Most people who hear about cataract surgery will immediately think of established companies such as Alcon, Johnson & Johnson, Zeiss, Rayner, Bausch + Lomb, HOYA, and Lenstec. These firms dominate the market with proven, widely trusted intraocular lenses. They have excellent safety records and offer a broad range of choices, from monofocals to trifocals and extended depth of focus designs.
Yet in the background, there is a very different conversation taking place. While the major players refine optics, smaller companies and start-ups are asking much bolder questions. What if we could replicate the natural ability of the human lens to change shape? What if instead of a fixed piece of acrylic, we could inject a flexible material that behaves like a young lens? What if the lens implanted today could be upgraded or adjusted years down the line without another major surgery?
This article takes a deep dive into those very ideas. We will look at emerging innovators such as LensGen, JelliSee, Atia Vision, Perfect Lens, and Omega Ophthalmics. Each is developing a unique approach that could radically change what cataract surgery offers patients in the future.
Why Do We Need New Types of Cataract Lenses?
The limits of current technology
Modern intraocular lenses are excellent at giving people back clear sight, but they do not fully restore the natural focusing system of the eye. Multifocal and extended depth of focus designs allow more than one point of clear vision, yet they achieve this by splitting or stretching light. The result is that while many people are delighted, others notice halos, glare, or a reduction in contrast, particularly at night.
What is missing is true accommodation. In a natural youthful eye, the lens changes shape continuously, allowing smooth shifts between distance, intermediate, and near vision. Replicating this has been the holy grail of lens design for decades, but it remains difficult. Capsular fibrosis, lens movement, and material stability are just some of the barriers that innovators are working to overcome.
The opportunity for new solutions
Emerging lens innovators believe they can go further than light-splitting optics. Their designs aim to use the eye’s own anatomy, muscles, or light-based adjustments to deliver personalised vision. Some look to create accommodating lenses that bend and reshape. Others focus on injectable or refillable materials that restore elasticity. A third group works on technologies that let a surgeon adjust an implanted lens without opening the eye again. And finally, some believe in turning the capsular bag into a platform for future upgrades.
The Four Big Innovation Families
1. Shape-changing accommodating lenses
These designs aim to physically change curvature or position within the eye when the ciliary muscle contracts. The goal is to reproduce natural accommodation rather than simulate it.
LensGen’s Juvene lens is one of the most advanced in this area. It uses a dual optic, modular design that changes curvature inside the eye. Clinical trials have shown encouraging levels of accommodation, with patients achieving useful vision across multiple distances. Long-term stability and safety remain under study, but momentum is strong.
Atia Vision’s OmniVu system is another example. It combines a base implant with a fluid-filled, shape-changing front optic. This allows for accommodative movement and the potential for future adjustments. Early feasibility studies are underway, and the design has attracted attention for its modular concept.
The promise here is clear: if these lenses can deliver consistent two to three dioptres of accommodation without optical side effects, they could become the closest option to a youthful, natural lens.
2. Gel-based or injectable concepts
Instead of a solid optic, these designs use a refillable or injectable material to restore lens elasticity. The idea is that when the ciliary muscle contracts, the gel changes shape, just as a young lens would.
JelliSee Ophthalmics is leading in this area. Its concept involves a flexible material that sits within the capsule and responds to muscle movement. The hope is to recreate genuine accommodation rather than simulate it through optical tricks.
The excitement is easy to understand. A successful gel system could revolutionise surgery by restoring natural lens behaviour. But challenges remain. Long-term clarity of the material, resistance to capsular contraction, and precise control of shape are all difficult engineering and biological problems.
3. In-situ adjustable optics
These are lenses that can be fine-tuned after surgery without removing them from the eye. This could mean adjusting spherical power, correcting astigmatism, or even altering multifocality.
Perfect Lens is one of the pioneers. Its system uses a femtosecond laser to change the refractive index of a lens already inside the eye. In theory, this could allow multiple adjustments over a patient’s lifetime, providing flexibility and reducing the need for lens exchange surgery.
The advantages are obvious. Refractive outcomes could be perfected after healing, and vision could be adapted years later if needs change. But the system still needs wide clinical validation and regulatory approval before it becomes a mainstream option.
