EW
FEATURE
51
The patient education process is
also the time to broach the possibil-
ity
of post-op LVC, Dr. Waltz said.
"When you do RLE, you have to
have the ability to do LVC or be pre-
pared to farm it out because the pre-
cision with RLE is not as great as
with the laser," he said.
Problem solving for a
55-year-old emmetrope
Although many surgeons agree that
RLE is great for a hyperopic presby-
ope and can be an option for my-
opes, the tough case to treat may be
that of a 55-year-old emmetrope—
this is the kind of patient who Dr.
Hovanesian said should walk into
practices with a big warning sign.
"You could do RLE in this pa-
tient, but it would be more contro-
versial," Dr. Waltz said. "If you are
starting with an emmetrope, that
patient is more difficult to make
happy."
"This patient may see that tech-
nology doesn't match Mother Na-
ture," Dr. Chu said.
If there is no lens opacity, Dr.
Hovanesian would recommend
monovision LASIK for the patient.
"The problem is that this patient is
very spoiled with distance vision,
and he or she may want better read-
ing vision. You have to help the pa-
tient understand the limitations.
The patient might be very unhappy
from dysphotopsias from a multifo-
cal IOL and may be underwhelmed
by the near vision limitations of ap-
proved accommodative lenses," he
said.
If the emmetrope has no other
signs of intraocular pathology, Dr.
Chu will encourage the patient to
hold off on surgery and educate him
or her about other technology cur-
rently available or becoming avail-
able, such as corneal inlays.
If this particular patient insists
on a surgical option, physicians
should emphasize pre-op education
and provide realistic expectations,
Dr. Packer said.
EW
Editors' note: Dr. Chu has financial in-
terests with Abbott Medical Optics
(AMO, Santa Ana, Calif.) and Bausch
& Lomb (Rochester, N.Y.). Dr. Durrie
has financial interests with AMO
and Alcon (Fort Worth, Texas). Dr.
Hovanesian has financial interests with
AMO and Bausch & Lomb. Dr. Packer
has financial interests with AMO and
Bausch & Lomb. Dr. Waltz has a
financial
interest with AMO.
Contact information
Chu: 952-835-0965, yrchu@chuvision.com
Durrie: 913-491-3737,
ddurrie@durrievision.com
Hovanesian: drhovanesian@harvardeye.com
Packer:
541-687-2110,
mpacker@finemd.com
Waltz: 317-845-9488, klwaltz@aol.com
February 2011
June 2011 PRESBYOPIA
Now available
www.EyeWorld.org/ascrsamolivesurgery2011
High Definition Live Surgery
from the 2011 ASCRS•ASOA Symposium and Congress
Innovating Refractive Cataract Surgery with
the Micro-Implantation Cataract Suite
Program Moderator: Richard L. Lindstrom, MD
Operating Surgeon: Kerry K. Assil, MD
Faculty: David F. Chang, MD
Randall J. Olson, MD
Mark Packer, MD
Roger R. Steinert, MD
2011.05.19-CT3456
