Key takeaways about cataract surgery
- Cataracts are the leading cause of treatable blindness across the globe.
- More than 30 million cataract surgeries worldwide are performed each year.
- In the U.S., nearly one in five adults between the ages of 65 and 74 years have cataracts that affect their vision.
- Innovations in artificial lens implants—known as intraocular lenses (IOLs)—surgical precision, digital tools and the introduction of AI have all dramatically advanced cataract surgery.
- The TECNIS PureSee™ IOL—the newest addition to the Vision portfolio of Johnson & Johnson—offers a broader range of vision and reduced visual symptoms, similar to a monofocal IOL.*
People approaching their 40s are familiar with that annoying sign of aging: the creeping need for reading glasses, a condition known as presbyopia. But a significant number within this same age group are also developing a more serious threat to their vision—cataracts—often without realizing it.
Cataracts form when oxidative damage causes proteins in the eye’s natural lens to clump together over time, leading to progressively cloudy and blurry vision. They are the leading cause of treatable blindness worldwide.
In the U.S., nearly 20% of people ages 65 to 74 have cataracts that affect their vision, and more than half of those over 80 either have cataracts or have already undergone surgery to remove them.
The good news is that the prevalence of cataracts has driven decades of research and innovation. Today, more than 30 million cataract surgeries are performed each year around the world, and about 95% of patients experience improved vision. The even better news is that advances in intraocular lens (IOL) design, precision surgery, digital operating rooms and artificial intelligence (AI) have transformed cataract surgery in just the past decade.
The profile of the typical patient is changing. Patients are coming in earlier, taking a more proactive approach to their eye health and expecting higher-quality vision with much less tolerance for compromise.
“We are in a golden age of cataract surgery,” says Habeeb Ahmad, M.D., M.S., Global Medical Director, Cataract Surgery, Johnson & Johnson. “We’ve progressed light years from the earliest recorded cataract surgeries performed thousands of years ago, when the cloudy lens was simply pushed aside to allow light to reach the retina—preventing total blindness but leaving vision severely unfocused. Now, with our revolutionary innovations in the field year after year, we’re not just restoring vision, we’re optimizing it beyond previous expectations. In some cases, patients can exceed 20/20 vision.”
“The profile of the typical patient is changing, too,” he adds. “Patients are coming in earlier, taking a more proactive approach to their eye health and expecting higher-quality vision with much less tolerance for compromise.”
These rising expectations—along with ongoing feedback from surgeons—have helped fuel 25 years of TECNIS™ innovation in advanced optics, as reflected in Johnson & Johnson’s TECNIS portfolio of IOLs.
“Our goal is to provide every patient with consistent, high-quality visual outcomes,” says Dr. Ahmad. That’s more achievable than ever thanks to what he calls “technology convergence”—the combination of advanced diagnostics and biometry, real-time surgical guidance and data analytics ushering in new sophisticated IOLs, including lenses designed to correct not only cataracts but also presbyopia.
In this new golden age of cataract surgery, innovation is accelerating rapidly. Read on to learn what Dr. Ahmad sees as the most exciting developments healthcare professionals should know about today—and what lies ahead.
1.
British ophthalmologist Sir Harold Ridley created the first IOL in 1949, after observing that World War II pilots could tolerate small pieces of acrylic plastic that entered their eyes during combat. His invention was hailed as revolutionary, but it did have a drawback: The lens was monofocal.
So while it provided clear vision at a single distance (usually far), it couldn’t correct other vision issues, such as astigmatism. Patients also still needed glasses to see up close.
Monofocal IOLs, still the most popular choice, have long been the default treatment for cataracts.
Over the last two decades, however, a new generation of IOLs has transformed cataract surgery. Johnson & Johnson’s TECNIS portfolio includes:
- TECNIS Eyhance™, an enhanced monofocal IOL that improves on the monofocal by extending depth of focus; its toric version corrects for astigmatism.
TECNIS Odyssey™, a full visual range IOL that allows patients to see clearly at every distance*—from near to far and in between, minimizing the need for glasses.
Patients “may have occasional, though minimal, glare and halos, but the TECNIS Odyssey IOL delivers very good near vision, in addition to robust intermediate and distance,” says Dr. Ahmad. “It’s for the patient who wants to rely less and less on glasses. Over 93% of our patients end up spectacle-free and don’t mind occasional glare.”
- TECNIS PureSee™, a next-generation Extended Depth of Focus (EDOF) IOL, offers significantly improved range of vision and reduced visual symptoms, compared to a monofocal IOL. It can also correct for astigmatism.
“TECNIS PureSee is revolutionary,” says Dr. Ahmad. Available globally since 2023 and now available in the U.S., the IOL solves for an issue that has plagued other non-monofocal lenses: a greater likelihood of occasional glare and halos.
“Traditionally there’s been a trade-off with EDOF IOLs,” Dr. Ahmad explains. “As you get more advanced technology and an extended range, you may sometimes lose some contrast in your vision and have glare and halos. TECNIS PureSee is the first EDOF IOL to be approved by the U.S. Food and Drug Administration without a warning about losing contrast sensitivity, as compared to a monofocal. This is a big moment.”
It’s for the patient who wants excellent distance and intermediate vision and contrast equivalent to a monofocal lens, with even less glare and halos than most advanced technology IOLs, and doesn’t mind sometimes using readers for small print.