It is worth noting that RxSight’s Light Adjustable Lens is already commercially available and adjusts with ultraviolet light after surgery. Perfect Lens and similar systems are seen as the next wave, going beyond immediate postoperative adjustments to lifelong adaptability.
4. Modular capsular platforms
Rather than focusing on the optic itself, these innovators see the eye as a potential upgradeable socket. The idea is to stabilise the capsular bag with a platform that can securely hold lenses and potentially other micro devices.
Omega Ophthalmics has developed the Gemini Capsule, which acts as a frame within the capsular bag. It can house an optic now and allow upgrades or changes in the future. It could even serve as a base for drug delivery or biosensors.
This approach is bold but logical. Instead of asking a single lens to last for life, the system could evolve with new technology. The main challenge is ensuring long-term stability and preventing the capsule from shrinking around the platform.
Who Could Benefit from These Innovations?
Different technologies will likely suit different patient types. Shape-changing accommodating lenses could appeal to those who want natural vision without halos. Gel refills might one day offer youthful sight to people in their fifties or sixties. Adjustable optics could be ideal for perfectionists who want their prescription fine-tuned. Modular capsules could help younger cataract patients who may live long enough to see major breakthroughs.
It is unlikely that one single innovation will dominate. More probably, we will see a range of solutions tailored to patient needs, just as monofocal, toric, and trifocal lenses coexist today.
Challenges Ahead for Start-up Innovators
While the ideas are exciting, these companies face several hurdles. They must prove long-term safety and stability in human eyes. The capsular bag is biologically active, and fibrosis can interfere with mechanical movement. Materials must stay clear, stable, and biocompatible for decades. Regulators will require robust, multi-year data.
Cost and adoption are another challenge. Surgeons are used to well-established lenses with predictable results. Convincing them to change practice requires not just clinical benefits but also ease of implantation and support.
Finally, the question of durability is crucial. A lens must work reliably for decades, not just a few years. Meeting that standard is a tall order, but without it, mainstream adoption will not happen.
Looking Ten Years Ahead
If even one or two of these concepts succeed, cataract surgery could look very different in a decade. We might see truly accommodating optics on the market, modular capsules that allow upgrades, or adjustable lenses that can be fine-tuned throughout life. Patients could have more personalisation than ever, and the line between cataract surgery and refractive surgery could blur completely.
The future will almost certainly not be dominated by one single solution. Instead, the landscape may become more diverse, with patients and surgeons able to select from a broader menu of options, each tailored to specific lifestyle needs
Frequently Asked Questions
1. What makes emerging cataract lenses different from established ones?
The main difference is that emerging cataract lens technologies are designed to go beyond simply restoring clear vision with a fixed optic. Established lenses, like monofocals or trifocals, provide good outcomes but are static once implanted. In contrast, many of these new designs focus on adaptability, either by changing shape in response to the eye’s natural focusing muscles, by using injectable gels to recreate lens flexibility, or by offering post-surgery adjustments to fine-tune vision. This could mean more natural sight, fewer side effects, and long-term personalisation for patients.
2. Are shape-changing lenses already available for patients?
At the moment, shape-changing accommodating lenses are still being tested in clinical trials and are not available for general use. Designs such as LensGen’s Juvene and Atia Vision’s OmniVu have shown promising early results in terms of restoring some level of natural accommodation. However, regulatory approval requires years of follow-up to ensure that these lenses are safe, effective, and durable. Patients may hear about them in research settings, but for now they remain investigational.
3. What is the main challenge with injectable or gel-based lenses?
The difficulty with injectable or gel-based lenses lies in making sure the material inside the eye stays clear, flexible, and stable for decades. The natural capsular bag, where the cataract sits, often shrinks or becomes cloudy after surgery, which could interfere with the gel’s performance. Researchers also need to prove that the material will not trigger inflammation or degrade over time. While the concept is exciting and has the potential to closely mimic a natural youthful lens, it still requires significant development before becoming a clinical reality.
4. Can implanted lenses really be adjusted after surgery?
Yes, this is already happening in limited ways. The RxSight Light Adjustable Lens, for example, allows surgeons to change the prescription using ultraviolet light after the eye has healed. Newer systems, such as those being developed by Perfect Lens, take this further by aiming to adjust a lens repeatedly over the course of a patient’s life. This could allow fine-tuning of vision years after surgery, making implanted lenses much more adaptable to changing needs or preferences.
