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Premium Intraocular Lens Selection in Patients With Glaucoma: A Clinical Review
Zhihao Liu1, Yajuan Zheng1, Mingxuan Wang1
1Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
Clinical & Experimental Ophthalmology
|August 6, 2026
Summary
Choosing premium intraocular lenses (IOLs) in glaucoma patients requires careful consideration of visual function and disease stability. Enhanced monofocal and extended depth-of-focus IOLs may suit select patients, but routine multifocal IOL use is not supported.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Intraocular Lens Technology
Background:
- Glaucoma and cataracts frequently coexist, complicating intraocular lens (IOL) selection.
- Factors like glaucomatous visual field loss, ocular surface disease, and anatomical issues can limit tolerance for premium IOLs.
- Treatment side effects and refractive variability further challenge IOL choice in these patients.
Purpose of the Study:
- To critically review the evidence guiding IOL selection for patients with glaucoma.
- To identify key clinical factors influencing the decision-making process for premium IOLs in this population.
Main Methods:
- Narrative review of existing scientific literature.
- Analysis of evidence pertaining to visual function, ocular health, and anatomical considerations.
- Evaluation of IOL types (enhanced monofocal, extended depth-of-focus, toric, multifocal) in the context of glaucoma.
Main Results:
- Enhanced monofocal IOLs may benefit selected patients with ocular hypertension or early, stable glaucoma by improving intermediate vision.
- Extended depth-of-focus IOLs are potential options if central visual function remains intact.
- Routine multifocal IOL implantation is not currently supported by evidence for established glaucoma cases.
Conclusions:
- IOL selection in glaucoma patients must be individualized, considering visual field status, ocular anatomy, disease stability, and treatment history.
- Enhanced monofocal and EDOF lenses can be considered for specific patient profiles, while toric lenses require stable astigmatism.
- Comprehensive patient counseling regarding uncertainties, visual side effects, and potential refractive changes is essential.
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