In order to achieve a high level of satisfaction with the quality of vision after implantation of a multifocal IOL in the capsular bag, not all patients are eligible for implantation of this multifocal lens, and patients need to meet a number of conditions. Patients are selected after a rigorous screening process, with all eyes having a preoperative corneal astigmatism of less than 1.5 D. In practice, the surgeon must follow the “4 A’s” principle. First, the patient’s preoperative astigmatism is understood; second, the precise biometry of the axial length and the thickness of the surrounding tissues is performed using immersion ultrasound; then, an appropriate formula is chosen to calculate the IOL; and finally, further adjustments are made based on the astigmatism, biometry, and IOL calculation formula. Successful surgery begins with precise preoperative ocular measurements and an examination of the cornea and macula. Precise small incisions, adjustment of astigmatism and centering of the IOL in the capsular bag are also necessary for a successful procedure. A 5.0mm median annular tear capsule and avoidance of suspensory ligament damage are essential to maintain the centering of the IOL. Multifocal IOLs are also very sensitive to minor postoperative macular edema, which can significantly affect vision and therefore require postoperative NSAIDs to avoid macular cystoid edema and inflammation.