Eyeworld

SPECIAL REPORT Introduction The current state of cataract care allows both physicians and patients to choose from a wide spectrum of available options. These options extend from the use of standard cataract extraction coupled with the use of glasses and/or contact lenses, to astigmatism management with limbal relaxing incisions (LRIs), laser vision correction (LVC), toric IOLs, and monovision or the use of presbyopia-correcting IOLs. Each of these options is associated with varying material, diagnostic and time commitment costs, and each has the potential to provide a unique solution for lifestyles and visual demands. Premium intraocular lenses (IOLs, toric, multifocal, "accommo- dating"), therefore, have become an integral part of the practice of ophthalmology, regardless of the location or size of the practice. This article will provide a basic framework for ophthalmolo- gists "who are sitting on the sidelines" with regard to premium IOLs. The framework is not to be taken as a best practice guide or definitive advice and reflects opinions of members of the com- prehensive ophthalmology clinical committee and community ophthalmologists. For in depth information, one can consult with experienced colleagues, attend meetings, and review text- books. This article will underscore the fact that ophthalmologists can have a rewarding experi- ence with premium IOLs irrespective of their surgical volume. We have asked a number of comprehensive ophthalmologists with low-, medium-, and high-volume cataract practices, who have been successful with premium IOLs, to participate in the preparation of this article in an effort to assist those surgeons who have resisted using premium intraocular lenses because of concerns of how to get started. The choice to offer premium IOLs in a surgeon's practice should not be dictated by the vol- ume of surgery, but rather by the preparation and comfort level of each individual practitioner. In other words, you do not have to be a high-volume cataract surgeon to implant premium IOLs. Indeed, the surgeon who is willing to spend time educating patients both before and after surgery is likely to have success with premium IOLs. Nothing should be daunting about premium lenses. The only challenge is that patient ex- pectations have been raised regardless of whether premium lenses are used or not. We all have patients now who expect to see without glasses following cataract surgery, whether they have had a premium lens implanted or not. Comprehensive Clinical Commitee report Premium intraocular lenses ASCRS Comprehensive Clinical Commitee Emmett Carpel, M.D. Bernard Milstein, M.D. Gary Foster, M.D. Uday Devgan, M.D. Bonnie An Henderson, M.D. Arthur Benjamin, M.D. Bhavna Sheth, M.D. John Polansky, M.D. Michael Oats, M.D. Alan Crandall, M.D.

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