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When I had my cataract surgery several years ago, after my eye exam I was sent to a tiny room where a young lady explained the lens options I would have. When I asked what lens the doctor would recommend for my specific condition-astigmatism-she said, “…that is up you…” and went on to describe 3 lens options they were offering with a strong ‘upsell” on the most expensive lens option. To the best of my knowledge, she had no medical training or certifications. She was a “SALESPERSON” and that is how she was trained. It was like talking to a car salesperson who subtly steers you to spending more money. My guess is the doctors wanted no part of this sales ‘game’ but merely selected the lens options that would be offered and let trained sales people steer patients to the more expensive options. At least in this practice, I left feeling the medical professionals had lost their way succumbing to the lure of increased profits…😥

I'll be 73 in March, never wore glasses except for readers at 2.50 strength prior to cataract surgery and at my age what am I waiting for? Cataracts rated at a low 2 on a 1 to 4 scale. Jan 3rd rt eye Jan 10 left eye. Medicare paid for cost of surgery I paid for the premium lens out of pocket. My cost was $3200 per eye plus $75 for 2 bottles of eye drops and $240 for medicare co-pay so just under $6600 is what I've spent. Lens is Clareon PanOptix UV IOL tri-focal. I'm very happy - halos don't bother me, vision is clear, no readers and distance is crisp. My cataracts gave me a warm white view, I'd say 3000 kelvin, my new lenses are more daylight, I'd say 5000K - white is hospital white. I had a crescent shape in corner of my right eye but after about 5 days I no longer noticed it. I have similar crescent in my left eye today, one day after surgery and I expect it to diminish. My exam today was 20/20 both eyes and Dr says usually best vision comes approx 3-4 months after surgery. I'm thrilled with the results. Surgery done by Dr Pugh at Eye Associates Jeffersonville Indiana. Highly recommend Dr Pugh and his surgery center is first class. I arrived at 6:30am and was out by 9am.

I have had my new lenses for 20 years now. I have monovision. My vision is 20/20 up close and 20/15 distance. I am very happy with that. My eye doctor said recently that these lenses would serve me for the rest of my lifetime. I think this new technology is great though. I was lucky enough to have a very prominent surgeon in Kansas City his name was Hunkeler but he is now retired. I took my patch off my first eye a couple hours after the surgery and I couldn't even tell I had an operation there was no redness or swelling of any kind and I could read signs a mile down the freeway. Amazing.

Had some Vivity lenses thrown into my eyeballs last year after 40 years of dealing with being effectively blind unless i had on glasses as thick as coke bottle bottoms or contact lenses. Then my presbyopia started kicking in. So had these Vivity lenses put in, and for the first time since i was 8 years old i can see again. Im impressed that it nearly knocked out the whole range of vision considering i was wearing -9.5 contact lenses, and also starting to need reading glasses. Now i dont need reading glasses at all, and the only time i need to wear glasses is at night when im driving. No halos either. From as bad as my vision was to where it is, id say these lenses fixed 95% of my vision. Was life changing.

Cataract surgery requires a simple choice, and many people utterly fail to make the right one. I had a surgeon who presumably just figured that everyone wanted "distance" lenses, but I had a lifetime with excellent "near" vision. NO WAY ON EARTH would I give that up, period. Who on EARTH needs "distance" vision, especially at the advanced age that most cataract surgery patients are getting this done? Are they "outside" all the time, hunting or doing whatever on Earth they need good distance vision for? Or are they mostly going to be "inside" most of the time -- reading, using smartphones, looking at computer screens, reading ingredient labels in the store, and so on? Most people are going to be using NEAR vision, for most of what they will be doing. GRAB THOSE GLASSES WHEN YOU DRIVE YOUR CAR, instead of reaching for them EVERY SINGLE TIME DURING THE REST OF YOUR LIFE WHEN YOU WANT TO READ SOMETHING. FOR CRYING OUT LOUD. I kept my good near vision with near vision lenses, and my distance vision improved so much that I was able to remove the "corrective lenses" requirement on my driver's license, for the first time in my life. Still, I use sunglasses while driving as needed, and I use normal glasses when driving in the dark or driving on the freeway. Otherwise, I DON'T WEAR GLASSES AT ALL. You don't need to pay for expensive lenses to get "perfect" vision -- just choose the lenses that will fit most of your needs most of the time. And you sure don't need "distance" lenses to see anything while you are "inside" a building. Sure, we're all different, but most of the people who I've tried to explain this to wouldn't budge from getting distance lenses -- and after the fact, every single one has told me that they have regretted their choice. All I can tell you is that I would rather NOT wear glasses at all. Which is how I live my life around 95% of the time, now.

