New IOL options may reduce dependence on glasses for patients with complex corneas

Presbyopia-correcting intraocular lenses (IOLs) can offer good visual outcomes and potential spectacle independence in patients with previous corneal surgery or co-existing corneal conditions, but success depends on careful patient selection, thorough corneal assessment, and realistic management of expectations, according to a review.

Recent reviews indicate that presbyopia-correcting IOLs can be safe and effective in eyes with previous corneal refractive surgery, providing good uncorrected vision. Advances in biometry formulas have improved the accuracy of IOL calculations in these eyes, although data specifically on presbyopia-correcting lenses remain limited. For patients with irregular or aberrated corneas, pinhole IOLs may offer a viable alternative. Evidence is still emerging for use in conditions such as dry eye disease, keratoconus, and corneal grafts.

Experts emphasize that achieving optimal outcomes requires careful patient selection, thorough corneal evaluation, and clear communication about expected results.

Reference
McNeely RN, Moore JE, Mehta JS, et al. Presbyopia-correcting intraocular lenses in eyes with corneal conditions: an update. Curr Opin Ophthalmol. 2025;doi: 10.1097/ICU.0000000000001175. Epub ahead of print. PMID: 40920465.