Presbyopia surgery is a compensation option which aims at creating an increased depth of field. Monovision preserves a good close-vision quality for myopes. Multifocality is well tolerated by hyperopes if it is compatible with good far-vision quality. Conductive keratoplasty and Lasik multifocal ablation patterns are newly emerging methods. Monovision and multifocality can be applied to surgery by using corneal or intraocular implantation techniques. Multifocal intraocular lenses (IOLs) are growing in popularity among patients and surgeons, and opened the way to refractive lens exchange. Still they are not used routinely in cataract surgery, for reasons probably connected to the frequently observed reduction in contrast sensitivity. Accommodative IOL provides new method to compensate accommodation of presbyopes. Indications depend on preoperative ametropia, patient age and visual needs.