The Myth of Premium IOLs: What You Should Know Before Upgrading Your Cataract Surgery
Cataract surgery is one of the most commonly performed and successful surgeries worldwide, with millions of patients regaining clearer vision every year. When you're scheduled for cataract surgery, one of the most critical decisions you'll face is choosing the type of intraocular lens (IOL) to replace your cloudy, natural lens. While government-insured, standard monofocal IOLs are included with your surgery, you may also hear about premium IOLs that promise better vision and more convenience. But are premium IOLs worth the upgrade, or is their reputation overhyped?
Let's explore the truth about premium IOLs, their benefits, and some of the myths surrounding them. By the end, you'll have a clear understanding of whether this upgrade is right for you.
What Are Premium IOLs?
Premium IOLs are specialized lenses designed to correct vision beyond the capabilities of standard monofocal IOLs. The most common types include:
Multifocal IOLs: These lenses correct vision at multiple distances, reducing the need for glasses for activities like reading, driving, or working on a computer.
Toric IOLs: These lenses correct astigmatism, a refractive error caused by an irregularly shaped cornea.
Extended Depth-of-Focus (EDOF) IOLs: These lenses provide a continuous range of vision from near to far, minimizing the "halo" and glare effects sometimes associated with multifocal lenses.
On paper, these options sound like the ideal solution for life after cataract surgery. Who wouldn't want to reduce their dependency on glasses? But the reality is more nuanced, and the pressure to upgrade can feel overwhelming for some patients.
The Pressure to Upgrade: Navigating the Sales Pitch
Many people feel caught off guard when presented with the option to upgrade to a premium IOL. It's not uncommon for patients to report feeling as though they're being upsold during a critical medical decision. At Helio Optometry, we believe that your decision should be informed by facts, not sales tactics.
Here's the truth:
The Surgery is Equally Safe: Whether you choose a premium or standard IOL, the safety of your cataract surgery does not change. Modern surgical techniques are highly reliable and effective with both types of lenses.
Your Vision May Not Be Significantly Clearer: Premium IOLs may offer lifestyle advantages, such as reducing your reliance on glasses, but they do not guarantee sharper vision compared to standard IOLs. For many patients, the standard monofocal IOL—which corrects vision at a single distance—can provide excellent clarity with glasses for near or far tasks.
Not Everyone is an Ideal Candidate: Conditions like macular degeneration, severe astigmatism, or dry eye disease may limit the effectiveness of premium IOLs. There's also no go back. If you're unhappy with your option, replacing the lens is not a simple process. The most common complaints we hear are from patients who choose multifocal IOLs because they often experience nighttime glare while driving.
The Benefits of Premium IOLs: Are They Worth It?
For some people, premium IOLs can deliver real value. If you're someone who prioritizes convenience and dislikes wearing glasses, a premium IOL might be a good fit. Suppose you're a person who has always worn contact lenses or previously paid for laser eye surgery such as LASIK, PRK or SMILE. In that case, consider these IOL options.
Who Benefits Most from Premium IOLs?
Patients with moderate to severe astigmatism may benefit significantly from toric IOLs, which are specifically designed to correct this condition during cataract surgery. Currently, toric IOLs are the most common IOL lens upgrade we see. I
People who frequently switch between near, intermediate, and distant tasks (e.g., reading, working on a computer, and driving) may benefit from the new extended-depth-of-focus IOLs or multifocal IOLs.
People looking to reduce their dependency on glasses or who often forget to wear their glasses. I.e., people who have always just worn 'cheater readers' from Costco. Sometimes, looking at multifocal or extended depth of focus, IOLs may be a good option.
Challenges with Astigmatism-Correcting IOLs
While toric IOLs are designed to correct astigmatism, they are not without their challenges. One of the key drawbacks is that these lenses must be perfectly aligned within the eye to achieve the desired correction. Even slight rotation of the lens after surgery can diminish the effectiveness, leading to residual astigmatism. Additionally, these lenses do not correct your near vision. Some people may still experience difficulty with fine details or contrast sensitivity, particularly in low-light conditions, necessitating glasses for tasks like reading or driving at night.