Back in about 1995 my doctor made the first mention of my cataracts, which were just beginning. He said that the good news was that by the time I needed a replacement the Crystalens would be approved. Every subsequent visit I heard the update that it still wasn't available, was still too new to be sure, et cetera. He took a serious interest in the possibilities of an accommodating lens because of my profound myopia and astigmatism. Then, I went to a zero carbohydrate diet and the cataract development stopped dead in its tracks and even improved. Hard to believe that that was thirty years ago. The good news is that I still have my natural ones intact, though the cataracts resumed development after I resumed a typical American diet. Now I'm thinking I'll probably be dead before I need the replacements.

Wish these were available 3 years ago. My eye doctor (not an MD) was worthless when it came to questions about which lenses I should get. I ended up with the middle choice out of 3 choices. I ended up with decent ability to see far but they made me me extremely farsighted. I have readers in every room, purse, car, office, etc. Its really debilitating for me especially with my new forgetfulness. Whatever you do in cataract surgery.....get the best lens offered. Costs a bit more but the additional cost is offset by happiness!

I got a single vision monofocal lens for distance to avoid halos, glare, starbursts, etc.. Prior to surgery, I was told I’ll likely need to use reading glasses, and in the future, I may develop a “secondary cataract” that can easily be taken care of in a few minutes at an office visit. However, I was not told anything about “negative dysphotopsia,” which in simple terms is a shadow or dark area in your peripheral vision. There’s about a 20% chance you’ll get this side effect, which may or may not go away on its own. If you’re considering cataract surgery, ask your surgeon about negative dysphotopsia. It’s 9 months after my surgery, and it hasn’t “gone away”.

I have the Crystalens in my eyes. At the time, December 2014, it was the only lens approved in the US that could potentially enable focus, though there were no guaranties. I also had a Capsulotomy and touchup lasek surgery to bring my vision to 20/20. Prior to my cataract surgery, I used reading glasses. Once, I found my reading glasses by my desk at home and I realized that I had not used them in weeks, and I did not notice because I no longer needed them. I have been fortunate with the results I experienced with these lenses and they continue to perform very well after getting them in December 2014. One thing noticed by some is that they sometimes can see the lens move as they focus. I also notice that I see movement in a magnifying mirror when I shine a light in my eye. I do not notice the lens movement as I look at things and I am still amazed I see 20/20 and can read small print up close. An additional change is that, as a wrist watch collector, I can once again wear and see the small complications of my mechanical watches, including tiny date windows without any reading glasses. Again, your results may differ.

Hmmm... perhaps better to focus on IOL designs and surgical techniques that minimize adverse outcomes - dysphotopsia, Maddox rods, postcapsular wrinkles, risk of capsule rupture, retinal detachment, macular edema, postcapsular opacification, floaters after Yag laser capsulotomy, etc. Seems to me the more complex the IOL the greater the risk.

Last year I chose a lense to correct my astigmatism and give me mid and far range vision. THAT was my mistake. I can't read labels or perform any near work without some corrective lenses. I had the option to choose the other option where I would only need correction for driving. At the time I was imagining a retire life of leisure but that didn't happen.

I had cataract surgery this year, and got the Light Adjustable Lenses. Most of my life I wore thick, heavy glasses and was limited to 2 companies that made a contact lens that came close to correcting my vision. My astigmatism was over .9 in both eyes. While I still need glasses for reading, the world around me is clear and I no longer need correction for distance. It was expensive, but I’m beyond grateful to have this gift.

