The reshuffling of intraocular lens: the biggest winner has emerged

Since 2025, the number of approved refractive intraocular lenses (IOLs), such as trifocal and extended depth of focus (EDOF) lenses, has surged. Multinational giants like Alcon and Johnson & Johnson Vision, as well as domestic companies like Wuxi Vision Pro and Tianjin Century Healthcare Biomedical Engineering, are accelerating their market presence. Group purchasing initiatives have further driven industry upgrades and iterations, enhancing the accessibility of these high-end lenses.

Behind this phenomenon lies an industry transformation driven by the aging of the myopic population and the advent of the refractive cataract surgery era: cataract surgery has shifted from "vision restoration" to "refractive correction." Patients now demand comprehensive near, intermediate, and distance vision after surgery, leading to the expanded use of multifunctional refractive intraocular lenses. Consequently, the market share of traditional monofocal lenses is expected to reduce.

With cataract surgery rapidly transitioning from vision-restoring to refractive treatment, the demand for refractive intraocular lenses is increasing in the market. Against the backdrop of an overall aging population, the structural changes in the cataract demographic determine this increasing need.

First, the trend of cataracts affecting younger individuals is becoming increasingly evident. According to data from the China Health Statistics Yearbook, the proportion of discharged patients aged 45-59 among elderly cataract cases in hospitals nationwide has increased from 10% in 2014 to 11.6% in 2023, peaking at 12.7% during the high-incidence period.

Second, a greater number of elderly individuals have both cataracts and presby. According to the Chinese Medical Association's Ophthalmology Branch, over 80% of elderly people aged 60 and above suffer from both presbyopia and cataract.

Thirdly, the myopic population is aging. Especially with the increase in patients with high myopia and a history of refractive surgery, complex cases are on the rise, making traditional monofocal solutions insufficient to fully meet their vision recovery needs.

Furthermore, even in the absence of cataracts, patients with conditions such as presbyopia in middle-aged and elderly individuals, clear lenses combined with high refractive errors may also undergo refractive lens exchange (RLE) for the implantation of refractive intraocular lenses.

Wang Su, co-founder of Rimonci Capital and Feitelan Medical, believes that against the backdrop of an aging population, the high frequency of mobile phone usage among elderly patients, coupled with the fact that more patients remain in the workforce due to delayed retirement policies, creates a significant demand for full-range vision care. For patients with a history of refractive surgery, "freedom from glasses" will continue to be their direct expectation for cataract.

The primary benefit that refractive intraocular lenses, represented by innovations such as trifocal and EDOF lenses, offer patients is a reduction in post-operative dependence on glasses through full-range vision.

For example, trifocal intraocular lenses are designed with three focal points for distance, intermediate, and near vision, enabling patients to achieve relatively clear vision at various distances. EDOF intraocular lenses are designed based on extended depth of focus technology, which redistributes the light energy entering the eye, converting focal points into focal lines to form discernible images. EDOF lenses can integrate extended depth of focus technology with monofocal or multifocal designs to meet personalized needs.

According to data from the European Society of Cataract and Refractive Surgeons Clinical Trends Survey Report cited in the Expert Consensus on the Clinical Application of Presbyopia-Correcting Intraocular Lenses in China (2025), the use of presbyopia-correcting intraocular lenses has been increasing annually. Among these, trifocal lenses account for approximately 50%, extended depth of focus (EDOF) lenses make up about 33%, and enhanced monofocal lenses represent around 8%.

Domestically, the use of refractive intraocular lenses such as trifocal and EDOF lenses is still relatively low, with factors like product functionality, suitability, and price being significant constraints. However, these limitations are now gradually being overcome.

In the past two years, the approval of refractive intraocular lenses such as trifocal and EDOF lenses has expanded the range of availability.

Since 2024–2025, nine new trifocal and EDOF intraocular lens products have been approved for market release. As of August 2025, there are a total of seven trifocal and nine EDOF lenses available domestically.

Although refractive lenses can address multiple issues simultaneously, they are not perfect. Among these, trifocal intraocular lenses, due to their special design, require an adaptation period after implantation to allow the brain to adjust to the focal changes. Some patients may even struggle to adapt long-term, and they are prone to glare, halos, and other visual phenomena at night, resulting in poorer night vision compared to monofocal lenses. EDOF intraocular lenses can provide better continuous intermediate and distance vision, but their near vision performance is relatively inferior

A large number of newly approved products have primarily improved upon previous shortcomings and optimized visual quality through enhancements in materials and design.

For example, Alcon covers diverse needs with a full range of intraocular lenses, including the PanOptix series of trifocal lenses and the Vivity series of EDOF lenses, while its material platform has evolved from AcrySof IQ to Clareon. From 2024 to 2025, Alcon will launch its next-generation Clareon PanOptix trifocal and Clareon Vivity EDOF lenses (including both toric and non-toric versions) in China. These new products offer improved contrast sensitivity, reduced visual disturbances, and enhanced clarity and field of vision.

Johnson Vision's intraocular lenses, with EDOF technology as the core competitive advantage, have seen all newly launched EDOF products since 2024 being pre-loaded, enhancing surgical efficiency. These include the astigmatism-correcting and non-astigmatism-correcting versions of Synergy, as well as the latest generation product, PureSee. Among them, PureSee features a refractive design, utilizing pure refractive continuous vision technology to provide high-quality continuous vision from distance to near.

Although domestic products started relatively late, they have still focused on core challenges and achieved differentiated functions.

The Vision Pro's total extreme multifocal IOL further enhances light energy utilization, achieving up to 89.5% efficiency, improving patients' vision in low-light conditions and reducing their active perception of glare. The Vision Unlimited EDOF extends depth of focus for far and intermediate distances, enabling continuous vision range while providing functional near vision to some extent. It minimizes visual disturbances caused by traditional EDOF diffraction ring designs.

