Implanting premium intraocular lenses (IOLs) such as multifocal (MF) and extended depth-of-focus (EDOF) IOLs after crystalline lens extraction is gaining more popularity day by day. Although these lenses are considered to provide good vision and spectacle independence, some patients end up dissatisfied after their implantation. Neuroadaptation plays a key role in such cases. When implanting a MF IOL, various factors can alter the neuroadaptation process to this IOL and eventually the final outcome. Neuroadaptation depends on the patient’s personality, lifestyle, expectations, age, and clinical condition. That is why it is essential to wisely select the candidate and the best IOL for him. However, when neuroadaptation failure happens and other management techniques fail, IOL explantation may be the only reasonable solution in such cases. MF IOL can be exchanged with another MF IOL of different technology or with a monofocal IOL, depending on each case.