EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/129516
Update on the latest in refractive cataract techniques and technologies 13 following refractive IOL implantation If your "doesn't practice perform PRK or LASIK, establish a relationship with someone in your community who does. " Data on the impact of residual error on patient satisfaction rates from 4,970 eyes implanted with multifocal IOLs Source: Steve Schallhorn, MD than positive reinforcement for refractive IOL use by the surgeon, and similarly turns patient word-ofmouth from positive to neutral or negative. Many cataract surgeons do not have a viable strategy for addressing residual spherical error and astigmatism in their refractive cataract patients. Several factors might potentially inhibit cataract surgeons from referring their patients to colleagues for keratorefractive laser enhancement. One might be the inability to control or specify cost. Another is a concern that patients will perceive that "something went wrong" if they are transferred to another surgeon's care. However, imagine keratorefractive surgeons trying to perform LASIK without the option or ability to enhance the initial result. In my opinion, this is the missing part of many refractive cataract surgeons' armamentarium. If you or someone in your practice doesn't perform PRK or LASIK, then I recommend establishing a relationship with someone in your community who does. Patients must then be prepared up front for the possibility of being referred to that surgeon for an enhancement (along with the estimated cost). References 1. Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009; 35:992-997. 2. de Vries NE, Webers CA, Touwslager WR, et al. Dissatisfaction after implantation of multifocal intraocular lenses. J Cataract Refract Surg. 2011; 37:859-865. 3. Zheleznyak L, Kim MJ, MacRae S, Yoon G. Impact of corneal aberrations on throughfocus image quality of presbyopia-correcting intraocular lenses using an adaptive optics bench system. J Cataract Refract Surg. 2012; 38:1724-1733. Dr. Chang is clinical professor of ophthalmology, University of California, San Francisco, and in private practice, Los Altos, Calif. He can be contacted at 650-948-9123. His consulting fees from Abbott Medical Optics are donated to Project Vision and the Himalayan Cataract Project through the ASCRS Foundation.