Intraocular Lenses in 2026:
The Complete Guide
Monofocal, EDOF, multifocal, and toric: understanding the different intraocular lenses to make the best choice with your surgeon.
What is an intraocular lens?
A permanent artificial lens
During cataract surgery, the clouded natural crystalline lens is removed and replaced by a intraocular lens — a precision optic placed permanently inside the capsular bag. Transparent, biocompatible, and less than one millimetre thick, it takes over the refractive role of the natural lens without ever becoming cloudy or requiring replacement.
A personalised choice based on your profile
The power of the intraocular lens is precisely calculated before surgery through a laser interferometry examination called biometry. The IOL type is chosen jointly between you and Dr Gozlan, taking into account your visual expectations, lifestyle, and complete ocular assessment.
Intraocular lens materials: hydrophobic acrylic as first-line choice
Nearly all modern IOLs are made of flexible foldable acrylic, injected through a micro-incision of < 2.2 mm. Two materials dominate in 2026:
Hydrophobic acrylic
The gold-standard material for IOLs: excellent biocompatibility, lower rate of posterior capsule opacification, and optimal optical clarity.
Hydrophilic acrylic
A more flexible IOL material suited to smaller incisions. Slightly higher rate of posterior capsule opacification. Used in specific anatomical situations.
The 3 intraocular lens families
Choosing the right IOL is one of the most important decisions in the pre-operative consultation. Each family addresses different visual expectations and ocular profiles.
Monofocal IOL
A monofocal IOL corrects vision at a single distance — far or near. Glasses remain necessary for the uncorrected distance. The standard option, used in the vast majority of cases.
EDOF IOL
Extended depth-of-focus intraocular lens providing continuous vision from distance to intermediate range (around 80 cm). An excellent IOL option for driving and screen use, with fewer halos than multifocal options.
Multifocal IOL
A multifocal IOL distributes light across three distinct focal points (distance, intermediate, near), offering spectacle independence in more than 85% of activities. May cause glare, night halos, and reduced contrast sensitivity.
Toric IOL
an intraocular lens that combines monofocal, EDOF, or multifocal correction with astigmatism correction. Recommended for patients with more than 1 dioptre of astigmatism who want spectacle independence.
⚠️ Multifocal and EDOF intraocular lenses are contraindicated in the presence of associated ocular pathology: corneal (cornea guttata), optic nerve (glaucoma), or retinal disease (AMD). In these situations, a monofocal intraocular lens remains the safest option. The pre-operative assessment identifies these conditions.
Related condition—retine.fr Wet AMD: anti-VEGF treatment and monitoringIntraocular lens comparison
This table summarises the visual performance of each intraocular lens type across the three distances. For pricing information, see our fees and reimbursement guide.
| Intraocular lens | Distance vision | Intermediate | Near vision | Night halos |
|---|---|---|---|---|
| Monofocal | Excellent | Glasses required | Glasses required | — |
| EDOF | Excellent | Good | Functional | Minimal |
| Multifocal | Good | Good | Good | Moderate |
How is an intraocular lens's power calculated?
Before surgery, laser interferometry biometry measures axial eye length, corneal curvature (keratometry), and anterior chamber depth. These measurements are entered into 4th-generation formulas to calculate the exact IOL power needed to achieve the target refractive outcome.
Barrett Universal II
The global reference formula for IOL power calculation. High precision across a wide range of axial lengths, particularly for short or long eyes.
Kane / PEARL-DGS
AI-based formulas combining advanced mathematical models with large biometric databases for optimal IOL power accuracy.
Secondary cataract after an intraocular lens
Posterior capsule opacification
Over time — generally 1 to 5 years after the IOL is placed — residual epithelial cells may proliferate on the posterior capsule surface, causing gradual clouding and a decline in vision similar to the original cataract. This occurs in approximately 30% of cases within 5 years.
A simple treatment: YAG laser
YAG laser capsulotomy is performed as an outpatient procedure in around 2 minutes. The IOL itself is not affected. No anaesthesia is required, and vision is restored almost immediately.
Frequently asked questions
A monofocal implant corrects vision at a single distance (distance or near): glasses are still needed for the other distance. A multifocal implant distributes light across multiple focal points, allowing 85% of patients to manage without glasses. EDOF implants provide continuous vision from distance to intermediate range with fewer night-time halos.
Modern acrylic intraocular implants are designed to last a lifetime. They do not need to be replaced. However, the capsule surrounding them may become cloudy in approximately 30% of cases within 5 years (posterior capsule opacification), which is easily treated with a YAG laser capsulotomy as an outpatient procedure.
Yes, night-time halos are possible after insertion of a diffractive multifocal implant. They are generally transient (a few weeks to a few months) as neuroadaptation occurs. EDOF implants produce fewer halos than conventional bifocal or trifocal multifocals.
Posterior capsule opacification (PCO) or secondary cataract occurs when residual cells cloud the capsule behind the implant, causing a gradual decline in vision similar to the original cataract. It affects approximately 30% of patients within 5 years. Treatment is a YAG laser capsulotomy - a quick, painless outpatient procedure.
References & medical sources
- Société Française d'Ophtalmologie (SFO). Guide pratique des implants cristalliniens : monofocaux, toriques, multifocaux et EDOF. Paris : SFO ; 2022.
- Haute Autorité de Santé (HAS). Implants cristalliniens — liste des produits et prestations remboursables (LPPR). Paris : HAS ; 2023.
- Kohnen T, et al. Intraocular lens power calculation for cataract surgery. Dtsch Arztebl Int. 2016;113(41):693–700.
- Kessel L, Andresen J, Tendal B, et al. Toric intraocular lenses in the correction of astigmatism during cataract surgery: systematic review and meta-analysis. Ophthalmology. 2016;123(2):275–286. doi:10.1016/j.ophtha.2015.10.002
- Cochener B, Lafuma A, Khoshnood B, Courouve L, Berdeaux G. Comparison of outcomes with multifocal intraocular lenses: a meta-analysis. Clin Ophthalmol. 2011;5:45–56. doi:10.2147/OPTH.S14325
- Behndig A, Montan P, Stenevi U, et al. Aiming for emmetropia after cataract surgery: Swedish National Cataract Register study. J Cataract Refract Surg. 2012;38(7):1181–1186.