*3.2.2.1 Clinical factors/exclusion criteria, contraindications*

Before the discussion between patient and surgeon for an eventual pseudophakic presbyopic correction with implantation of a mIOL, a detailed patient history should be taken and a first general ophthalmologic examination (VA, slit-lamp biomicroscopy, IOP measurement) should be performed, which might reveal some clinical parameters that could rule out this type of surgery; among them, significant preexisting ocular pathology that could reduce the postoperative visual outcome, severe untreated dry eye disease, Fuch's endothelial dystrophy or other corneal dystrophies, keratoconus, corneal scars, macular degeneration, diabetic retinopathy or other retinal disease, advanced glaucoma or other optic nerve diseases, and amblyopia. In addition, mIOLs should be avoided in patients with pupillary abnormalities such as corectopia and colobomas, as well as in patients with phacodonesis zonular dialysis or pseudoexfoliation due to the high risk of IOL decentration [61, 64].
