/ /

  • linkedin
  • Increase Font
  • Sharebar

    How to manage patient’s IOL expectations pre-operatively


    Patient selection

    When deciding if a particular patient and an IOL are a good fit, the surgeon needs to consider the patient’s personality. First, surgeons should engage with the patient to determine his or her expectations and how much less-than-perfect vision might be tolerable and the patient’s willingness to compromise.

    Ocular health is a primary consideration for IOL candidates because of the impact the presence of retinal, corneal, or the ocular structure might have on IOLs. Are there patients for whom a multifocal or extended-depth-of-focus (EDOF) IOL might be contraindicated? Dr. Braga-Mele asked.

    Surgeons should be alert to the presence of pseudoexfoliation; trauma; small atonic pupils; advanced glaucoma; corneal pathologies, such as epithelial basement membrane dystrophy (EBMD), dry eye disease, Fuchs’ dystrophy, astigmatism, and keratoconus; and retinal diseases, such as age-related macular degeneration and diabetic macular edema.

    Cataract surgery and dry eye: Ocular surface must be optimized pre-operatively for accurate keratometry. (Images courtesy of Rosa Braga-Mele, MD)

    Surgeons also should ask about any previous refractive surgeries that patients might have undergone.

    Regarding dry eye and EBMD, Dr. Braga-Mele emphasized the importance of irregular results on testing, differing K values on different tests, irregular astigmatism, the results of Rose Bengal and lissamine green staining, tear osmolarity exceeding 316 mOsm/L, and topography results, including Placido disc, scanning slit or Scheimpflug photography.


    New Call-to-action


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available


    View Results