In the past decade, several new IOL technologies have become available: extended depth of focus (EDOF), multifocal (MFIOL), and light adjustable lenses (LAL). EDOF IOLs offer a range of vision from distance to intermediate. MFIOLs, which are now available as trifocals, offer 3 steps of vision (distance, intermediate and near). The LAL is a monofocal lens that allows for post-operative adjustments based on refraction using a UV light to “lock in” the final desired power.

EDOF

AcrySof IQ Vivity (Alcon Inc., USA) FDA-approved

This non-diffractive lens that has proprietary wavefront shaping technology through elevation and curvature change that channels almost all the incoming light through the IOL. Outside the 2.2mm central optic, light is focused for the distance. Inside the 2.2mm central zone, the IOL provides continuous focus up to -1.5 to -2.0D. These changes help focus the central light for near vision as well as maintaining good image quality by not splitting the light as in diffractive IOLs which may reduce the risk for dysphotopsias and higher order aberrations. It offers similar visual outcomes to a monofocal but with an increased range for intermediate vision.

Symfony Plus Optiblue (Johnson & Johnson Inc., USA)

This uses InteliLight technology which can reduce the risk of haloes and has improved contrast sensitivity. This technology filters violet light to decrease chromatic aberration without compromising near vision in dim light.

IC-8 (AcuFocus Inc., USA) FDA-approved

This small aperture lens allows central light rays to travel through the central aperture and blocks unfocused peripheral light rays via a nondiffractive opaque mask, increasing the depth of focus up to 3.0D and reducing higher order aberrations. 

MFIOL

Panoptix (Alcon Inc., USA) First FDA-approved trifocal MFIOL under Alcon Inc., USA

This has a diffractive surface on the central 4.5 mm optic, which splits incoming light to add intermediate (+2.17D) and near power (+3.25D). This central diffractive 4.5mm optic allows high light utilization, offering optimized performance in various lighting conditions due to low dependence on pupil size. The anterior surface has negative spherical aberration to compensate for the positive spherical aberration of the average cornea.

EDOF + MFIOL

Synergy (Johnson & Johnson Inc., USA)

Incorporating EDOF and MFIOL technology, Synergy combines diffractive features of EDOF and MFIOL to provide good distance vision while providing a continuous range of vision from intermediate to near. The EDOF technology reduces the risk of haloes and dysphotopsia commonly seen by MFIOLs while providing the range of vision MFIOLs can offer. Synergy also offers the InteliLight technology described above.

Monofocal

LAL (RxSight, USA)

This monofocal silicone 3-piece lens can be adjusted postoperatively from -2D to +2D sphere and -0.5D to -3D cylinder. Two to four UV-protection light treatments may be necessary to fine tune to the lens prior to “locking in” the final refraction. The patient must wear sunglasses at all times postoperatively until the lens has been locked in. This technology can be particularly useful in patients with high risk for refractive surprises, such as those with a history of post refractive surgery.