Supplementary IOLs

If you’ve already had cataract surgery but still have a problem with your eyes or maybe just need some adjustment to your vision, a supplementary lens could be an option for you.


Supplementary lenses are implanted in front of your existing IOL, in a section of the eye just behind the iris called the ciliary sulcus. These special lenses can provide additional clarity or correction of your vision.


Supplementary IOLs may only be available through private healthcare or surgery.

Rayner offer a range of supplementary IOLs:


Sulcoflex Aspheric

A monofocal supplementary lens that can be used to adjust the dioptre power of the lens currently in your eye.


Sulcoflex Toric

A toric supplementary lens that can correct astigmatism in your eye that may be causing blurriness of your vision.


Sulcoflex Trifocal

Sulcoflex Trifocal is the world’s first supplementary trifocal intraocular lens (IOL) for people who have already had cataract surgery and was designed in partnership with a leading European technology institute.


Unlike a monofocal IOL, Sulcoflex Trifocal can focus light from any distance. The innovative design splits the light as it enters your eye, giving you separate points of focus for near, intermediate and distance vision. When placed in front of the original lens that was implanted during your cataract surgery, Sulcoflex Trifocal offers a flexible solution that can reduce your need to wear glasses for more close-up activities, like reading or gardening.

Be free from frustration

Whether it’s because of constantly putting them on and taking them off throughout the day, or accidentally leaving them behind when you need them, using reading glasses can be annoying.


Even simple ‘transition’ situations such as watching TV and then reading a message on your mobile phone, or reading a menu and then looking up to say your choice can be slowed down by the use of glasses.


Sulcoflex Trifocal gives you the opportunity to increase your independence from wearing glasses for the majority of everyday activities, at any distance. Sulcoflex Trifocal’s innovative design encourages stable positioning in the eye, for reliable and dependable outcomes. Fewer rings on the optic surface than many trifocal IOLs results in reduced potential visual disturbances and improved night vision.


The Sulcoflex Trifocal procedure is performed by an eye surgeon and usually only takes a few minutes. Your eye surgeon may perform the procedure on both eyes in the same session or may arrange a separate visit for your second eye. Unlike other procedures which are permanent with no option of adjustability, Sulcoflex Trifocal can be removed, replaced or even upgraded at any time – providing you with flexibility and peace of mind.

What are the possible benefits of Sulcoflex Trifocal?

Sulcoflex Trifocal is the world’s first trifocal supplementary IOL for people who have already had cataract surgery.


  • Convenience – reduce your reliance on glasses for activities at any distance.
  • Safety – similar to your cataract surgery, Sulcoflex Trifocal implantation is fast, safe and clinically proven.
  • Visual adjustments – if your vision after cataract surgery is not as good as it should be then Sulcoflex Trifocal can correct this at the same time.
  • Flexible – Sulcoflex Trifocal can be implanted at any time after your cataract surgery.
  • Reversible – unlike other procedures, if you don’t adapt to Sulcoflex Trifocal lenses then your eye surgeon can remove them.

After Sulcoflex Trifocal surgery, your brain will have to get used to the way your new trifocal IOL processes light. All trifocal IOLs split light at different points across their surface to give you multiple points of focus at any one time. You may need a little more time to adjust, reinterpret and resolve these images so you see one clear image. This process of adjustment is called ‘neuroadaptation’ and varies from person to person, but usually you will have adjusted within a few weeks.


If you struggle with the neuroadaptation then you may choose to discuss removing Sulcoflex Trifocal with your eye surgeon, reverting back to your previous vision and the use of glasses for near and intermediate activities.


Sucloflex Trifocal is suitable if you…

  • Are keen to get rid of your glasses for activities at near and intermediate distances
  • Spend a lot of time doing near and intermediate distance activities, like reading or using a mobile phone/computer


Sulcoflex Trifocal may not be suitable if you have co-existing eye conditions or do a lot of night driving – please discuss your suitability for Sulcoflex Trifocal with your eye surgeon.

