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INNOVATIONS IN LENSES
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96 | EYEWORLD | APRIL 2019
is a deal killer. The real goal is plano unless a
mini-monovision effect is desired. Of course,
mild PCO must be evaluated and managed as
well.
"For the truly unhappy patient there may
be no alternative other than explantation for a
monofocal IOL," he concluded.
"While no IOL is perfect, EDOF IOLs rep-
resent a major step forward in our efforts to treat
presbyopia," Dr. Chang said. "They have given
me the confidence to offer a surgical solution for
presbyopia in a majority of my patients. When
used wisely and in conjunction with high-quality
multifocal IOLs that minimize optical aberrations,
EDOF IOLs make many of my patients very
happy."
it is generally not a quality of visual acuity issue in
the long term from any permanent waxiness, but
from night vision-related concerns or the need for
some reading glasses for near vision. Preoperative
chair time to set these expectations is essential in
the process."
In Dr. Loden's experience, residual refractive
error is the main source of postop unhappiness.
Residual sphere and cylinder as low as 0.25 D, he
said, can affect patients. "I have seen patients with
refractions of +0.25–0.50 @180 with dramatic
resolution of symptoms when trial framed," he
said. "This patient then needs PRK/LASIK or to
accept spectacles on a part-time basis. Cylinder of
0.75 D or greater is a near 100% need for PRK/
LASIK in my practice. Sphere of +0.50 or greater
Slit lamp photo of a Tecnis Symfony EDOF IOL
Source: Daniel Chang, MD
continued from page 95
Financial interests
Chang: AcuFocus, Johnson &
Johnson Vision
Loden: Johnson & Johnson Vision
Wong: Johnson & Johnson Vision
Yeu: Alcon, Johnson & Johnson
Vision, Carl Zeiss Meditec
