A clear guide to modern Intraocular Lenses in 2026
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As an ophthalmologist, one of the most important conversations I have with my patients before cataract or presbyopia surgery is not about the surgical technique itself, but about which intraocular lenses we are going to implant. Classifying intraocular lens (IOL) technologies is not an easy task, primarily because of the various categories that can be integrated into a classification. For years, this has been a source of confusion, even for specialists.
To clear this up, a group of experts from the European Society of Cataract and Refractive Surgeons (ESCRS) has developed a new evidence-based functional classification. This system is designed so that both doctors and patients can speak the same language when discussing visual expectations.
It’s Not Just the Design; It’s How You See
When we define an IOL, it is crucial to differentiate between three main categories to avoid confusion:
1. The structure (lens feature): This includes the material, the platform, and the physical design of the lens.
2. Optical outcomes: How light is physically focused and distributed by the lens.
3. Functional outcomes: The patient’s actual visual performance and how it affects their daily life.
Historically, we focused on whether a lens was “diffractive” or “refractive” (its optical principle), but what truly matters to you is the Range of Field (RoF) you will achieve.
| Classic naming | Updated naming | Ejemplo |
| Monofocal | Partial RoF Narrow | Hoya Vivinex XC1 |
| Monofocal Plus | Partial RoF Enhance | Johnson & Johnson Eyhance |
| EDOF | Partial RoF Extend | Alcon Vivity |
| Bifocal | Full RoF Steep Transition | Johnson & Johnson Tecnis Bifocal |
| Trifocal with higher addition | Full Rof Smooth Transition | BVI Finevision POD |
| Trifocal with lower addition | Full Rof Continous Transition | Zeiss AT ELANA |
The New Categories: Understanding Your Visual Range
The new classification divides lenses into two main groups based on the defocus curve, which measures visual acuity at different distances.
PARTIAL-Range of Field (PARTIAL-RoF)
These lenses are primarily designed for distance vision but offer varying degrees of help for intermediate distances.
• Narrow: This represents the common performance of conventional monofocal IOLs, which provide excellent distance vision but a limited range of focus.
• Enhance: These are the “enhanced monofocal” lenses. They offer a slight boost in intermediate vision compared to standard lenses, making tasks like seeing a car dashboard or walking on uneven ground safer.
• Extend: This group includes Extended Depth of Field (EDOF) lenses. They stretch the focus from distance through intermediate (like computer or mobile phone use), significantly reducing the need for glasses.
FULL-Range of Field (FULL-RoF)
These lenses aim for total spectacle independence by covering everything from distance to near vision (reading).
• Continuous: Provides a fluid transition from far to near, typical of low-addition trifocal lenses.
• Smooth transition: Offers high performance across all distances, common in high-addition trifocal lenses.
• Steep transition: Provides sharp points of focus at far and near (common in high-addition bifocals), but may have a slight “step” or less clarity in the intermediate zone.
Balancing Quantity and Quality of Vision
In optics, there is often a trade-off. While lenses with a wider range of field (FULL-RoF) provide more “quantity” of vision, they may affect “quality” due to photic phenomena. These include:
• Halos: Circles of light around lamps or headlights.
• Glare: Visual discomfort in bright light.
• Starbursts: Star-shaped flares around light sources at night.
Most patients adapt to these through a process called neuroadaptation, but it is a vital factor to discuss depending on your lifestyle—for example, if you frequently drive at night
Choosing the Right Lens
The choice is not just about “wanting to see up close.” It depends on your eye health and your personal priorities. This new classification is crucial because it allows surgeons to rely on solid scientific evidence rather than just manufacturer claims.
By standardizing terms like Monofocal, EDOF, and Full Range, we can better predict your post-operative vision. My advice as a professional is to talk openly with your surgeon about your daily activities. Do you spend hours at a screen? Do you love reading paper books? Do you worry about night driving? With these new functional categories, finding the ideal lens for your lifestyle is more precise than ever.
Sources:
Ribeiro, F. et al. Evidence-based functional classification of simultaneous vision intraocular lenses: seeking a global consensus by the ESCRS Functional Vision Working Group. J Cataract Refract Surg50, 794–798 (2024).