Being human, we don’t always achieve perfection. And even when we do achieve surgical perfection, a significant number of patients are still dissatisfied with their vision following cataract and refractive surgery – particularly patients with multifocal IOLs.
Although several options exist for managing an unhappy patient, I would like to focus on IOL exchange. It is a good option, as it provides the capability to address both errors of refraction and IOL intolerance. But when we are contemplating IOL exchange, we have a dilemma: performing the exchange too early might deprive the patient of the chance to adapt to the lens, but performing it too late increases the possibility of increased surgical complexity due to capsular fibrosis. Ideally, we need a solution without time constraints, and I believe the new generation of multicomponent or modular lenses will give us this capability.
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