Dr. Eric Donnenfeld shares practice tips for premium IOL patients in a discussion with refractive editor Dr. David Goldman. Some key points: Premium IOL patients need premium care including premium pre-op evaluation. Careful attention needs to be given to the tear film, ocular surface (staining methods), and eyelid margins. His patients receive a full retinal exam including OCT and corneal topography mapping. This data may influence which IOL to use. Pearls on how to manage epiretinal membrane and cystoid macular edema risk in the premium or multi-focal IOL setting and the use of pre-op NSAIDs. Dry eye management in premium multi-focal IOL patients. Topical cyclosporin treatment regimen for multi-focal IOL patients. Research showing that preop use of Restasis in patients without dry-eye yields better quality of vision. Dr. Donnenfeld then discusses his research presented at this year's ASCRS meeting regarding argon laser iridoplasty for pupillary aperture centration relative to the lens axis (angle kappa) in multi-focal IOL patients. He then defines his "6 C's method" and the "5's" of the iridoplasty technique. In ReZoom lens patients iridoplasty has a role for the enhancement of near visual acuity by expanding the pupil thereby compensating 2.1mm central visual plane.