The Lianshian trifocal intraocular lens of Century Healthcare Biomedical Engineering utilizes a proprietary "intelligent targeted light field distribution" design, achieving over 90% light energy utilization and reducing glare. It is the first trifocal intraocular lens in China with a 60cm intermediate distance design, featuring 40cm near focus and 60cm intermediate focus, tailored to the visual habits of Chinese patients.

Domestic companies such as Eyebright Medical, Haohai Healthcare, Henan Universe, Simedice Biotechnologies, and Naich have also begun to develop trifocal or EDOF intraocular lenses, with the fastest progress already reaching the product registration.

In addition, following the classic AT LISA tri series of trifocal products, Zeiss introduced the extended depth-of-focus intraocular lens "SeeYoung" 419MP in 2025. The Hanita Intensity pentafocal intraocular lens, introduced by Feitelan, has been granted special use in Boao, Hainan. This product adds a small focus between the far, near, and intermediate focal points and is expected to receive NMPA approval within the next two years, officially entering the mainland.

For patients undergoing refractive cataract surgery, the complexity of their eye conditions means that the best intraocular lens (IOL) is not necessarily the one with the most impressive product data or the highest price. Instead, the selection should be based on more precise examination parameters and tailored to daily visual needs. In some cases, different types of IOLs may even be implanted in each eye to achieve the best possible visual quality for the individual.

Different brands have their own strengths and weaknesses. The launch and iteration of more new products can provide doctors and patients with more choices, thereby increasing market share.

Price is a major direct factor influencing the use of refractive intraocular lenses. In the past, a single lens could cost as much as 20,000 to 30,000 yuan, making it less accessible. The centralized procurement and dynamic supplementation of intraocular lenses have accelerated the market penetration of refractive IOL.

In March 2025, Johnson & Johnson Vision's "preloaded toric extended depth-of-focus intraocular lens" was approved among new products, and by May it had applied to be included in the centralized procurement supplementary list (thus considered a selected product), with only over 70 days in between. According to the announcement, this intraocular lens, which provides near, intermediate, and distance vision simultaneously, offers continuous range of vision and corrects astigmatism, with a selected price of 9,290 yuan.

So far, the number of trifocal and EDOF intraocular lenses included in the procurement has reached nine, with prices ranging from 3,596 yuan to 14,537 yuan, significantly improving accessibility. At the same time, the renewal of the first round of procurement and the upcoming second round of procurement for intraocular lenses present another opportunity to reshape the market.

According to an announcement from the National Organization for Joint Procurement of High-Value Medical Consumables, two types of imported monofocal intraocular lenses were disqualified from the centralized procurement program in February 2025 due to quality issue.

Wang Shu said, following the implementation of centralized procurement, the utilization rate and volume of trifocal and EDOF intraocular lenses have significantly increased, driving industry upgrades and iterations. Coupled with factors such as market demand, the intraocular lens market structure is shifting toward high-end products, with refractive intraocular lenses inevitably reducing the market share of conventional monofocal. Currently, single-focus IOLs account for approximately 70% of domestic usage, while refractive IOLs such as bifocal, trifocal, and EDOF lenses make up only about 30%. The proportion of the latter is certain to increase in the future.

From a market dynamics perspective, influenced by policy factors such as centralized procurement, both upstream medical device companies and ophthalmic medical service institutions are more motivated to promote the research, development, and application of refractive intraocular lenses.

Haohai Biological and Eyebright Medical have recently released their semi-annual reports for the first half of 2025. According to the financial reports, Haohai Biotech's revenue from intraocular lens products in the first half of the year was RMB 127 million, a decrease of 29.84% year-on-year. The main reasons include price reductions due to centralized procurement policies and a decline in sales of ordinary spherical and aspherical products caused by DRG/DIP payment reforms. In response, Haohai Biological has optimized its sales structure to offset losses, with increased sales of mid-to-high-end products. During the same period, Achieve Medical's full-vision multifocal intraocular lenses also experienced rapid growth, with their sales proportion continuously increasing.

On the server side, large ophthalmic chains are vigorously promoting high-value-added cataract surgical techniques and stimulating demand for refractive intraocular lenses through service innovation.

In the first half of 2025, He Eye Specialist Hospital's cataract business revenue decreased by 17.67% year-on-year, with a corresponding decline in gross profit margin. In response to changes in the operating environment, He Eye continued to optimize its business structure by promoting high-value-added procedures such as femtosecond laser cataract surgery, while also meeting the demand of mid-to-high-end patients for multifocal intraocular lenses.

Huaxia Ophthalmology established the first "High Myopia Cataract Specialty Clinic" in China in the first half of 2025, focusing on patients with both high myopia and cataracts. By integrating technologies such as femtosecond laser-assisted phacoemulsification and multifocal/continuous vision intraocular lens implantation, it has innovated service models in the field of complex refractive cataract diagnosis and treatment.

In the first half of 2025, Aier Eye Hospital Group's cataract service revenue increased by 2.64% year-on-year, largely due to the growth in refractive cataract surgeries and a higher adoption rate of multifocal intraocular.

Overall, driven by refractive cataract surgery, "all-in-one" refractive intraocular lenses are rapidly reshaping the ophthalmology market landscape. In this field, domestic companies are competing head-to-head with multinational giants, addressing the shortcomings of previous products through material upgrades and design innovations. Meanwhile, volume-based procurement policies are breaking down price barriers, accelerating the adoption of premium lenses in broader markets.

With the increasing market penetration of refractive intraocular lenses, patients facing various complex refractive conditions due to aging trends will have access to higher-quality visual solutions.