Navigating Your Vision: A Guide to Trifocal Lenses in Cataract Surgery
Trifocal IOLs for Cataract
As an ophthalmologist, one of the most rewarding aspects of my job is witnessing the life-changing impact of modern cataract surgery. What was once a procedure simply to restore vision lost to a cloudy lens has evolved into a remarkable opportunity to refine and customize a person’s sight, often reducing or even eliminating their dependence on glasses.
At the forefront of this revolution are the advanced technology intraocular lenses (IOLs), specifically the trifocal IOL.
From Cloudy to Clear: The Role of the IOL
A cataract is the clouding of the eye's natural lens. During surgery, this cloudy lens is removed and replaced with a clear, artificial intraocular lens (IOL). The most basic IOL is a monofocal lens, which provides excellent vision at a single, fixed focal point—usually distance. This is a fantastic option, but it means patients will still need glasses for intermediate tasks like computer work and near tasks like reading.
For many of my patients who desire greater freedom from glasses, a trifocal IOL is the answer. As the name suggests, a trifocal lens is designed with three distinct focal points, providing clear vision at distance, intermediate (arm's length), and near (reading). By splitting light entering the eye to these three points simultaneously, it allows the brain to select the clearest image for the task at hand.
However, not all trifocals are created equal. Lens manufacturers have engineered sophisticated optics that, while all providing three ranges of vision, can emphasize one focal point over the others to better match a patient's lifestyle. Today, I want to discuss two of the leading trifocal lenses and their unique design philosophies: the Alcon PanOptix® Pro and the Johnson & Johnson TECNIS Odyssey™.
The Alcon PanOptix® Pro: The Distance-Focused Performer
The Alcon PanOptix® lens was the first trifocal IOL approved in the United States and has a long, successful track record. It is what I would describe as a distance-focused trifocal.
The optical design of the PanOptix Pro prioritizes providing the sharpest, highest-quality vision for distance. Its intermediate focal point is set at 60 cm (about 24 inches), an exceptionally practical "workstation" distance for computer screens, dashboards, and seeing your dining partner across the table. Its near vision is very good, allowing most patients to read menus, price tags, and their cell phones comfortably.
Who is the ideal candidate for a PanOptix Pro?
The active individual: Patients who spend a lot of time outdoors, play sports like golf or tennis, or enjoy hiking.
The frequent driver: Those who value crisp, clear vision for driving, especially at night when seeing road signs clearly is paramount.
The "horizon watcher": Someone whose primary visual goal is to see the world around them with stunning clarity, while still having excellent, functional vision for their intermediate and near tasks.
The PanOptix Pro offers a comprehensive range of vision, but its "sweet spot" is anchored in providing a superb distance experience.
The Johnson & Johnson TECNIS Odyssey™: The Near-Focused Innovator
The TECNIS Odyssey™ is a newer-generation trifocal that takes a different approach. I characterize it as a near-focused trifocal.
The engineers at Johnson & Johnson designed this lens to provide an exceptional near-vision experience. It delivers a powerful, close reading point that many of my patients who are avid readers or do detailed craftwork find remarkable. It combines this strong near performance with excellent intermediate vision and very good distance vision.
Who is the ideal candidate for a TECNIS Odyssey™?
The avid reader: Patients who love to get lost in a book for hours and want to do so without reaching for reading glasses.
The professional or hobbyist: Individuals who spend significant time with near-work, such as artists, engineers, crafters (knitting, model-building), or anyone who frequently reads fine print on documents or tablets.
The "details person": Someone whose greatest frustration is their dependence on reading glasses and whose primary goal is to achieve effortless, crisp near vision.
While the Odyssey provides very good distance vision for daily activities, its design philosophy is built from the near-point outwards, ensuring that up-close tasks are as clear and comfortable as possible.
The Necessary Conversation: Halos, Glare, and Neuroadaptation
It is crucial for patients to understand that the "magic" of splitting light into three focal points comes with a trade-off. All multifocal and trifocal lenses can produce visual phenomena like halos (rings around lights) or glare, which are most noticeable at night. The good news is that modern lens designs have dramatically reduced the intensity of these effects, and for the vast majority of patients, they are mild. Over several weeks to months, a process called neuroadaptation occurs, where the brain learns to ignore these halos and focus on the clear image. Most patients find the immense benefit of spectacle independence far outweighs this manageable side effect.
Conclusion: Which Lens is Right for You?
