Patient selection for multifocal intraocular lenses

Patient selection is the key to patient satisfaction with multifocal intraocular lenses (mIOLs). While multifocality provides spectacle independence, it is associated with potentially bothersome side effects inherent in multifocal optics. Photic phenomena such as halos and glare, as well as loss of contrast in low light environments, can be potentially problematic in visually demanding occupations and leisure activities. The use of mIOLs may also be disadvantageous in patients with certain comorbidities that affect vision or increase the risk of complications. In addition, unilateral mIOL implantation, preoperative myopia, postoperative ametropia, unrealistic patient expectations and certain personality traits may lead to lower patient satisfaction with mIOLs. Healthy, hyperopic patients with presbyopia or cataracts, a desire for spectacle independence and a willingness to compromise tend to achieve the highest satisfaction with mIOLs.