Eyeworld

JUNE 2022 | EYEWORLD | 75 R again because that's what they've been all their life, you have to give them that choice," Dr. Braga-Mele said. "If they have astigmatism, it can be unmasked by cataract surgery, too, and patients may be unhappy if you don't offer them an astigmatic choice. Moving forward from that refractive challenge is the challenge of presbyopia-mitigating IOLs. ... We're trying to minimize the need for glasses but not get rid of glasses completely; that's how I tend to explain it to my patients. We can get rid of glasses for 85–90% of their tasks but we're not getting rid of glasses completely." Dr. Braga-Mele said she started with Alcon presbyopia-mitigating IOLs because she liked the consistency she experienced with their other IOLs. She said that when getting into these tech- nologies to choose brands that you're familiar and comfortable with. Even if patients are not a candidate for a presbyopia-mitigating IOL, Dr. Davidson said that it's important to discuss with them and share why you're recommending a specific IOL. "I say it with every patient because I don't want them going home thinking, 'Why didn't he mention it to me?' We had that situation in our practice when ReSTOR [Alcon] first came out. We had a couple of physicians who didn't offer it. We had patients in the waiting room hearing stories, and we had some upset patients because we didn't offer it to them. We now have a policy in our practice … that if you don't feel com- fortable doing a refractive IOL, you need to at least mention it to the patient, and if the patient wants it, you need to refer to another surgeon in the practice who offers this technology." Dr. Davidson further clarified that just because there are several lens options offered at a practice, it still important to come up with a single "best" recommendation because too many choices can be confusing for patients and they look to us as their surgeons for guidance. "It's still my job to recommend a single lens to the patient," he said. Dr. Braga-Mele also said that she educates patients about all the choices that are available, not focusing on brand names but rather help- ing them choose the best visual range for their needs. "Look at the patient, look at their needs and personality, look at their eye anatomy and what's a fit, then offer what's available," she said. Dr. Braga-Mele said that in order to suc- cessfully offer the full range of IOLs, there are certain diagnostic tools that will help ensure continued on page 76

• Cover