Sulcoflex Trifocal is a high precision optical device that is surgically placed behind the iris and in front of the primary intraocular lens (IOL) that was implanted in your eye during cataract surgery. Sulcoflex Trifocal can help to remove the need for glasses for the majority of everyday activities.

Sulcoflex Trifocal uses advanced diffractive optic technology that splits the incoming light to create simultaneous multiple images on the retina of distant, intermediate and near objects. The optics transmit 89% of available light to the retina.

Sulcoflex Trifocal is primarily intended for people who have already had the natural lens in their eye replaced with an artificial lens during cataract surgery (known as pseudophakia). These people consequently need to wear glasses for near and intermediate activities, which they find frustrating.

Sulcoflex Trifocal may not be suitable if you have co-existing eye conditions or do a lot of night driving. You should always discuss your suitability for Sulcoflex Trifocal with a suitable refractive eye surgeon - use our postcode tool to find your nearest surgeon.

The key potential benefit of Sulcoflex Trifocal is the ability to see clearly and perform activities at any distance (near, intermediate, far) without the need for glasses. If your vision after cataract surgery is not as good as it should be then Sulcoflex Trifocal can correct this at the same time. Unlike other procedures, if you do not adapt to your new vision then your surgeon has the option to remove Sulcoflex Trifocal.

Sulcoflex Trifocal is made of Rayacryl, Rayner's proprietary hydrophilic acrylic material. Rayacryl has been safely used in cataract surgery around the world for over 20 years. The material is clinically-proven to have excellent biocompatibility (it does not cause a reaction inside the eye) and offers superb optical clarity.

Unlike many other corrective procedures, Sulcoflex Trifocal can be removed, exchanged or upgraded at any time. If Sulcoflex Trifocal is removed then you will revert to needing glasses for near and intermediate vision.

No, Sulcoflex Trifocal is implanted behind your iris (the coloured part of the eye). Only eye care professionals will be able to tell that you have had the advanced lens implanted.

The procedure is very similar to your original cataract surgery, except that it is less invasive because your natural lens has already been replaced. Local anaesthetic is administered and there is very little discomfort during the procedure which only takes a few minutes. You can leave the clinic the same day but will need someone to drive you home. Some eye drops or medication will be prescribed, and you will typically visit your eye surgeon the next day to see how your vision is adapting to the new lens.

Everyone is different but most people experience the benefits of Sulcoflex Trifocal within a couple of days, with many seeing vast improvements the very next day.

Because Sulcoflex Trifocal can be removed by your eye surgeon if you do not adapt to trifocal vision, they may re-evaluate your suitability. Use our postcode tool to find your nearest surgeon.

An eye surgeon will only remove a monofocal IOL under special circumstances because it can cause damage to the eye. Sulcoflex Trifocal can help you to achieve glasses-free vision without the need to remove your monofocal IOL.

Sulcoflex Trifocal lenses can be removed, replaced or upgraded by your eye surgeon at any time.

No, Sulcoflex Trifocal can be placed in front of any monofocal IOL that was implanted at any time.

The price of the Sulcoflex Trifocal procedure varies by surgeon and clinic. Your surgeon will be able to advise pricing and payment plans during your initial consultation. Unfortunately Sulcoflex Trifocal is not available on the NHS.

Side effects and complications to cataract surgery are rare. Some of the visual compromises that have been associated with the implantation of trifocal intraocular lenses are:


  • Lower contrast than that provided by a monofocal IOL
  • Halos and glare when driving at night
  • Visual disturbances including halos and glares, which decrease with time (neuroadaptation).


As with all surgical procedures, the outcomes for a trifocal intraocular lens cannot be guaranteed. It is important to be aware of possible effects on vision after surgery. Please discuss possible risks and side effects with your eye surgeon. Not all patients are suitable for this type of intraocular lens. Your surgeon at the time of consultation will indicate whether this type of lens is suitable for you.

"I was buying glasses and having them in every room in our home. I had to wear them for shopping and cooking and even eating… and that was becoming really tiresome."

Susan R, Sulcoflex Trifocal patient (UK)