Eyeworld

45 EW FEATURE December 2015 • Patient satisfaction the postoperative recovery would be, and how long they would have to take some regimen," he said. "Now the first thing they ask, 'Is it possi- ble for me to be spectacle-free after surgery?' and they sometimes come with information about multifocal IOLs or toric IOLs." For the cataract patient today, a lot of time may be spent discuss- ing why it's not possible for them to have a certain IOL. For refractive laser surgery, Dr. Gatinel finds that the preoperative consultation is the most important part of the surgery. "This is the time that you have to train the patient's needs to an achievable goal," he said, adding that this can be time-consuming, particularly when educating pres- byopes. "In presbyopes, you need to cover the fact that they have di- minishment of the accommodation amplitude," he said. "You sometimes have to cover monovision and mul- tifocality, so it's more demanding in terms of time and explanation than with a simple young, myopic situation." When talking to cataract pa- tients, Dr. Gatinel also stresses the potential variability of results. "I explain to them that the IOL power is a prediction and not an exact science because we cannot predict some of the parameters," he said. It's a matter of the uncertainty of the biological system. "We have models and we have calculations, but I tell them that it's more of an IOL power prediction, and they accept any re- fractive surprise better," Dr. Gatinel said. He adapts this talk for refrac- tive patients, explaining that while modern lasers achieve good preci- sion, for patients with a significant amount of astigmatism, it can be difficult to tackle the refractive error because there are more risks that the treatment will not be perfectly delivered. In addition to explaining that it's more difficult, Dr. Gatinel enables them to experience this for themselves. "When they put on their spectacles at a little bit of an angle, they will automatically notice that there is a drop in their vision," Dr. Gatinel said. "I say, 'If your spec- tacles are not perfectly aligned on your face, your vision is not opti- mal,' and I explain to them that the laser has to be perfectly aligned." case is invaluable. "This obviously takes up time, but I avoid many problems, and despite [the time it takes], I am a high-volume surgeon," he said. "I think that this time is gold for the patient." Shifting perspective Damien Gatinel, MD, PhD, Rothschild Foundation, Paris, like- wise finds himself dedicating a lot of preoperative time to educating patients. The demands on him as a refractive and cataract surgeon have changed over the years. "Ten years ago, I would discuss how the surgery was performed, how long An NSAID formulated to penetrate target ocular tissues PROLENSA ® POWERED FOR PENETRATION Available in a 3-mL bottle size Please see brief summary of Prescribing Information on adjacent page. References: 1. PROLENSA ® Prescribing Information, April 2013. 2. Data on file, Bausch & Lomb Incorporated. 3. Baklayan GA, Patterson HM, Song CK, Gow JA, McNamara TR. 24-hour evaluation of the ocular distribution of 14C-labeled bromfenac following topical instillation into the eyes of New Zealand White rabbits. J Ocul Pharmacol Ther. 2008;24(4):392-398. 4. BROMDAY ® Prescribing Information, October 2012. ®/™ are trademarks of Bausch & Lomb Incorporated or its affiliates. © 2015 Bausch & Lomb Incorporated. All rights reserved. Printed in USA. US/PRA/15/0015 PROLENSA ® delivers potency and corneal penetration with QD efficacy 1,2 • Advanced formulation delivers corneal penetration 1-3 • Proven efficacy at a low concentration 1,4 INDICATIONS AND USAGE PROLENSA ® (bromfenac ophthalmic solution) 0.07% is a nonsteroidal anti‑inflammatory drug (NSAID) indicated for the treatment of postoperative inflammation and reduction of ocular pain in patients who have undergone cataract surgery. IMPORTANT SAFETY INFORMATION ABOUT PROLENSA ® Warnings and Precautions • Sulfite allergic reactions • Slow or delayed healing • Potential for cross‑sensitivity • Increased bleeding of ocular tissues • Corneal effects, including keratitis • Contact lens wear Adverse Reactions The most commonly reported adverse reactions in 3%‑8% of patients were anterior chamber inflammation, foreign body sensation, eye pain, photophobia, and blurred vision. continued on page 46

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