5. How safe are these new lens technologies?
Safety is the key question for all of these emerging designs. Every lens must go through extensive laboratory testing, animal trials, and human clinical trials before regulators approve it for widespread use. The challenges include ensuring that moving parts continue to function, that injectable materials remain clear, and that adjustments can be made without harming surrounding tissues. Until multi-year safety data is available, these lenses will remain investigational.
6. Who might be the first patients to try these new lenses?
The first patients to receive these emerging lenses will almost always be those who volunteer for clinical trials. Trial participants help researchers gather evidence on how well the lenses perform and how safe they are in real-world use. These trials are usually conducted at leading specialist centres with experienced surgeons who are part of the research programme. It is unlikely that standard cataract patients will have access to such lenses until they have passed through the full approval process.
7. Will these new lenses eliminate glasses completely?
That is the ambition behind many of these designs, but in practice outcomes will vary. Even the most advanced current lenses cannot guarantee that every patient will be glasses-free, and the same will apply to new technologies. Some people may still prefer glasses for very fine tasks or specific conditions such as reading small print in dim light. However, if these innovations succeed, they could significantly reduce the overall need for spectacles and make natural, flexible vision a realistic possibility.
8. Are modular capsule platforms already being used?
Modular capsule platforms, such as Omega Ophthalmics’ Gemini Capsule, are still in the investigational stage and are not available for routine cataract surgery. These platforms are designed to turn the eye into an upgradeable system, where lenses or devices could be swapped or added later. While the idea is highly appealing, it must be proven safe and practical. Surgeons will need evidence that lenses can be exchanged easily without complications and that the capsule remains stable over many years.
9. How long could it take for these innovations to reach everyday clinics?
For most of these technologies, the timeline is measured in years rather than months. It typically takes five to ten years for a new intraocular lens concept to move from early trials to widespread clinical use. Regulatory approval requires long-term data, which cannot be rushed. That means patients are unlikely to see these lenses in ordinary cataract clinics until the next decade. However, progress is being made steadily, and some of these concepts may become available sooner in specialist centres.
10. Should patients delay cataract surgery to wait for these new lenses?
In most cases, delaying cataract surgery is not recommended. Current lenses offer excellent results and can restore clear vision quickly and safely. Waiting too long can lead to worsening vision, reduced quality of life, and more complicated surgery later. While the new technologies are exciting, they are not yet ready for general use. Patients can benefit from proven modern lenses today and, if modular or adjustable options become available in the future, they may still have opportunities to adapt their vision later on.
Final Thoughts
The next generation of cataract lenses is being designed not just to restore sight, but to restore something much closer to the natural function of the eye. Whether through shape-changing optics, injectable materials, laser-adjustable lenses, or modular platforms, these innovations promise a future where cataract surgery is more personalised, adaptable, and enduring.
For patients considering cataract surgery today, it is worth knowing that excellent options already exist. But it is also exciting to see what lies ahead. At London Cataract Centre, our team follows these innovations closely, ensuring that when proven technologies do become available, patients will benefit from the very latest advancements in vision care.
References
- Garg, S. (2024) ‘Update on Accommodating IOLs’, CRSToday, August. Available at: https://crstoday.com/articles/aug-2024/update-on-accommodating-iols (Accessed: 15 October 2025).
- Crago, S. et al. (2023) ‘36-month outcomes for the Juvene modular intraocular lens’, Ophthalmology Times, 11 May. Available at: https://www.ophthalmologytimes.com/view/ascrs-live-36-month-outcomes-for-the-juvene-modular-intraocular-lens (Accessed: 15 October 2025).
- McKee, Y. (2024) ‘The JelliSee Accommodating IOL’, Presbyopia Physician, December. Available at: https://www.presbyopiaphysician.com/issues/2024/december/the-jellisee-accommodating-iol (Accessed: 15 October 2025).
- Koury, C. (2023) ‘Adjustability: The “Holy Grail” for IOLs?’, Ophthalmology Management, August. Available at: https://ophthalmologymanagement.com/issues/2023/august/adjustability-the-holy-grail-for-iols (Accessed: 15 October 2025).
- Wiley, W. F. (2018) ‘The Gemini Refractive Capsule’, CRSToday, May. Available at: https://www.crstoday.com/articles/2018-may/the-gemini-refractive-capsule (Accessed: 15 October 2025).