There is no single "best" trifocal lens—there is only the lens that is best for you. The choice between a distance-focused lens like the PanOptix Pro and a near-focused lens like the TECNIS Odyssey is a deeply personal one.
The most critical step in this journey is a thorough pre-operative consultation. During this discussion, we will go beyond the clinical measurements of your eye and delve into your life. What are your hobbies? What are the visual demands of your profession? What frustrates you most about your current vision?
By understanding your unique visual goals, we can align them with the technological strengths of a specific trifocal IOL. Cataract surgery today is not just about seeing again; it's about seeing the world the way you want to.
Possible Side Effects
- Glare and halos: Some people notice rings or glare around lights, especially at night. These effects are usually mild and may improve over time.[1][2][6][4]
- Reduced contrast sensitivity: In some cases, it may be a little harder to see in dim lighting or to tell similar colors apart.[6][4]
- Not for everyone: People with certain eye diseases (like macular degeneration or advanced glaucoma) may not be good candidates for trifocal IOLs.[6]
**Types of Trifocal IOLs: PanOptix Pro vs. Odyssey**
There are different trifocal IOLs, each with unique features. Two common options are:
- Alcon PanOptix Pro: This is a distance-focused trifocal lens. It is designed to give especially sharp vision for far and intermediate distances, while still providing good near vision. Many patients find it helpful for driving, watching TV, and using a computer, with less need for glasses for most activities.[5][3][4]
- Johnson & Johnson Odyssey: This is a near-focused trifocal lens. It is designed to give especially clear vision for near and intermediate tasks, such as reading, using a smartphone, or working at a desk. It still provides good distance vision, but may be best for people who do a lot of close-up work.
What to Expect After Surgery
- Most people are very satisfied with their vision after trifocal IOL surgery.[4]
- You may notice glare or halos at first, but these often become less noticeable over time.[1][2][6][4]
- You may still need glasses for some tasks, especially in low light or for very fine print.[1][2][3][4]
Is a Trifocal IOL Right for You?
Choosing the right IOL depends on your lifestyle, vision needs, and eye health. Your eye doctor will help you decide which lens is best for you.
Questions to Ask Your Doctor
- Will a trifocal IOL work well with my eyes?
- Which trifocal IOL is best for my daily activities?
- What side effects should I expect?
- Will I still need glasses after surgery?
Summary
Trifocal IOLs can help you see well at all distances and reduce your need for glasses after cataract surgery. The Alcon PanOptix Pro is best for people who want sharp distance and intermediate vision, while the Johnson & Johnson Odyssey is best for those who prioritize near and intermediate tasks. Talk with your eye doctor to find the best option for your needs.
References
Effectiveness of Intraocular Lenses Designed to Correct Presbyopia After Cataract Surgery: An Overview of Systematic Reviews. Daka Q, Henein C, Fang CEH, et al. The British Journal of Ophthalmology. 2025;:bjo-2025-327363. doi:10.1136/bjo-2025-327363.
Trifocal Versus Extended Depth of Focus (EDOF) Intraocular Lenses After Cataract Extraction. Tavassoli S, Ziaei H, Yadegarfar ME, et al. The Cochrane Database of Systematic Reviews. 2024;7:CD014891. doi:10.1002/14651858.CD014891.pub2.
Comparison of Refractive and Visual Outcomes of 3 Presbyopia-Correcting Intraocular Lenses. Ferreira TB, Ribeiro FJ, Silva D, et al. Journal of Cataract and Refractive Surgery. 2022;48(3):280-287. doi:10.1097/j.jcrs.0000000000000743.
Visual, Refractive, Functional, and Patient Satisfaction Outcomes After Implantation of a New Trifocal Diffractive Intraocular Lens. Mendicute J, Lauzirika G, Illarramendi I, Martínez-Soroa I. Clinical Ophthalmology (Auckland, N.Z.). 2024;18:2785-2795. doi:10.2147/OPTH.S480311.
Multicenter Visual Outcomes Comparison of 2 Trifocal Presbyopia-Correcting IOLs: 6-Month Postoperative Results. Lapid-Gortzak R, Bhatt U, Sanchez JG, et al. Journal of Cataract and Refractive Surgery. 2020;46(11):1534-1542. doi:10.1097/j.jcrs.0000000000000274.
Cataract in the Adult Eye Preferred Practice Pattern. Miller KM, Oetting TA, Tweeten JP, et al. Ophthalmology. 2022;129(1):P1-P126. doi:10.1016/j.ophtha.2021.10.006.