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    Patient expectations high as level of surgery advances

    Samuel Masket, MD, challenges young U.S. physicians to further the state of anterior segment eye surgery


    I try to ascertain where they sit on that balance beam. Are they more motivated by vision quality, or are they more concerned with the convenience of spectacle independence?

    Unfortunately, we cannot always give high levels of quality as well as spectacle independence. I make certain the patient understands this concept. Some patients absolutely abhor the concept of wearing spectacles, and others are very particular about their ability to see fine detail. Most patients lie somewhere in between and our task is to figure out where they fit in the mix. As I explain, unlike purchasing shoes or clothing, one cannot “try on” an IOL.

    Dr. Noreika: Is this something that you do or something you delegate?

    Dr. Masket: Decision making regarding the IOL, in my view, is something that the surgeon should do.

    Dr. Noreika: What technologies do you use to assess cataract surgery candidates preoperatively?

    Dr. Masket: It’s important to consider the patient’s lifestyle and for what tasks they prefer or require spectacle independence, whether they drive or fly for a living, etc. In addition to a comprehensive eye exam we evaluate corneal topography, evaluating the corneal surface and corneal astigmatism; I also use the OPD to evaluate higher-order aberrations.

    If there is any suspicion about the appearance of the optic nerve or macular region, we perform optical coherence tomography. I am very cautious regarding macular health before choosing an IOL.


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