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    Formula for achieving successful multifocal IOL outcomes

    Achieving a successful outcome with multifocal intraocular lens (IOL) implantation depends on a careful preoperative evaluation and nailing refractive error correction, said Karolinne M. Rocha, MD, PhD.

    The preoperative evaluation involves gaining an understanding of the patient’s expectations, personality, and visual needs to determine whether the individual is a good candidate for a multifocal IOL and for what technology. A comprehensive ocular examination is also needed with special attention to pathologic conditions that can preclude an optimal visual outcome.

    Because the available multifocal IOLs have different performance characteristics, surgeons need a thorough understanding of the different technologies, explained Dr. Rocha, director of cornea service, Storm Eye Institute, Medical University of South Carolina, Charleston.

    Characterization of the patient’s lifestyle to understand his or her visual needs is important for guiding IOL selection. There are questionnaires available that can help surgeons gather the proper information.

    However, Dr. Rocha cautioned that planning surgery based on the questionnaire responses and patient input does not guarantee good outcomes. She described an experience with her mother as a patient to illustrate this point.

    “My mother completed a few questionnaires and indicated she wanted really good uncorrected visual acuity for distance,” Dr. Rocha explained. “When I followed her around to observe her usual activities, I saw that she was often using her cell phone or a tablet.”

    Anatomical considerations

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