[Evidence-based approach for premium intraocular lenses: management of postoperative dissatisfaction]

The majority of patients report a high degree of satisfaction after implantation of premium intraocular lenses (IOL); however, cases of postoperative dissatisfaction occasionally occur. The most frequent symptoms are blurred vision and dysphotopsia. The possible causes include a deviation of the target refraction, cystoid macular edema, dry eye, secondary cataract, decentration of the IOL and a large pupil size. A standardized evaluation can help to identify the possible cause and to initiate an adequate treatment when a pathology has been identified. If the complaints are inherent to the IOL optics, an exchange of the IOL is available as a last resort.