Eyeworld

58 | EYEWORLD | DECEMBER 2022 R EFRACTIVE Contact Schoenberg: evan.schoenberg@ gaeyepartners.com Shamie: ns@maloneyshamie.com Walton: drwalton@visiontexas.com Williamson: blakewilliamson@weceye.com Zaldivar: zaldivarroger@gmail.com He added that for cataract surgeons and refractive surgeons who are new to the ICL, it's important to make sure the lens unfolds right side up, with a right-sided leading corner aque- ous port. He also said to be gentle, and don't chase bubbles at the end without viscoelastic in the eye, since a chamber collapse could result in touching the anterior capsule. In terms of refractive predictability, Dr. Zaldivar considers the ICL among the most predictable refractive procedure available, with 98.4% within 0.5 D of target. "In our hands, it has the highest level of satisfaction, with 99% of patients extremely satisfied," he said. "Given the significant improvements in vision and quality of life made possible by the ICL, and the high degree of patient satisfaction, I think the benefits of ICL implantation out- weigh the risks," he said. Dr. Zaldivar said the surgery is faster than before, taking 4.5 minutes per eye in his hands. "I always check patients' vault with intraoper- ative OCT, and I rotate the lens 90 degrees to decrease vault in the vertical meridian in cases of excessive vault," he said. If you don't have intraoperative OCT, check the patient at the slit lamp right after the procedure, Dr. Zaldivar said. Since the launch of the EVO ICL, he has aban- doned the use of acetylcholine after the pro- cedure and checks every patient's IOP 4 hours after the procedure. Results Dr. Williamson said it's rare to have a patient who isn't better than 20/20 postop. "It seems like everyone bilaterally is 20/20, and the ma- jority are better than 20/20. It has restored that 'wow' factor," he said. "Most of these patients have been told that there's nothing that can be done for them, so to tell them that there's something we can do and have them seeing better than 20/20 hours after the procedure is life changing. "I think my EVO ICL patients are happier, that makes me happier, and that's why I'm rec- ommending it so much more," Dr. Williamson said. He added that it's nice to have an option that avoids the cornea, making a refractive procedure available to patients who might have a "suspicious cornea." Dr. Schoenberg has been impressed so far with results and said that patients are thrilled as well. "I think the vision quality is very good. The reliability of the lens is excellent," he said. "I love LASIK, but the more treatment you do, the less precise your treatment becomes. With the ICL, the surgery is the same whether you're treating –3 or –16, so there's a tight response curve." The one thing that can throw off the results is the glare, and he said he has done one ex- plant due to glare. Dr. Walton has also been having success with the EVO ICL. "The fact that the ICL can coexist in the moderate myopia world with as successful a procedure as modern LASIK speaks to the amazing optics and materials engineer- ing," he said. "In the high myopes who still have accommodation or aren't ready for lens replace- ment, it's a phenomenal way to improve quality of life." continued from page 56 The EVO ICL pre- and post-rotation to 90 degrees Source: Roger Zaldivar, MD

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