Blurred vision, glare from headlights, or struggling to read signs may all be signs of cataracts. The lens in the eye focuses light onto the retina, allowing us to see objects clearly at different distances. It also adjusts its shape to switch between near and far vision, a process called accommodation. As cataracts progress, the eye’s natural lens becomes cloudy, affecting everyday activities like driving, reading, and recognising faces. Fortunately, modern cataract surgery can safely restore clarity. A critical part of the surgery, however, lies in selecting the right intraocular lens (IOL) to replace the cloudy natural one.
For many patients, the aim also is not only to regain clear sight but also to remain spectacles-free. In recent years, refractive Extended Depth of Focus (EDOF) lenses have emerged as an exciting new option.
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Why Lens Choice Matters in Cataract Surgery
Cataract surgery provides clear vision by replacing the cloudy natural lens with an IOL. The type of lens selected plays a key role in how comfortably and safely you see afterwards—and in whether you remain free of spectacles.
The type of IOL you choose can greatly affect how comfortably and safely you see in your daily life.
In Singapore, the main options include:
- Monofocal Lenses. These provide clear vision at one fixed distance (usually far). Reading glasses are still required for near and intermediate vision.
- Multifocal Lenses. These lenses allow vision at multiple distances (near, intermediate, and far) by splitting light into separate focal points. However, because light is divided, there is less light available at each focal point. This can lead to reduced contrast and patients may require more light to read comfortably. The multiple rings in the lens design which enables the ability to focus at different distances, can also cause haloes and glare, particularly at night and night driving can be affected. These are usually best suited for patients whose eyes are healthy, without additional eye diseases such as glaucoma, macular degeneration, or corneal problems. In general, multifocal lenses are not recommended in eyes with previous refractive surgery as the visual quality cannot be predicted accurately.
- Refractive Extended Depth of Focus (EDOF) Lenses. EDOF design is the newest type of IOL currently available for use in cataract surgery. It creates an extended range of clear vision, particularly from far to intermediate distances, by elongating the focus rather than splitting light. This means that patients enjoy a continuous zone of clear vision, mainly from far to intermediate vision (such as for driving, computer use, and reading dashboards), without the effects of the multifocal lenses like glare and halos. This makes EDOF IOL more suitable for a wider range of patients, such as those with co-existing eye conditions or those who have had LASIK surgery previously.
Why Refractive EDOF IOL Are Safer For Drivers And Older Adults
Unlike multifocal lenses, refractive EDOF IOL are designed to provide sharper vision with reduced glare and halos in low-light conditions. This makes night driving safer and more comfortable. They also allow drivers to see objects within the car clearly without glasses, which is especially helpful for reading navigation displays or dashboards.
For older adults, refractive EDOF IOL offer another critical advantage: improved contrast sensitivity and smoother focus across distances. This reduces the risk of missing curbs, steps, or uneven ground, lowering the chance of falls and injuries compared to multifocal lenses.
EDOF IOL Can Help Patients Who Have Had LASIK Or Patients With Co-Existing Eye Conditions Remain Spectacle-Free After Cataract Surgery
In the past, patients who have had LASIK surgery and patients with co-existing eye conditions, were limited to monofocal lense after cataract surgery. EDOF lenses now offer these patients the ability to be free of glasses after cataract surgery
In patients who have has LASIK surgery, the shape of their cornea would have been altered by the surgery. This makes it harder to predict how light will focus through the eye. Since multifocal IOLs split light into different focal points, any irregularities from LASIK can increase the risk of glare, halos, reduced contrast, and overall poor visual quality.
On the other hand, for cataract patients who have co-existing eye conditions, such as glaucoma, macular degeneration, corneal disease, or diabetic retinopathy, multifocal IOLs are not suitable because these co-existing conditions already reduce the patient’s quality of vision. Multifocal lenses divide light into different focal points, which lowers contrast sensitivity. When combined with an eye disease that also limits contrast or clarity, patients may experience blurrier vision, more glare and halos, and less overall benefit from the lens.
The design of EDOF lenses conversely avoids these pitfalls, making them currently the only option for such patients who wish to be able to focus well at near, intermediate and distant distances, largely without the need for glasses (reading glasses may still be needed for very fine near vision).
Summary Of Pros And Cons For Each Type Of IOL
| Pros | Cons | Who Is It Suitable For? | |
| Monofocal IOL | 1) Clear and sharp vision at the chosen focal point. 2) Reliable and predictable outcomes. 3) Minimal risk of glare or halos. 4) Often the most affordable option. | 1) Dependence on spectacles for near or intermediate activities such as reading, using smartphones, or working on a computer. | 1) Patients comfortable with wearing glasses after surgery. 2) Those with complex eye conditions where spectacle independence is not the main goal. |
| Multifocal IOL | 1) High level of spectacle independence for a wide range of activities. 2) Convenient for patients who value freedom from glasses at all distances. | 1) Higher risk of visual side effects such as glare, halos, and reduced contrast sensitivity. 2) May make night driving more challenging. 3) Not recommended for patients with LASIK history, glaucoma, macular degeneration, or corneal problems. | 1) Patients with otherwise healthy eyes. 2) Those who prioritise being glasses-free for both near and far tasks and are willing to accept some trade-offs in visual quality. |
| EDOF IOL | 1) Natural, smooth vision without abrupt changes between distances. 2) Fewer side effects like glare and halos compared to multifocals. 3) Better contrast sensitivity, especially in low-light conditions. 4) Particularly helpful for night driving, reading dashboards, or using digital devices. 5) Suitable for patients with prior LASIK or certain eye conditions that exclude multifocals. | 1) Reading glasses may still be needed for very fine near tasks such as small print or needlework. 2) Slightly higher cost compared to monofocal lenses. | 1) Patients seeking freedom from glasses for most daily activities, especially distance and intermediate tasks. 2) Those with prior LASIK or co-existing eye conditions where multifocals are not advisable. 3) Older adults who value clearer contrast and safer mobility, particularly for night driving. |
Our Preferred Doctors (Ophthalmologist) For Cataract Surgery
[SG] Featured Doctor- Dr Kevin Koo
See Clearly, Move Confidently, Live Safely With EDOF IOL
If you’re noticing cloudy vision, glare, or difficulty driving at night, it may be time for an eye check-up. Cataracts progress gradually, and the earlier they are detected, the more options you have for safe, effective treatment.
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Contact UsPreferred Doctor: Dr Lee Shu Yen (Ophthalmologist)
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