I’m curious if the cililary muscle suffers from atrophy as you get older. Or does it keep fighting the stiff lens and maintains its strength.

I just had the EDOF lens called Vivity. My vision after just 4 days from 2ft to extreme distance is great.

I'm 57 now and had my eye surgery in 2017. I couldn't handle glasses (which I'd been using for around 8 years) or contacts (about 2 years). Most places I'd researched seemed to indicate that the rings and starbursts are filtered out by your brain after about 11 months. Certainly now, I don't experience them anymore, and I'm fortunate to have excellent near, middle and distance vision.

I got Panoptix Toric lenses this year. Prefect vision near, mid, and far. I do have some haloing but don’t mind it at all. Best decision ever. No more glasses or contacts again.

I had Crystal Lens IOL in my left eye due to a scar from my a nasty eye infection that kept me from getting LASIK. I was farsighted in both eyes prior to surgery (I had LASIK on my right eye). After surgery, my dr told me that it’s really a crap shoot on the prescription and they try to get you as close to 20/20 as possible. Well he ended up overshooting and the lens made me nearsighted, but he said the upside was that I wouldn’t need reading glasses in the future. I was ticked about this because I felt he was a little cavalier about this. The surgery was in 2006 and my vision has regressed a little and I do need glasses at times. As for the eye with the IOL, that nearsightedness doesn’t really help anything. It has always messed me up when it came to sports (I’ve been a lifelong athlete) and I wished he would have under shot the script and left it farsighted because now that my LASIK eye has regressed, I get headaches due to each eye doing their own thing instead both being farsighted prior to surgery.

I got multi focal lens after being very very near sighted. My vision is now 20/20. Far and near. Very little glare at night. Can drive with no vision problems. It’s the perfect lens for me with no problems since 5 /2023.

I literally just got my cataract surgery today and i found this video. Decided to go with monofocal lenses because i didn't want to lose colour contrast and deal with halos at night. Hopefully in the future the risk are low for replacing new lenses and the technology are better.

Great, concise presentation of IOL options!

Wow, great info. Thank you!

Thank you for this news Dr. Chia, excellent video!

Very worthwhile video. Accommodation lenses.

That was awesome. Thank you

Thanks for all you awesome info..

This is phenomenal news. Also, you show a great deal of excitement . For a few moments there I thought you were going to pop from excitement.

Impressive video. Your explanations are clear and easy to understand. Thanks so much!

Great explanation of what "accomodation" is and how these new lenses function. Very clear and interesting presentation! Thanks very much for your work....

According to my Doctor, I have a few years before I need to think about cataract surgery, but it's nice to know that my vision might actually improve. It will be weird having worn corrective lenses since childhood to be able to go without any correction.

Excellent summary and overview of new lens technology, and of the basic natural functioning of the accomodation process that naturally occurs.

Thank you for the interesting update. I think improving today's available lens is a high hurdle. It's very early, yet I am thrilled with my panoptix lens installed over the last two weeks. For me, the disadvantages so far are way overstated and being 20 20 near and far is wonderful, even if not equal to my 20 year old eyes.

Thanks for this very clear, comprehensive and hype-free account of current experimental efforts! It tells me not to hope for a workable fluid-filled lens just yet. Maybe this will always be the lens of the future...

I am excited to hear about advancements in lens replacements. I hope it will be possible for many patients who have already had cataract surgery, to replace their existing lenses again.

Great video, thank you.

I don’t have cataracts but at 57, I long to have my accomodation back. I use multifocal glasses, but my work as a field engineer requires me to be able to see close up above my head (where my glasses provide distance vision.) It drives me crazy! My question for Dr Chua, is the accomodation reflex to the cillary muscle preserved after decades of presbyopia? I assumed that the muscle would atrophy and the reflex would be lost after the lens hardens. Does it take time for the reflex to recover?

Thanks Doc.

Great! I’m 51 and experiencing these issues with my eyes.

Exciting news. As someone whose getting close to 50 I’m going need science to advance faster than my already deteriorating vision! 😅

OK, that was a pretty damn fine job. Thanks.

