Eyeworld

69 November 2018 EW MEETING REPORTER an IOL option and ultimately having a happy patient. Editors' note: Dr. Lee has financial in- terests with Allergan (Dublin, Ireland). Maximizing outcomes and managing patient expectations after cataract surgery Amy Lin, MD, Salt Lake City, shared tips for how to approach the unhap- py postoperative patient when the outcome falls short of expectations. You may encounter these patients in cases where you were not the sur- geon and the patient wants a second opinion, she said, or when you were the surgeon. In cases when you were not the surgeon, Dr. Lin said that one of the most important things is not to blame the surgeon, regardless of your personal views. You can explain that complications are part of the risk of surgery, she said, and explain that people react differently to sur- gery and heal differently. Asking for the patient's records is another way to continue helping that patient. Meanwhile, if you're dealing with an unhappy postoperative patient when you were the surgeon, Dr. Lin said that preoperative coun- seling is very important. She said she never guarantees a good result, and it's important to have proper informed consent. Dr. Lin added that you should disclose any mistake or complications and discuss with the patient that it's possible that unexpected events can happen, and it's not necessarily anyone's fault. Dr. Lin said it's also important to be available to the patient, to be an advocate for the patient, and to be open to a second opinion. She added that you may consider con- tacting risk management, depending on the case. is to express meibum and what the quality of the meibum is. Dr. Lee said that in his practice, meibomian gland disease manage- ment is mostly individualized. He said it's important to use a variety of tools, to squeeze the lids, and to look at the quality of oil. When making a diagnosis, Dr. Lee said that TBUT, rosacea, the quality of the lids, and quality of eyelashes may all be factors. Dr. Farid stressed the impor- tance of patient education, particu- larly noting the number of patients she sees who do not routinely remove their makeup, which can become a problem. Editors' note: The panelists have finan- cial interests with a number of ophthal- mic companies. Incorporating presbyopia- correcting IOLs into practice A late morning session on Saturday focused on presbyopia-correcting IOLs. Dr. Lee highlighted some of the patient considerations for ad- vanced technology IOLs. He present- ed several cases, dissecting certain factors that may or may not make a patient an ideal candidate for this technology. He also offered char- acteristics of "the ideal candidate": hyperopic, healthy ocular surface, little to no astigmatism (or regular astigmatism), an easy-going and pos- itive personality, tolerant to using glasses to some degree after surgery, tolerant to some dysphotopsia, and tall with long arms. However, Dr. Lee did note that it's unlikely you will encounter a completely perfect candidate. He also noted that having the patient fill out a questionnaire, obtaining biometry and topography, performing an exam, and under- standing the patient's expectations and goals are key steps in choosing continued on page 72

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