Eyeworld

63 EW FEATURE March 2019 • Refractive corrections Swan: Russell.swan@vancethompsonvision.com Contact information Gordon: mgordon786@gmail.com Greenwood: Michael.greenwood@vancethompsonvision. com has financial interests with Alcon and Johnson & Johnson. Dr. Swan has financial interests with Alcon, Allergan (Dublin, Ireland), Equinox, and Glau- kos (San Clementine, California). Additionally, Dr. Swan builds a laser fine-tune into the process. "One of the biggest issues that patients can have with these lenses is residual refractive error. If you're not treating that residual refrac- tive error, it's going to be hard to meet patients' expectations. At 3 months after refractive cataract surgery, we do an advanced visual analysis where we bring patients back, dilate their eyes, and look for posterior capsule opacification and check their refractive error. If they have significant refractive error and would benefit from a fine-tune, we'll do a laser fine-tune and get them perfect," he said. "I think that by educating and screening patients well, we can pick up on problems on the front end and achieve success with the lenses that we have today," Dr. Swan said. Dr. Greenwood agreed. "We dis- cuss that cataract surgery is a multi- step process. The first step is taking out the cataract and putting in a new lens. The second step is remov- ing any capsule opacity, if any oc- curs during the healing phase. Then, if there's any leftover refractive error, whether it's sphere or cylinder, we need to fine-tune that, usually with LASIK or PRK. Once we've done all of that, it can take a little time for neural adaptation to occur. We let them know that it's a journey, and there's no magic bullet," he said. Dr. Greenwood thinks that the popularity of premium lenses will continue to increase as surgeons become more comfortable implant- ing them. "The technology has advanced so much just in the past 5 years that surgeons have more confidence in using these lenses because they perform a little bit better, especially with the advent of the low add multifocals and extend- ed depth of focus lenses. As patients keep demanding more, surgeons keep pushing for more, and industry keeps developing more, I think more patients will ask for them. As the technology gets better, the margin of error gets a little more forgiving, and that's why we're able to have more success with these lenses in more patients," he concluded. EW Editors' note: Dr. Gordon has financial interests with Alcon. Dr. Greenwood

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