George O. Waring IV, MD, FACS, speaks with Dagny C. Zhu, MD, about refractive lens exchange and her same-day bilateral refractive lens exchange workflow in an office-based surgery setting. Dr. Zhu discusses how refractive lens exchange fits into her cash-pay refractive practice, how her team screens and evaluates candidates, and the steps involved when patients proceed from consultation to surgery on the same day. She also shares her approach to diagnostic testing, patient counseling, premium IOL selection, oral sedation, femtosecond laser sequencing, refractive accuracy, and IOL calculations in eyes with a history of corneal refractive surgery.