Eyeworld

Editors' note: Drs. Dugel and Regillo have no financial interests related to this article. Dr. Heier has financial interests with Heidelberg (Heidelberg, Germany) and Optos (Dunfermline, Scotland). Contact information Dugel: pdugel@gmail.com Heier: jsheier@eyeboston.com Regillo: cregillo@aol.com The final reason he cited as to why it is important to conduct an OCT prior to surgery is because of extremely high patient expectations with these premium lenses. Patients will have certain expectations if they are paying a significant amount of money, he said. Is a careful 90 D or fundus contact lens exam sufficient? Although it may also be important to perform a 90 D exam, this does not substitute for a preoperative OCT. Dr. Dugel said the resolution would not be sufficient, as an OCT is much better. Dr. Regillo said that no lens- based examination is as sensitive as a spectral domain OCT when looking for preexisting retinal con- ditions. A 90 D exam certainly is not adequate, Dr. Heier said. Even as a retina specialist, he said he is some- times fooled by a relatively normal appearing macula, and an OCT can show this more significantly. "A contact lens exam is a little more helpful than a straightforward 90 D exam," he said. However, he said contact lens exams are not done that frequently and do not measure up to the effectiveness of a spectral domain OCT. How should these exams be charged? Dr. Heier said he would leave the specifics of extra charges to the reim- bursement experts. "If no disease is present, I would think that this should be packaged into the cost of the multifocal IOL," he said. If dis- ease is present, then the OCT can be charged with the uncovered disease as the reason. Some of the most unhappy pa- tients after cataract surgery are those with mild to moderate underlying retinal disease that was likely present prior to surgery but not diagnosed. It is vital to identify this problem prior to surgery. However, the pa- tient should be prepared to pay out of pocket for testing if no pathology is found, Dr. Regillo said. EW Be Part of WOC2016! • Submit an Abstract to present at one of the most prestigious and long-running international ophthalmic congresses in the world. • Participate in sessions with new interactive formats such as: Clinical Interest Grouops (CIGs), Debates, and Case Presentations. • Network with more than 7,000 ophthalmologists from over 120 countries. • Learn about the latest products and services in ophthalmology from over 100 exhibiting companies. • Visit beautiful Guadalajara, Mexico. /attendwoc /attendwoc World Ophthalmology Congress ® of the International Council of Ophthalmology Host: Mexican Society of Ophthalmology Co-host: Pan-American Association of Ophthalmology Early Registration Deadline April 15: woc2016.org Abstract Submission Deadline June 1: wocabstracts.org 133 EW RETINA March 2015

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