Eyeworld

EW REFRACTIVE SURGERY 36 July 2015 conscientious to optimize their eyes and make sure their eyes are the best they can be postoperatively," Dr. Slade said. He expects that practitioners will likely use the ReSTOR 2.5 more frequently than the 3.0. "I think that most people would rather have their near moved out a little bit," he said. "Our expectation is that we're going to start putting this in as our main multifocal." Dr. Slade believes that this will ultimately surpass use of the ReSTOR 3.0. He remains very excited about the future with this new option. If you have just one lens, you're not going to make every patient happy. Now that there's an additional op- tion this should increase the number of contented patients, he thinks. "I always like it when they come up with variations of the product," he said. "I don't know all the ways we will be able to use this new lens yet, but we'll find out." EW Editors' note: Dr. Slade has financial interests with Alcon. Contact information Slade: sgs@visiontexas.com by Maxine Lipner EyeWorld Senior Contributing Writer be worried because they're seeing something you didn't alert them to. However, with the ReSTOR 2.5, Dr. Slade expects that there will be fewer complaints since there are fewer rings and the central zone is larger. "The fewer rings should mean less halos," he said, adding that looking at the FDA results there were fewer halos with this lens than with the 3.0. Practical pearls For the right patient, it is possible to tailor the ReSTOR to their needs. For patients who want more reading vision, give them the 3.0, Dr. Slade noted. "If they say, 'I want to be able to see my cell phone,' then you would give them the 2.5," he said. These lenses are also very sensitive to dry eye, he pointed out. "That needs to be optimized before and after surgery," he said. Residual astigmatism also needs to be addressed, Dr. Slade continued, explaining that the amount of astig- matism that will reduce the vision with a spherical lens will reduce the vision with a ReSTOR lens even more. "You want to be very ReSTOR lens, he said. In addition, as with any of the more complex optics, the rest of the eye has to be in normal condition. Someone who has undergone RK or hyperopic LASIK would not be a good candi- date. "Likewise, you've got to have a good retina," he said. "The rest of the optical system has to be in excel- lent shape to work well with these more complex optics." In addition to medically quali- fying, the patient needs to have the right kind of personality to deal with the possibility of glare and halos with the multifocal lenses. "If you pick up that the patient would have a problem with that, then that's not a good patient," Dr. Slade said. "If the patient has a very demanding night vision job, that might not be the best person for a ReSTOR." You want to make sure patients understand they might have halos. "There's a level of halos that can be debilitating, but there are also halos that are just noticeable," he said. "You want to make sure the patient is aware that he or she might see halos." You don't want patients to IOL moves the near point out farther T he AcrySof IQ ReSTOR 2.5 (Alcon, Fort Worth, Texas) was granted FDA approval in April as a presbyopia-cor- recting lens, according to Stephen G. Slade, MD, director, Slade & Baker Vision Center and Laser Center of Houston. He views the new lens as a needed one, which builds on what the ReSTOR 3.0 has already done. These lenses have 2 areas of focus, Dr. Slade explained. "The way they originally came out, people had near reading vision and they had distance vision, but they lagged with intermediate vision," he said, adding that for Baby Boomers who want to view their cell phone, laptop, or dashboard, this tends to be more important than reading long novels. "One of the main complaints we had with the ReSTOR (3.0) was that patients missed all of that intermediate," Dr. Slade said. "They love the fact that they can read, but when people come in and say that they want to be able to read without glasses, most of the time what they mean is they want to be able to do their close work without glasses, which is typically [using] intermedi- ate vision." The more tools the practitioner has, the better, he believes. "[The better] you can match the solution to the patient, the happier you're going to make them," Dr. Slade said, explaining that the 2.5 moves the near focal point out a little bit, which is what people want. Happy patients He finds that in general the ReSTOR lens tends to be the best one for those who don't want to wear glass- es. "With a ReSTOR lens we have the best chance of getting rid of glasses," Dr. Slade said. "Our ReSTOR patients are some of our happiest patients for that reason." So if patients express that they don't want to wear glasses, they might be well suited for a Latest ReSTOR lens garners FDA approval AcrySof IQ ReSTOR 2.5 Source: Stephen Slade, MD

• Cover