Significant advances in intraocular lens designs have not been over the last year. The lack of successful lens implant designs to match the requirements of small-incision cataract surgery is frustrating. Although it is possible to comfortably remove the crystalline lens through a 2.7-mm incision, this incision inevitably has to be enlarged to accommodate even the most malleable lens implant available. Polymethyl methacrylate remains the preferred lens material for most surgeons, but silicone lens implants have gained consideration and have incited controversy. Acrylic polymers are in the early stages of clinical evaluation. Phakic lens implants for high myopia remain controversial while longer-term evidence for the safety of renewed designs is gathered.