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Indication multifocal IOL in very high hyperopia is a challange. The accuracy and the effectivity of the MIOL are unpredictable. The combination of 2 Lenses per eye improve the accuracy and is reversible.

A clear lens has many physical advantages that help to perform the extraction safer and easier than in the routine cataract extraction. A surgeon adapting his technique for CLE without phacoemulsification profits from these advantages.

A capsule phymosis caused late decentration of a MIOL. Technique of recentration is explained.

A 13 mm 1-piece trifocal IOL may be implanted safely in the sulcus in case of posterior capsule tear. Surgical technique is presented.

A capsular anterior tear may expand over night posteriorly, causing subluxation of a in-the-bag IOL or even worse. In case of a radial tear possibly extending to capsule equator it would be safer to implant a larger sulcus IOL as primary procedure. Explanting an IOL already implanted in the torn capsule may be done safely by rolling it in the AC, without widening the tunnel or cutting the IOL. Surgical technique is presented.

The loading of the flimzy collamer ICL needs experiance and strong nerves. Several techniques are shown.

A mature cataract surgery with pseudoexfoliation may be complicated by zonule weakness and small pupil. Certain methods are shown to reduce the risk, but the risk can not be fully eliminated.

Cataract surgery in pseudoexfoliation risk not only zonulolysis and glaucoma but also a small pupil during surgery. Principles of intra-operative pupil expantion are demonstrated.

10 years after successful myopic LASIK a 40 y.o. female patient appeared with an irregular astigmatism, both refractive and topographic. The differential diagnosis included a surprising cause. Diagnosis and treatment are presented.