EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1215009
44 | EYEWORLD | MARCH 2020 ATARACT C for those who have done monovision in the past and expressed concerns about night vision and dysphotopsias. Patients with very regular stromal beds post-LASIK or PRK "do quite well with the Symfony lens," Dr. Yeu said. For monovision patients, Dr. Yeu has per- formed modified monovision to maintain dis- tance with monofocal lenses in their dominant eye and an EDOF with a slightly myopic target in the non-dominant eye. Providing pseu- dophakic monovision through placement of an EDOF lens in the non-dominant eye maintains "their monovision with greater stereopsis and greater range of vision," Dr. Yeu said. Although Dr. Clinch's greater experience with EDOF lenses and the visual disturbance profile makes him more comfortable with them, both EDOF and trifocal IOLs have an important place in the patient's decision pro- cess, he said. More "visually discriminating" patients who prefer quality over range may perform better with EDOF IOLs, while those who em- phasize function and have an ability to tolerate visual disturbances may do well with trifocals, Dr. Clinch said. "I will work with them to try to choose the appropriate IOL for their individual needs, but it is impossible to be 100% correct in predict- ing how their brain will process the informa- tion," Dr. Clinch said. "I try to determine if the patient has a 'positive' or 'negative' psycholog- ical outlook and whenever possible get input from family members." Contraindications Dr. Yeu worries about under estimations of adverse effects on postop satisfaction due to marginal ocular surfaces. She prioritizes exam- ining the meibomian gland architecture with infrared meibography preoperatively. "I look carefully at the quality of what is coming out of their meibum, their blink, and what the ocular surface looks like before and after vital dye staining because I know from experience that using a presbyopia-correcting continued from page 43 Tecnis Symfony IOL Source: Daniel Chang, MD PanOptix IOL Source: Eric Donnenfeld, MD