Intraocular Lens Selection in Cataract Surgery

Although cataract surgery dates back to the fifth century BC, patients remained aphakic until the pioneering work of Sir Harold Ridley. He implanted the first intraocular lens (IOL) composed of polymethyl methacrylate (PMMA) in London in 1949. PMMA was previously used in World War II airplane windshields. The iconoclastic concept of planned intraocular foreign body implantation was originally complicated by glaucoma, uveitis, corneal decompensation, massive refractive error, and frequent dislocation. Ongoing research and improvements in materials, fixation techniques, and accuracy paved the way for the great outcomes we enjoy today. With expert biometry, modern calculation formulas, and A constant optimization, one can expect 90% of patients to achieve within ±0.5 diopter (D) of the refractive aim [1]. Despite our current ability to safely and predictably restore focus after crystalline lens removal, we still strive toward ever more accurate restoration of ideal youthful vision. This chapter covers the state of the art today in both normal and pathological eyes as well as some forward-looking goals within our grasp.