*3.2.2.2 Patient factors/preoperative counseling*

The history taking and the general ophthalmologic examination should be followed by a detailed preoperative counseling. As part of the counseling, each patient should be warned about the risks of the lens extraction surgery, but also for the specific risks of the implantation of a mIOL. The selection of both the proper patient and the proper mIOL results in high patient satisfaction rates. Specifically, the following aspects should be discussed:

The determination of each patient's personality type, lifestyle, hobbies, needs, occupation, and expectations should not be omitted.


vision [64]. In addition, patients who drive at night for long periοds of time should not be considered as good mIOL candidates.


The surgeon should never promise full spectacle independence, but they should explain to patients that there is a good chance that they will not need glasses for the majority of their activities of daily living and that no perfect IOL to simulate their pre-presbyopic continuous vision exists yet [61]. However, spectacles may be needed under highly demanding conditions or during reading under low lighting conditions. Additionally, patients should be counselled about the optimal level and direction of light for easier reading. Finally, patients should be counselled about adverse events including halo, glare, reduced contrast sensitivity as well as discussing neuroadaptation in greater detail [75]. If patients are able to understand all benefits and risks of mIOLs, they could be good candidates to continue the preoperative examination for a potential pseudophakic presbyopic correction with mIOL implantation.
