Enhancements after cataract surgery

PURPOSE OF REVIEW: To provide a review of the recent literature on the indications and results of refractive and nonrefractive enhancements after cataract surgery. RECENT FINDINGS: Laser in-situ keratomileusis proves to be the most accurate procedure to correct residual refractive error after cataract surgery. Other lens-based procedures can be used for the enhancement after cataract surgery but with lower predictability. Depending on the cause of the visual problem, these may be toric intraocular lens (IOL) rotation for excess residual cylinder and IOL exchange for unsatisfied patients with multifocal IOL or for IOL dislocation. SUMMARY: Modern lens removal techniques and advanced preoperative diagnostic methods allow most cataract patients to be spectacle-independent for distance and sometimes also for near. Refractive considerations are integrated into modern cataract surgery and these days, patients expect an adequately predicted refractive outcome. Despite such advances in cataract surgery, unsatisfactory refractive and visual outcomes occasionally occur and in these cases, the enhancement after cataract surgery is required to achieve the best final visual outcome.