“These lenses give surgeons the ability to match the lens to the patient,” says Dr. Ahmad. “Not the other way around.”
2.
Cataract surgery is considered one of the most successful treatments in all of medicine, but that doesn’t mean it’s simple or routine.
“Every patient, and every eye, is different,” says Dr. Ahmad. “We’re moving from a one-size-fits-all model to precision surgery that enables predictable, reproducible outcomes across all patients.”
One revolutionary tool to achieve that goal is the femtosecond laser, a computer-guided, ultra-precise tool that helps surgeons perform key steps of cataract surgery more gently and accurately.
“The femtosecond laser can take precise measurements of the eye, so you can plan surgeries specifically for each patient,” Dr. Ahmad says. It can also make a pre-programmed incision in the cornea to access the cloudy lens and then soften and break it up so it can be suctioned out.
“We’re also combining advanced technologies,” such as how to integrate using the laser and Johnson & Johnson’s VERITAS™ Vision System (phacoemulsification) in concert, says Dr. Ahmad. “Our goal is to continuously elevate every surgery, from our best-in-class IOLs to integrating innovative surgical and laser systems, and advancing imaging for operative guidance, to meet each patient’s expectations.”
3.
AI has entered not only the operating room (OR) but every step of the cataract-treatment process, leading to what Dr. Ahmad calls “a democratization of tech” that allows every patient to get an optimized outcome.
“As a surgeon, I am truly excited with the advent of AI in the operating room and how it helps us interpret data more effectively—identifying patterns, refining calculations and predictions, flagging inconsistencies and possible complications, guiding lens selection and surgical decisions,” says Dr. Ahmad. “That creates more predictable outcomes.”
All of that input allows surgeons to have more informed conversations with their patients, and then walk into the OR with greater confidence.
“Some surgeons are concerned that AI will replace them, but AI doesn’t replace clinical judgment—in fact, it strengthens and supports it as a tool,” says Dr. Ahmad. “There are a lot of complicated eyes out there, whether it’s because of genetics, previous surgeries or medical conditions. With AI helping to interpret all the patient factors, both surgeons and patients have the opportunity for better outcomes. That’s why Johnson & Johnson is proactively investing in robotics and the potential of AI.”
4.
Just as digital devices have changed everyday life in both small and profound ways (with a smartphone being the entry point for everything from a food order to personal health records), digital integration has transformed the entire preop to postop journey for cataract patients and their surgeons.
“Traditionally, we were looking at biometers that were printed on paper and being faxed around,” says Dr. Ahmad. “It wasn’t seamless—data flow was sitting in silos.”
The digital OR, however, is an interconnected surgical ecosystem that integrates data, imaging, hardware automation and software intelligence. And research suggests it consistently makes for better—and faster—results.
A study of digital workflow in cataract surgery, published in 2024 in the Journal of Cataract & Refractive Surgery, found that it significantly reduced the time needed for each step in the process, from preoperative measurements to surgical planning to the surgery itself.
A prime example of how this works is the AI-derived TECNIS™ Toric Calculator from Johnson & Johnson. This online planning tool assists surgeons in precisely measuring astigmatism before surgery, producing thousands of data points.
“This is a specialized tool that helps cataract and refractive surgeons accurately determine the power and rotational alignment of toric IOLs,” Dr. Ahmad says. “This allows the surgeon partners to make an informed decision on which lenses a patient is a candidate for and why, which improves accuracy and consistency.”
The TECNIS™ Vision Simulator, meanwhile, allows prospective patients to select a number of factors that matter to them—night driving, dining out, grocery shopping—and watch videos that simulate how various IOLs work in those situations.
“Patients can experience what their vision may be like after surgery, comparing one IOL with another,” says Dr. Ahmad. “It’s an incredible illustrative aid that allows them to understand the benefits and trade-offs of the lenses they’re choosing from. It’s easier for the surgeon, too, because it helps streamline the time once required for a doctor explaining the options and allows for a truly interactive educational experience ahead of surgery with visualization of IOL performance.”
5.
Things are moving fast in the world of cataract surgery and ophthalmology in general, says Dr. Ahmad. “It’s one of the few fields where if you miss one or two big conferences in a year, you’re already out of the innovation loop. Both surgeon feedback and increasingly sophisticated patient demands are driving that innovation, and ophthalmic medtech, including Johnson & Johnson, has been truly pioneering in bringing those innovations to reality.”
For example, “people in their 70s and 80s are using smartphones and social media more now, so they want more flexibility with visual distance,” Dr. Ahmad says. “One patient chose an IOL that would support his curling habit; another was a pilot who needed to take his work into account. It’s become very personalized for each individual’s needs.”
The future is about advancing the optics further. A recent report in the journal Eye predicts an even greater role of robotics and AI in cataract surgery. Just around the corner are revolutionary innovations like a fluid lens and possibly eye drops to replace surgery.
What excites Dr. Ahmad is the continued evolution of cataract and refractive surgery and the ability to benefit a broader range of patients than ever before. Innovations across the field from industry leaders like Johnson & Johnson have expanded treatment possibilities to individuals with stable comorbidities who may not have previously been offered advanced vision correction.
“Increasingly, we’re really enhancing how people experience the world through unparalleled vision, and to see this impact in patients’ lives and surgeons’ practices is priceless.”
*Learn more about TECNIS IOLs, including important safety information.
