EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1400530
SEPTEMBER 2021 | EYEWORLD | 51 C Dr. Naids noted the importance of having an excellent support staff when doing these cases. You have to have a close team of optome- trists and ophthalmologists working together on this, he said, because patients will spend about 2 hours in the office for each treatment. seemed a little more comfortable wearing the glasses at home rather than the workplace. "We talk about how much work is involved on their end," he said. "Then we talk about how that is all for long-term gain. In general cases, accuracy is around 60–70%, but now we're upward of 90%," he said. "With every cataract consultation that comes through the doors, we're always getting biometry and topography," Dr. Ristvedt said. "We make sure that we're honing in on tech- nologies where we can start to sort out who are good candidates for different refractive IOL technologies." She added that she likes to look at the ocular surface and do an osmolarity test, helping identify dry eye, corneal irregularities, higher order aberrations, etc. "The patient can become confused if we give them too many options," Dr. Ristvedt said. She likes to keep it simple and ask the patient "How do you want to use your vision?" This helps determine if the patient wants to wear glasses or be less dependent or if the patient prefers to see at distance; distance and interme- diate; or distance, intermediate, and near. "I've found that with the LAL, I'm using it on patients who want good distance or to correct astigmatism." When talking to patients about the LAL, Dr. Chang compares it to putting a golf ball, explaining that IOL power selection requires assumptions and estimates, and he cannot guarantee hitting the target with a single putt. "The LAL gives me three putts, which effectively allows us to also change the target (e.g., the amount of myopia in the second eye) based on the patient's postoperative experience and function," he said. Workflow challenges and differences from other IOLs One major difference that Dr. Chang explained is that he offers every bilateral LAL patient the option of immediate sequential bilateral cata- ract surgery (ISBCS). "By adjusting both eyes simultaneously postoperatively, they are typi- cally returning the same number of times that immediate sequential patients are for non-ad- justable IOLs," he said. continued on page 52 Dr. Naids uses the Light Delivery Device. Source: Steven Naids, MD