult to get used to. If you’re considering monovision, you’ll want to try it out with contacts or glasses first. 

What about blue-light-blocking IOLs?

Some IOLs — both standard and premium — are designed to block blue light as it enters your eye. The idea behind these lenses is that they can protect the back of your eye (your retina and macula) from the effects of blue light. Although this sounds like a good idea, when they were studied carefully the blue-light-blocking IOLs didn’t make much difference for eye health.

Because blue-light-blocking lenses are slightly yellow-tinted to start out with, they might be worth avoiding if precise color vision is important to you (for example, if you’re an artist). 

Recovery after cataract surgery

Since standard and premium IOLs are implanted in the same way, the recovery from cataract surgery is the same no matter what type of IOL you have chosen.

How do you know if your IOL is working correctly?

Once your eye has healed from cataract surgery, you’ll begin to use your new lens. You’ll figure out how much glasses can help you focus on objects near and far. No matter what type of lens you’ve selected, it could take some time for you to adjust to the change.

It’s important to remember that even with the most advanced, premium IOLs, many people still need to use glasses to see their sharpest — especially at very close distances.

Why trust our experts?

Written by:

Heidi I. Becker, MD

Heidi has almost two decades of experience practicing ophthalmology in academic, private, government, and HMO settings. She earned her undergraduate degree in history from Reed College and her medical degree from the Geisel School of Medicine (formerly Dartmouth Medical School).

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

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