EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1186984
I DECEMBER 2019 | EYEWORLD | 53 er, he noted, two problems with this are that people spend a lot of time on how the contact feels rather than the vision. If somebody likes the contact lens trial, they'll like blended vision LASIK, but if they don't like con- tact lens trial, they'll still probably like blended vision LASIK, as a few days isn't neces- sarily enough time to determine if you're going to blend it with your vision, he said. The presbyopic age is complex, Dr. Rebenitsch said, so he recommended careful ocular analysis. We want to make sure the macula is healthy without early AMD or epiretinal membrane, he said, adding that it's also important to look for the ocular surface disease. "For anyone who has poor ocular surface, blended vision is even more likely to cause blurry, fluctuating vision," he said, adding that he will treat the ocular surface first, if needed, and likely recommend a lens- based option instead. Dr. Baartman will always personally perform a precision refraction at distance and show non-emmetropic patients what their best-corrected vision can be with both eyes at distance. It's important for patients to understand the limitations their own eyes are setting, Dr. Baartman said. "With loose lenses, I'll then add power to their non-dominant eye until they love the monocular near vision and then show them what it looks like with optimal monovision correction at both distance and near," he said. added. It's also important to counsel patients about the adaptation period. Any preoperative testing that is special to these patients? Determining the dominant eye is really import- ant, Dr. Kugler said, even though he believes patients still tolerate it well if you make the dominant eye near. "We'll certainly use contact lens trials in certain situations," he said. Howev- continued on page 54 Dr. Rebenitsch's practice simulates monovision by adding plus in the nondominant eye until the patient loses stereopsis. Source: Luke Rebenitsch, MD About the doctors Brandon Baartman, MD Vance Thompson Vision Sioux Falls, South Dakota Lance Kugler, MD, PCEO Kugler Vision Omaha, Nebraska Luke Rebenitsch, MD ClearSight Center Oklahoma City