should be performed as soon as possible after the primary surgery to avoid manip-
ulation in the capsule with abundant fibrosis. Although it is recommended to
recenter the lens in the first months after primary surgery, it has been reported
that the lens can be safely repositioned even 15 months after its implantation.^13
5 Multifocal Intraocular Lenses
First IOLs successfully dealing with presbyopia, named multifocal lenses, were
launched on the market in the early 1980s. They were the first step towards full
vision correction after cataract surgery. These lenses, due to their design, were able
to provide patients with good near vision even without the use of spectacles, thus
correcting presbyopia.^14 First generations of multifocal IOLs were designed to have
different refractive power in the central zone and toward periphery, producing in
this manner several foci. The main disadvantage of first multifocal IOLs was their
Fig. 4 Patient aged 56, after refractive lens exchange and bilaterally implanted trifocal toric IOLs,
in a primary position (left) and with a dilated pupil (right). Visual acuity in both eyes is 100 % for
distance, intermediate (80 cm), and near without any spectacles
(^13) Brandlhuber et al. ( 2014 ).
(^14) Barisˇic ́et al. ( 2008 ).
Implantation of Toric Intraocular Lenses: Personalized Surgery on the Lens 237