Aiming for Emmetropia

When discussing how to achieve emmetropia using lens-based surgery, it is imperative to consider that some patients may need postoperative enhancements. When using multifocal IOLs, the vision is most satisfactory when you hit the target right on because the residual sphere or residual cylinder can affect both the distance and the near acuity. Preoperative planning significantly helps improve the accuracy of targeting, but in some patients you may need to adjust that target postop based upon patient feedback. One important aspect of multifocal IOL implants is trying to achieve maximum visual acuity at various distances. This requires patients to tolerate some loss of contrast at each specific distance.