Eyeworld

EW CATARACT 46 by Richard Tipperman, MD What size tire is on your car? A large part of the challenge of using advanced tech- nology IOLs is educating patients about concepts they need to understand in order to make an informed decision about their options. There are numerous resources that practices can utilize including DVDs, websites, handouts, and brochures to help with patient education. However, ultimately this process will include face-to-face time with the surgeon and/or a counselor. They will be speaking directly to the patient. Concepts that we deal with everyday such as loss of accommo- dation, near point with myopia, or binocular balance can be so simple and intuitive to healthcare providers that it can actually be difficult to explain in an effective and timely manner to the patient. In this article I would like to describe some analo- gies and examples that I have found helpful in trying to educate patients about cataract surgery. Tire analogy One of the most common things I discuss everyday is how patients will feel, function, and deal with ocu- lar imbalance when they have had their first eye done. Obviously this is especially important in patients with high levels of ammetropia as they need to understand that if they choose an emmetropic aim for their first eye, they will likely be extreme- ly imbalanced postoperatively; if they are not a contact lens wearer, they will require surgery in their fellow eye to function comfortably. In these cases I say the follow- ing to the patient: "Please don't take this the wrong way, but imagine that you are a car with 2 very old front tires. You're used to how the car drives and it's easy to make the car go straight. Now replace one of the tires with a brand new tire—even though that tire is better, the car is actually harder to drive and harder to keep straight. Finally, imagine if you replace the tire with one of a larger diameter; now the car is even more unbalanced and harder to drive straight, even if the new diameter is a better one for the car." I've found this simple, brief analogy quickly helps patients understand the ocular imbalance they will experience once their first eye undergoes surgery. Knee surgery analogy Another analogy I've found helpful is comparing cataract surgery to knee surgery. One of the difficulties with cataract surgery is patients' expectations that their vision will be "perfect" following surgery. All surgeons have had the experience of explaining preoperatively to patients receiving a monofocal IOL that they will require reading glasses following surgery, only to have the patient postoperatively ask why they cannot see up close. Managing expectations is especially an issue for patients receiving a presbyopia-correcting IOL. Most surgeons will explain to their patients that they may still need glasses for some near activities, but just like with patients receiving monofocal IOLs, patients receiving presbyopia-correcting IOLs can become frustrated at times with their near vision function. I have found this is a challenge especially for pre-presbyopic patients undergoing cataract surgery. Because they have had a full range of accom- modation prior to developing their cataract and undergoing surgery, they can be intolerant of anything less than a "perfect" result. I have found the "skier's knee analogy" helpful for patients who have high visual demands Visit www.owlsite.org for information and to register Developing Leaders. Advancing the Industry. Building Community. Join us in San Diego! OWL • ASPENS Event Friday, April 17 | 5:30 - 7:30 pm Hilton San Diego Bayfront Don't miss the inaugural, collaborative event between Ophthalmic Women Leaders (OWL) and ASPENS. The program will enable networking with women who are advancing the practice and business of ophthalmology and will feature an inspiring, joint speaker program focusing on "Competence, Confidence and Courage". OWL Reception Monday, April 20 | 5:30 - 7:30 pm Join us for OWL's annual reception and award ceremony honoring three outstanding women as recipients of: The Visionary Woman's Award, the Catalyst Award and the Rising Star Award! Included in the evening will be an exciting program revealing the results of the "Women's Leadership Trends" survey that OWL and the Fundingsland Group created. Don't miss hearing the results from this "first-ever" survey reflecting the status of women in the ophthalmic space. OWL Interest Group Programs Visit www.owlsite.org for details on exciting programming hosted by OWL's new interest groups: • Ophthalmic Business Owners (O.B.O.) • Ophthalmic Industry Professionals (O.I.P.) • Professionals In Practice (P.I.P.) • Bright Eyes (B.E.) In addition to benefitting from relevant programs and lively discussions, OWL members will have the opportunity to connect with friends in the industry. Advance registration is required. The art of advanced technology IOLs Richard Tipperman, MD

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