Premium IOL's in glaucoma patients: Guidelines from the French Glaucoma Society (SFG) and the Society of the French Intraocular Lens and Refractive Surgery Association

Recent advances in surgical techniques and intraocular lens implants have transformed cataract surgery into a true refractive procedure, enabling many patients to forgo optical correction. “Premium” IOL's offer multiple options for correcting refractive errors, including astigmatism, and addressing the effects of presbyopia. While cataract surgery is often beneficial for glaucoma patients, glaucomatous optic neuropathy can impair visual quality and impact the outcomes of premium IOL's, particularly multifocal IOL's. This concise review provides practical recommendations for the use of premium IOL's based on the type, stage and progression profile of glaucoma, supported by current scientific data. Monofocal toric IOL's may be considered to correct astigmatism in glaucoma patients but require careful clinical evaluation. “Monofocal plus” IOL's and certain extended depth of focus (EDOF) IOL's may also be viable options, provided that specific precautions are taken. However, diffractive and refractive multifocal IOL's are not recommended for patients with glaucoma or ocular hypertension with risk factors for development of glaucoma. In conclusion, the indications for premium IOL's in glaucoma patients should include rigorous, individualized selection, along with comprehensive patient counseling.