EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/129516
May 2013 EW CATARACT 31 Device focus Contact lens trials in (potential) premium IOL patients by Michelle Dalton EyeWorld Contributing Writer Is it worth it? A diagnostic test that can definitively determine which patients will be successful with premium lenses and which will not is still a pipedream. In the interim, ophthalmologists use a variety of methods to attempt to determine which patients will be satisfied and which will end up unhappy. Multifocal contact lens trials can be useful in determining who will readily adapt to multifocal IOLs, but only if the patient has worn these types of lenses in the past and does not yet have a visually significant cataract. "If a potential patient hasn't tried multifocal contact lenses, there's not much value in a clinical trial if they have a visually significant cataract as the blur from the cataract will make the vision unsatisfactory," said Richard Tipperman, MD, attending surgeon, Wills Eye Institute, Philadelphia. There is not yet a diffractive multifocal contact lens "that matches the optics of the multifocal implants we have closely enough for direct comparison," said Steve Safran, MD, in private practice, Lawrenceville, N.J. Plus, Dr. Safran believes there is "significant neuroadaptation and a contact lens trial might take a while." He said that the main reason not to use multifocal contact lens trials is because of the presence of a cataract. "Patients can't see well because of the cataract so it doesn't have any predictive value under those circumstances." Dr. Safran stated that he sometimes does clear lens extraction, but rarely uses a multifocal implant under those circumstances. Since his patients would not see well without the initial cataract being removed, continued on page 32