Abstract Following cataract surgery in which the target refraction is emmetropia with a monofocal IOL, it has been found that 30–40% of patients achieve functional near vision as well. Further investigation of this outcome has determined that nature has optimized certain ocular parameters to allow this to occur. By understanding these factors, it is possible to plan our refractive outcome to provide similar outcomes for most of our surgical cataract cases. This planning involves measuring the preoperative pupil size and corneal spherical aberrations, using an intraocular lens that does not adjust spherical aberration, and targeting the refractive outcome based on these findings. This approach will be presented in the session.