Ringless Premium Intraocular Lenses - a Narrative Review of Technological Advances

The standard method for achieving presbyopia correction after cataract extraction has traditionally centered on intraocular lens (IOL) optics featuring concentric diffractive patterns or combinations of diffractive and refractive elements, or "rings". While there has been a transition from simple monofocality to intricate polyfocality in IOLs, this has been accompanied by associated side effects. Halos, glare, reduced contrast sensitivity, waxy vision, low reading speed, reduced depth of focus and difficulty in night vision and driving are important photic phenomena that IOL developers have attempted to improve for decades. "Ringless IOLs" refers to lenses that provide an extended range of vision without relying on concentric diffractive rings or annular diffractive structures on the optic. We have also clarified that ringless designs may use different optical strategies, including refractive, asymmetric, transitional, or other non-annular optical profiles. Recently introduced IOLs without concentric diffractive rings include light-adjustable IOLs, polyfocal progressive IOLs, spiral architecture IOLs and non-diffractive segmented multifocal IOLs. These advanced-technology IOLs circumvent the drawbacks of concentric annuli through the use of continuous optical profiles. As far as we know, the present narrative review is the first such review that includes published articles from 2000 to 2026 to describe the current status of these IOLs and the nuances required to achieve best results after IOL implantation.