[Indications and contraindications for implantation of bifocal intraocular lenses]

Bifocal intraocular lenses (BIOLs) performed satisfactorily in a certain number of patients only. This paper therefore provides an overview of the indications and contraindications of BIOLs.

BIOLs are indicated in younger and active patients without ocular pathologies. BIOLs should be implanted bilaterally, corneal astigmatism should be less than 1 dpt, emmetropia should be the target refraction, pupil size and responsiveness must be normal, and IOL decentration should be avoided.

Corneal astigmatism in excess of 1 dpt, very small or atonic pupils, ocular pathologies, and a monofocal fellow eye are definite contraindications. In addition, BIOLs are contraindicated in patients who require maximum resolution at low contrast. Relative contraindications include very old patients, eyes with an axial length of more than 24.5 mm or less than 22 mm, and patients who may not tolerate the visual side effects (halos, glare).