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Let's say that you have a patient who already had cataract surgery more than a year ago. At that time the patient elected to have a monofocal IOL and the patient decided not to treat the pre-existing astigmatism. The patient currently has a refraction of +0.75 -1.50 x 120 which gives 20/20 distance vision. Same in both eyes. But now the patient has decided that she would rather have a trifocal IOL in both eyes, just like her best friend recently received. Would you go back and perform an IOL exchange for this patient? Our guest surgeon agreed to do so, would you? I would probably not and here is why...