It's exciting reading about all the new lenses on the horizon. With so many videos on KZfaq, the amount of information and personal stories help a lot in making informed choices. I had my first eye surgery this week and after three days couldn't be happier. The surgery for the other eye is scheduled in 1 1/2 weeks. I opted to get toric lenses and wholeheartedly believe that I made the correct choice, after doing my research. The $11k cost is something I debated at first ($8k for the lenses and $3k for the laser-assist), but as I only have one set of eyes, I didn't want cost to be the defining factor in my decisions. To all of you getting this surgery in the future, I wish you all the best and hope that you have equally successful surgery and results.

So, I'm a little confused because I've had a lens implanted in my eye for almost twenty years that gives superb distance and intermediate vision and really good close up. Only in very dim light do I need to reach for a pair of reading glasses. Interestingly, even though this lens was made in the USA, it has never been approved by the FDA despite having European approval for over twenty years. What lens is it? Lenstec Tetraflex. It works absolutely great! I was so fortunate to have had my cataract surgery in the UK, where I was able to have these lenses implanted with no issue instead of having to rely on much inferior multi-focal lenses. It's absolutely disgusting that Americans are deprived of this solution. Chalk up another win to US bureaucracy!

Awesome video! I had Staar Evo+ ICLs implanted for -8/-8.5 myopia 3 years ago, and I am extremely happy with them. I am 45, and presbyopia is setting in. Hoping one of these accomodating lenses works out. Has anybody considered putting a multi element optic into the eye, with focus and zoom motors? Would need a wireless charging pad, electronics to read the muscle activation and some clever way to anchor it to the eyeball, enormous challenges to be sure, but the payoff could be massive…

Very well done Doctor. May I suggest that you slow down a little bit to allow old folks like me to take this information in better. Thanks.

Those are amazing. Eye doctor said I have just the start of cataracts. He said maybe 10 yrs before I need surgery. When it happens I hope these will be available then.

My wife's eye surgeon gave her monovision without even asking or telling her... not what she was expecting at all. But it is working okay.

very well done

This was such a good video.

I had my appointment today to get laser eye surgery done, but the entire team advised against it, and suggested I go with IOL. I'm so happy to see this information, especially "recently" as this gives me hope for a glasses free life, hopefully sooner rather than later..

I love how you present this information in a very easy to follow format. I also love the new technology that’s coming out in ophthalmology. I do have a question as to how long it takes for new implant to attach to the ciliary structures in the eye, and enable the implant to work properly, for near and far distances.

Hi, great explanation, thank you. I'm 52 and 2 years ago had got implanted a fixed lens for far vision in one eye: all good except that I need 2 pair of glasses for the close distance tasks (for different distances) Now It's almost time to fix my second eye. I'm waiting hoping for tech advancement as you nicely described. I was wondering if I could change my first fixed lens to a flexible one and the ciliary muscles would still work or they might have been compromised by a standard fixed lens implant. Tank you and greetings from Milan

This is exciting. I remember hearing about the juvene lens about a year ago, along with a lot of other competitors. My near vision is already started to crap out on me, so maybe in 5-10 years, I could get lucky and long term results for this lens will look good and I can get back my near vision w/o reading glasses :D

Fascinating. One assumes that the muscles automatically stop when focus is achieved via feedback from the brain ? Or do these lenses have to be crafted to match the muscle response of the patient ?

Wow....great work........

Thats very interesting, I had basic cataract surgery about 2 years ago and am pretty happy, only need to wear glasses for night time driving. These incredible inventions in the video look clunky, thats a lot of stuff to get inside the lens cavity, but the prelim results do look promising. Another issue is the need for other surgeries like vitrectomy and other retinal surgeries and the need to do laser repair for PCO or hazing that covers the new lens.

Very good no need antipara

I'm loving monovision after about a year. The only thing I wear glasses for is using a computer, with both eyes corrected to -1.25. I wanted one eye at computer distance but the surgeon talked me out of it. It was probably a good decision since wearing glasses when using a computer is more convenient than when using a phone or reading. I do have a pair for full correction at distance, but only wear them when driving in unfamiliar places where I want to be able to read road signs at great distance. Anyone who is worried about not handling monovision should get a pair of glasses or contacts with appropriate corrections and try it out for a few weeks when first diagnosed with cataracts (before they get bad). Assuming you have almost no focusing ability left, which is true for most people at that point, it will be basically the same.

