**7. Multifocal toric IOLs**

Toric designs are even more required in multifocal IOLs [66] because patients undergoing multifocal IOLs may not tolerate residual astigmatism of <1 D, and multifocal IOLs without toric design perform best with less than 0.75 D of cylinder [67].

In previous studies [68–72], toric multifocal IOLs achieved good visual performance, with UDVA better than 20/40 in more than 97% of patients, uncorrected near visual acuity better than 20/40 in 100% of patients, spectacle independence in more than 80% of patients, and residual refractive astigmatism lower than 0.50 D in 38–79% of patients. Toric trifocal IOLs such as a trifocal spherical hydrophilic IOL (FineVision POD F) [73] also showed great performance.

But on the other hand, the selection of multifocal toric IOLs should be more restricted than monofocal toric IOLs, especially for the following candidates: (1) patients who had unrealistic expectations of visual quality when having related ocular comorbidities; (2) patients who may not tolerate dysphoric symptoms such as glare and halos; and (3) patients who had specific contraindications for multifocal IOLs, such as abnormal κ or α angle, etc. Thus, a comprehensive ocular examination should be undertaken to rule out any ocular comorbidities that may interfere with the postoperative outcomes.
