Eyeworld

HIGHLIGHTS FROM THE 2025 ASCRS CLINICAL SURVEY Presbyopia Correction Survey respondents indicated the percentage of their current cataract procedures that in- volve presbyopia-correcting IOLs, with a mix of responses. Of the 981 respondents, 17% use these IOLs in 1–5 % of patients; 28% use them in 6–15% of patients; 21% use them in 16–35% of patients; and 13% use them in greater than 35%. Twenty-one percent of respondents do not use these lenses, most of whom have no plans to integrate them in the future. On average, 19% of cataract procedures involve presbyopia-correct- ing IOLs. Compared to other surveys on presby- opia-correcting IOL use, this seems surprisingly high but encouraging. We should be careful to differentiate true presbyopia-correcting tech- nology from other cash-paying procedures, including monofocal toric IOLs, femtosecond laser-assisted cataract surgery, and adjustable IOL technology. Ideally, presbyopia correction is performed in 100% of eyes because there is a risk of presbyopia with every lens extracted. Survey respondents also commented on pri- mary reasons for not using presbyopia-correcting IOL procedures. These reasons can be broken down to two basic things: cost and outcomes. While cost remains a true and significant barrier for some, it ultimately comes down to the per- ceived value of presbyopia correction. The per- ceived value depends on the outcomes that we can deliver. These fall into three categories: vi- sual quality, visual range, and visual symptoms. I'm surprised that issues such as dysphotopsia and chair time were not mentioned, but all of these outcomes depend on our ability to hit the refractive target, so tolerance to refractive error becomes important as well. Respondents also indicated the percent- age of presbyopia-correcting lenses (implanted within the last 2 years) where they've had to manage issues related to patient dissatisfaction. I was pleasantly surprised at how low response rates were relating to patient dissatisfaction. As technology improves, fewer issues arise. We're continuing to improve, making more patients happy, which means less chair time and more surgeon confidence. Having the office team fully on board to help with these technologies is key. ASCRS is committed to helping surgeons and our teams to be better in all of these areas. —Daniel Chang, MD ASCRS Refractive Surgery Clinical Committee Chair pq Statistically significant difference between segments n=981 What percentage of your current cataract procedures involve presbyopia-correcting IOLs? AVERAGE PROCEDURES BY SEGMENT 2025 Practice location U.S. 18% International 19% Years in practice Early stage (0–5 years) 15% Mid-stage (6–10 years) 21% Late stage (11+ years) 20% Perform majority of surgeries in Hospital outpatient department 16% Office 21% Gender Male 18% Female 19% 19% Average cataract procedures involving presbyopia- correcting IOLs 4% None, but plan to integrate in the next 12 months 17% None, and I have no plans to integrate 1–5% 17% 28% 6–15% 13% >35% 21% 16–35% Based on those who are not currently performing presbyopia-correcting IOLs (22%) n=214 What are your primary reasons for not performing any/additional presbyopia-correcting IOL procedures? (Select all that apply) 7% Concern over inadequate unaided distance vision 6% Prevalence of ocular comorbidities 4% Concern over inadequate unaided near vision 1% Concern over inadequate unaided intermediate vision 67% Other Lack of accessibility to laser vision correction to correct residual error 10% 9% I do not always present the option because I do not think patients will want to pay out of pocket 7% I'd like to present the option, but my patients cannot afford the additional cost 8% Concern over quality vision Based on those who are currently performing presbyopia-correcting IOLs (78%) n=767 Of the presbyopia-correcting lenses that you have implanted within the last 2 years, what percentage have you had to manage issues related to patient dissatisfaction with their outcomes (including the need for optical correction, refractive enhancement, visual disturbances from ocular surface disease, need for explantation, etc.)? AVERAGE BY SEGMENT 2025 Practice location U.S. 4% International 4% Years in practice Early stage (0–5 years) 5% Mid-stage (6–10 years) 5% Late stage (11+ years) 4% Perform majority of surgeries in Hospital outpatient department 4% Office 5% Gender Male 5% Female 4% 1% >20% 0–1% 28% 42% 2–5% 4% 11–20% 25% 6–10% 5% Average presbyopia-correcting lenses implanted needing postop management

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