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    How to manage patient’s IOL expectations pre-operatively


    Preoperative considerations

    Lifestyle factors are important when choosing the proper IOL. “Find out what patients value most in vision–i.e., distance, intermediate, near–and determine the ocular dominance with plano the goal,” Dr. Braga-Mele explained. “Surgeons need to discuss astigmatism and the impact it has on vision postoperatively. Is the patient using monovision or multifocal contact lenses? Of utmost importance are the work and play activities that patients engage in and their visual needs in relation to them.”

    Detailed communications between the patient and surgeon must occur to discuss all potential visual outcomes, which include informing the patient about the postoperative presence of glare and/or halo with some multifocal IOLs. These might improve with EDOF IOLs and low add powers.

    Patients might not want to hear that they may not be totally spectacle independent postoperatively. However, explaining that before surgery results in fewer problems postoperatively. Patients also should be informed that a second procedure might be required, although in most cases that is unlikely.

    “Every patient deserves to be informed of all available options whether you do it or not,” Dr. Braga-Mele said. “Obtaining informed consent to undergo any procedure should not be overlooked. Give them time to digest all of the information. The final choice of an IOL then can be made at the next visit or during a phone call.”


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