Eyeworld

53 February 2015 EW REFRACTIVE high expectations of patients who have paid for a premium lens or laser cataract surgery. "Even with intraoperative aberrometry, we're hitting about 80% within 0.5 D; with the LAL, it's closer to 95%," he said. Dr. Jones said in his hands, "the LAL surpasses LASIK in terms of refractive accuracy. This should be considered with respect to only correcting sphere and cylinder. Additional corrective capabilities are realistic treatments that should be available as the technology contin- ues to evolve." James Lehmann, MD, in pri- vate practice at Focal Point Vision, San Antonio, is likewise enthusiastic about the IOL's potential. In the current FDA trial, implantation of the LAL has been limited to patients without a history of previous refrac- tive surgery. However, Dr. Lehmann thinks this IOL has great potential in exactly that patient population because "it is in these post-refractive surgery eyes that current formulas fall short and we miss our mark." Dr. Hengerer uses the lens liberally among his cataract patients and "especially for those post-cor- neal refractive surgery like LASIK or PRK. IOL calculation in these eyes is always a challenge for the surgeon, and the expectations of these pa- tients are difficult to fulfill without any postoperative means of refrac- tive shaping." Pros and cons Although the lens has great poten- tial, there are some limitations, Dr. Jones said. "Currently one of the biggest limitations is pupil dilation. You must be able to treat the lens optic and not leave any untreated material in the lens," he said. Other potential areas of concern "can be very acceptable if properly presented to the patient," he said, including why the patient must wear a filtering pair of spectacles until the lock-in appointment. Dr. Wiley was "a little worried" about patient response to the glass- es, but has been pleasantly surprised that no one seems bothered by them. "They just don't seem like an issue for patients," he said, acknowl- edging that may change once the lens is available commercially and not as part of a clinical study. Being able to "try out different refractive situations in daily life while wearing the UV light protect- ing spectacles" makes patients hap- py, Dr. Hengerer said. "They benefit from the precise adjustments within 0.25 D range from target refraction. We can simulate monovision, and Far Intermediate Near TRIFOCAL DIFFRACTIVE TORIC IOL Online FineVision Toric calculator: physioltoric.eu physiol.eu continued on page 54

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