Challenges with Multifocal and Extended Depth of Focus IOLs
While the multifocal and extended depth of focus IOLs promise freedom from glasses, they come with unique challenges that are often overlooked. One primary concern is that these lenses can make it more difficult for your optometrist to refine your eyeglass prescription after surgery. Unlike standard monofocal IOLs or toric IOLs, which provide a predictable baseline for corrective lenses, multifocal and EDOF lenses can complicate the process of fine-tuning your vision.
This means that, even with glasses, it may not be possible to make your vision significantly sharper. Additionally, these lenses can somewhat reduce your fine contrast sensitivity—the ability to distinguish subtle differences in shades and textures. This can affect activities like night driving or reading in low-light conditions, where contrast is critical. While these trade-offs may be acceptable for some patients, weighing them against your vision goals and lifestyle needs is important before committing to a premium IOL.
The Myth of "Better" Cataract Surgery with Premium IOLs
One of the most pervasive myths about premium IOLs is that they make cataract surgery itself more effective or safer. This isn't true. The quality of your cataract surgery depends primarily on the surgeon's skill and the technology they use, not the lens you choose.
Standard IOLs Are High Quality: The government-insured monofocal IOLs used in cataract surgery are rigorously tested and provide excellent outcomes for most patients.
Premium IOLs Are About Convenience, Not Necessity: Upgrading to a premium lens is a lifestyle choice, not a medical necessity. If you're comfortable wearing glasses or contact lenses post-surgery, there's often no compelling reason to spend extra money on a premium option.
Making the Right Choice for You
At Helio Optometry, we always recommend starting with a conversation about your vision goals, lifestyle, and expectations. Here are a few key considerations to help you make an informed decision:
Understand Your Vision Needs: If you only need clear vision at a single distance and are comfortable using glasses for reading or other tasks, a standard monofocal IOL might be the perfect fit. If you prefer freedom from glasses, explore the premium options. But please understand there is no guarantee that you won't require eyeglasses.
Evaluate Your Budget: Premium IOLs are not covered by government insurance and often involve significant out-of-pocket costs. Ask yourself if the potential convenience outweighs the financial investment. At the time of writing this blog post, in 2025, the average price for premium IOLs in Edmonton is about $1,500-$3,000 per eye.
Consider Your Eye Health: If you have pre-existing conditions, such as diabetic retinopathy or macular degeneration, premium lenses may not deliver the benefits you're hoping for. Speak to your optometrist or ophthalmologist about your suitability for premium IOLs.
Be Wary of Marketing Hype: Remember, premium doesn't always mean better. Your surgeon and optometrist should provide honest, unbiased recommendations based on your needs.
Final Thoughts: Empowering Your Cataract Surgery Journey
Choosing the right IOL is a deeply personal decision, and there is no one-size-fits-all solution. While premium IOLs can offer lifestyle conveniences, the benefits are often overstated. At Helio Optometry, we prioritize transparency and patient education, ensuring you feel confident in your choice. We would love to discuss your IOL options with you during your eye exam to ensure that you better understand your options. You can also check out our Guide to Cataract Surgery in Edmonton for more information.
If you're preparing for cataract surgery and want to discuss your options, we're here to help. Book a consultation today through our online booking portal, or visit our Cataract FAQ page for more insights.
Clear vision begins with informed decisions. Let's find the best solution for you.
Disclaimer: The content provided in this blog post by Helio Optometry eye care clinic in West Edmonton is intended solely for informational purposes and does not replace professional medical advice, diagnosis, or treatment by a Licensed Optometrist. No doctor/patient relationship is established through the use of this blog. The information and resources presented are not meant to endorse or recommend any particular medical treatment or guarantee and outcome. Readers must consult with their own healthcare provider regarding their health concerns. Helio Optometry and its optometrists do not assume any liability for the information contained herein nor for any errors or omissions. Use of the blog's content is at the user's own risk, and users are encouraged to make informed decisions about their health care based on consultations with qualified professionals.
