Patient-reported outcome measures after multifocal and extended depth of focus intraocular lens implantation in refractive lens exchange and cataract surgery.

Presbyopia-correcting intraocular lenses (IOLs) represent a fast-growing segment of ophthalmic surgery. The evaluation of lens performance has undergone a fundamental shift: best-corrected visual acuity alone is an insufficient measure of the clinical benefit of premium IOLs, whose true value lies in spectacle independence, visual quality, and visual function in daily activities. In that regard, patient-reported outcome measures (PROMs) are a cornerstone of presbyopia-correcting IOL assessment. This review provides an overview of the current landscape of IOLs, PROM instruments and their limitations, visual function outcomes across IOL types and comorbidities, and future directions. Higher near performance often comes at the cost of greater dysphotopsia, and no single IOL design dominates across all PROM domains. Optimal IOL selection or combination therefore requires identifying which PROM domain matters most to the individual patient. While not absolute contraindications, dry eye disease and prior refractive surgery are the strongest predictors of suboptimal outcomes and therefore warrant careful preoperative consideration. As visual demands increasingly shift toward near and intermediate distances with growing digital device use, clinicians and manufacturers must align IOL design priorities and patient selection with evolving patient needs. The visual function index (VF)-14 questionnaire and most other vision-specific PROM instruments were developed in a pre-digital era and require modernization to remain valid measures of patient success. In an aging active population, multifocal and extended depth of focus IOLs, when matched to the right patients, represent one of surgery's most impactful quality-of-life interventions.