DECEMBER 2020 | EYEWORLD | 123
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Relevant disclosures
Osher: None
Parker: None
that he or she may need a thin pair of glasses
after surgery. It's better to under promise and
over deliver," he said.
"I will finish by saying something reassuring
… always try to end on a high note," he said,
such as, "I'm confident that you will be seeing
much better after your surgery."
"I always try to show each patient that I sin-
cerely care and that I plan on doing my best,"
Dr. Osher added.
Unhappy patient
Even if the surgery went perfectly and the
outcome, by quantifiable measurements, was a
success, patients can still be unhappy with the
result.
Dr. Osher reiterated the importance of giv-
ing the patient time, reassurance, and an honest
explanation. He likes to compare unaided vision
in the operated eye to the other; if that isn't
impressive enough, he shows the patient the
preoperative and postoperative lines on the
Snellen vision chart for their comparison.
Dr. Parker said. First, Dr. Parker said the chapter
described talking about how IOLs come in steps,
similar to shoe sizes. The problem is the exact
size of your eye might not be the exact size of
the lens, so you have to choose the closest size,
up or down.
"That inevitably leaves some refractive error
in everyone," Dr. Parker said.
Ophthalmologists should also explain that
the shape and curvature of the eye can influence
the IOL decision, and errors in measurements
can result in a refractive surprise.
In this situation, give the patient hope.
These errors are usually rectified by a simple
additional surgery, Dr. Parker said.
Dr. Osher discussed this situation in his
interview with EyeWorld. He explains to the pa-
tient that IOLs "are made in steps, for example,
+21, +22, and +23. You may need a +22.6
for perfect vision, which isn't made. Therefore,
we err up or down to the nearest available lens,
which may leave a touch of nearsightedness,
farsightedness, or astigmatism," he said.
In addition, Dr. Osher explains to patients
that everyone heals differently and how this can
influence the outcome. "I always tell the patient
continued on page 124
Contact
Osher: RHOsher@cvphealth.com
Parker: jack.parker@gmail.com