All of this is great the problem is most insurance company’s won’t pay for them, causing out of pocket costs and most insurance companies won’t pay for laser surgery, the insurance companies rule our health care which is BS.

A video on icl options for myopia would be great

I had Crystal Lenses in both eyes about 10 years ago. I can see near 20/20 in both eyes at distance, 20/20 intermediate and better than 20/20 near vision in both eyes. Maybe I am an exception, but I took the eye exercises seriously worked hard to achieve the near vision results. One thing that may have helped is having Lasik surgery back in the 90's. Doesn't matter, I am very happy with my vision.

I'm 70. At age 35 I developed a cataract without any indication as to why. At the time there was only 1 lens offered. I was covered under my Ontario healthcare in Canada (OHIP). The lens has done its job and was better than my remaining natural lens for clarity and colour. In fact, being a graphic designer and continually tasked with matching colours under different light condition, I quickly discovered that the IOL implant had no tint at all and my natural lens added a yellowy hue over everything. Now at 70 I am developing a cataract in my other eye. The surgeon told me I had two choices, the free one covered by OHIP or a $400 alterative that was "better". I thought that the free one was probably better than the one I had already after 35 years, and he agreed that it was a good lens. No pressure. I feel comfortable in his care. With "free" (nothing is actually free) healthcare I have to wait a year. My cataract isn't bad and my other eye is perfect so no problem. I was surprised to find that the "better" lens would allow me to get the operation scheduled right away with perhaps a few weeks wait. Still $400 to move to the front of the cue with a better lens seems cheap, but also sus.

thank you

Great stuff

Wow, these technologies are pretty cool

Thank you so much! This information is so helpful. hope I can afford these lenses through Medicare. I have severe dry eye and the surgeon who wants to do the surgery said dry out was not a big deal and that the toric lenses would solve everything. So I’m waiting to get dry eye better and will be seeing a different surgeon.

Thank you for the information! I had read about Juvene lens a couple of years ago, but like others, have been patiently waiting for their approval and availability. Shoot, at this point, I'd be willing to participate in the studies. Would you happen to have any contact info for them??

Lainie writes I had cataract surgery done in de 1990s due to a chronic eye infection in back of de eye which clogged de lens. The pupil of de eye stayed open, & I'm also experiencing another picture in my view or focus. I was told years ago that it was a muscle issue. I think thus far it may be something I have to live with, however i need to get surgery done in de other eye. These lenses mentioned sounds really exciting & seems be good prospective options, but what's one to do, wait for it, get what's available or do surgery all over again for a better option. Thanks though for your presentation.

Time will tell if the materials that are used for the soft lens component will last for decades or not. Nice summary of where the whole field will eventually go. Unfortunately I don't think I can wait for another three years for my implant. Going through a replacement lens implant will likely be costly and have its complications. However, I'm hopeful that others will have these future benefits.

Doctor Lee, as I understand it, the muscles that allow for natural focusing atrophy by the late 50s. So what good does it do to have accommodating IOL lenses that depend on those muscles?

I have J&J lenses in both eyes. I'm grateful that they are working as they should. Still, I do miss the better than 20/20 vision I had before the onset of cataracts. I am hoping the technology will be there in a few years that I can get them replaced. Of course, I'll have to unchain myself from Kaiser Permanente, first.

What about the risk of retinal detachment?

This is super exciting. One question, would it be possible to alter the focal length slight to improve near vision at the expense of distance vision. I build models for a hobby and would love better near vision. I had LASIK done once I hit three different prescriptions. So I have good distance vision, but I wear readers for work and hobbies all the time. I also lost a lot of contrast so I need bright light for any detail work.

