Over the past 70 years intraocular lenses (IOLs) have revolutionised ophthalmic care, providing a life-changing solution for people faced with losing their sight as a result of cataracts. The history of the IOL dates back to 1949 when Sir Harold Ridley implanted the first intraocular lens in a patient’s eye. The inspiration for Ridley’s incredible invention came after he realised that acrylic fragments left in the eyes of British World War II fighter pilots remained inert, leading to his concept of artificial plastic lenses to replace natural cataract-clouded human lenses. These first ‘Ridley’ IOLs were rigid, hand-finished devices, featuring a single large optic, and implanted using a significantly invasive procedure.

Despite significant initial resistance from within the ophthalmic community, IOL technology became widely accepted over the following decades, with gradual advancements in design, materials, manufacturing and surgical techniques. The introduction of foldable IOLs in the 1980s drove significant improvements in surgical outcomes by allowing smaller incisions that led to faster recovery times and reduced risk of post-operative complications. Later, the development of multifocal and toric premium IOLs greatly expanded options for patients, enabling correction of both distance and near vision as well as corneal astigmatism.

Today, IOL implantation is standard-of-care in cataract surgery, with nearly 30 million operations performed globally each year. Most modern IOLs are made by machining or moulding biocompatible acrylic and silicone materials, and offer excellent optical clarity and long-term stability within the eye. Advancements in customised mechanical and optical designs give the 21^st century ophthalmic surgeon the ability to tailor IOL selection to every patient’s unique visual needs, and even lifestyle preferences. Ever-improving precision engineering and manufacturing techniques now allow highly accurate products to be mass produced and distributed to every country worldwide.

Looking to the future, the field of IOLs shows great promise for more innovation and quality-of-life enhancing benefits. Researchers are exploring novel materials and designs to further improve optical performance and compatibility with the eye. Advances in accommodating and adjustable IOLs aim to better mimic the natural state of the human crystalline lens, providing improved depth of focus and hoping to achieve the ultimate goal of restoring patients vision to that of a young person. The integration of smart technologies, such as intraocular sensors and drug-delivery systems, holds potential for other benefits, including monitoring intraocular pressure and administering medications directly to the eye, potentially offering options for managing conditions such as glaucoma and age-related macular degeneration.

The evolution of the IOL from that first hand-made Ridley lens to today’s mass-produced cornerstone of ophthalmic surgery underscores their profound global impact on restoring vision and improving patients› quality of life. With continued innovation and research, the future of IOLs promises ever greater advancements in visual correction and ocular health care.