I hate my results. My close vision is at least twice as bad as before the surgery. I only needed 1.5 diopter reading glasses to read. My vision was clear from about 3 feet to 100 feet. Farther than 100 feet was a bit fuzzy. Now I need 3.0 diopter reading glasses everywhere. I can’t even see to shave. I can’t prepare food without glasses. I can’t see things on the floor without glasses. Sure distance vision is good, but I spend most of my time indoors. Extremely frustrated.

I'm glad to see that there are efforts to improve IOLs. Is replacing implanted IOLs possible? I currently have fixed focus lenses which give me good distance vision, but I would consider getting them replaced someday when one of these multi-focal lenses is perfected and approved.

What about the ocumetics lenses? What are your thoughts about it?

Medical advances disclosed on uTube. The king of medical resources.

Excellent presentation Dr. I am in NJ where are you located? I have interesting visual problems. I will be an excellent test candidate.

I have a crystallens HD in my right eye. Biggest mistake I ever made. Do yourself a favor, don't rush out and get any multifocal lens. The laser surgeries performed to correct it caused several PVDs, and 16 tears and detachments on my retina. I now have a silicone strap around my eyeball trying to stop any future detachments. I wish I could join a class action suit against the manufacturer .

So, doctor Chua. I got a generic lense one 15 months ago in my "nearsighted" feft eye. Now my near vision sucks and I'm thinking about getting a Vivity lens in the other eye which needs help.. Should I go generic, get the Vivity or hold out for one of these miracle lenses? How can I get into a clinical trial? By the way your video was great.

Dr. Which of theseis available at this time? Im going have the surgery very soon and still not positive which lens to go with.

Good talk but what are the other two lenses that you tease in the title?

Visionary!

Had Lasik done in 2003 La Jolla to correct my 20/2000 vision. Went great, no halos, but now at 67 yrs old using 1.5d reading glasses typically. No cataract issues, but would be great to have a lens that would be better than typical at all distances.

Will any of these work where the post capsulary membrane has been removed?

Would you say that these new lenses are removable so they can be replaced with new lens technology later? Very interesting technology. Thanks for sharing.

I want it!

That Juvene lens looks pretty cool because supposedly, you can change the lens out if they get the prescription wrong or if anything changes.

Your expression of genuine joy and happiness about these potential improvements makes me hopeful as well

HI~ In cases of patients over 60s, in which their accommodation power goes about 1D, what happens to the patients? if the patients lose their accommodative power, will that lens acts like monofocal? thanks for your wonderful videos.

I went to France for my surgery the lenses that I got were not approved by FDA in the States. I got my pilot vision back. In 2019 f the fda.

I would like to know is there any help with changing lenses if you feel you want to change if there not the right ones

Very happy with my EDOF lenses and do not often resort to reading glasses. Just a bummer that 3 months post surgery I had a Retinal tear and subsequent eye preassure of 37 so another 2 months of the evil eye drops 😅 All good now 1 yr later 👀👍

Thank you! Question: are any of these new lenses good for astigmatism?

Is this helps for the lazy eye?

I am undergoing the tests for surgery right now in Kamloops, BC, Canada. What are the names of these new lenses, and are they available all over or are they even available in Canada.

When will these be available? I have have very poor vision all of my life.

Until recently, I had natural monovision but time did its thing and I got old. Wearing glasses to make both eyes the same just gives me a headache so will look into this kind of surgery when these lenses become available in my area.

I had multifocal lenses inserted 2 years ago and while very happy with the results (no longer need glasses to read) I would welcome improvements in the long vision and halo effect. Does having replacement lenses decrease the strength of the ciliary muscles over time due to them not having to be used once you have artificial lenses, and if so, would this mean newer accommodating lenses may not be effective for people who have had years of use from artificial lenses?

I am watching this from Canada. Hopefully we will get the opportunity to buy these in the next twenty years.

I wonder one thing. I will ask my doctors about this, but I will ask here. What will be (i know getting ahead of myself) ,the options for those of us who have already had cataract surgury? I was told that removal of a lens that has been in for years is a difficult procedure. I got my surgeries done very early due to antiVegf treatment. My cataract was exploding. (also young to have DME). But I would someday like to see at all ranges of vision. Just wondering if I should hold out hope. Can these solutions be layered?