85
EW INTERNATIONAL
May 2016
Editors' note: Dr. Carones has financial
interests with Alcon (Fort Worth, Tex-
as), AcuFocus (Irvine, California), and
Abbott Medical Optics (Abbott Park,
Illinois). Dr. Grabner has financial
interests with Abbott Medical Optics,
Patient selection
Dr. Carones thinks that treatments
should be individualized. "One of
the most important challenges for
us is identifying the best solution
for every patient," he said. "We have
multiple options and patients with
different needs, desires, and life-
styles. So our most important task
is to individualize what is best for
each. We need to understand expec-
tations through questionnaires, sur-
veys, chair time and conversation,
and through speaking with relatives
and friends.
"In my experience, EDOF IOLs
are best for younger, active, and
taller patients, with a focus on the
intermediate visual range that is
good for heavy driving, PC, laptop,
or tablet use, and less book reading.
Trifocal IOLs are suitable for all ages
and all heights. They are for patients
with an active lifestyle wanting a
full visual range for driving, PC, and
smartphone use, and a lot of book
reading. I recommend bifocal IOLs
in the reading range for older and
shorter patients with a more seden-
tary lifestyle that includes occasional
driving, smartphone use, and a lot
of book reading. Taking the time
to set postoperative expectations is
key," Dr. Carones said.
Rehabilitative RLE
RLE is performed in patients with
high ametropia. Factors to weigh in
highly myopic eyes include patients'
retinal status and age, since younger
patients are at a higher risk for reti-
nal detachment. In highly hyperopic
eyes, RLE can be therapeutic. In
addition to refractive correction, the
removal of the natural lens causes
the anterior segment to expand and
the anterior chamber to deepen,
reducing the risk of glaucoma devel-
opment.
Children with high ametropia,
severe bilateral ametropia, congeni-
tal conditions disabling proper bin-
ocular function, and non-compliant
children with high refractive errors
can also benefit from RLE.
"Rehabilitating means that pla-
no is not the primary target of this
surgery, but the reduction of high
ametropia," said Dr. Carones. EW
Alcon, Croma (Leobendorf, Austria),
Allergan (Dublin), Transcend Medical
(Menlo Park, California), AcuFocus,
CellSeed (Tokyo), HumanOptics
(Erlangen, Germany), and Schwind
(Kleinostheim, Germany).
Contact information
Carones: fcarones@carones.com
Grabner: g.grabner@salk.at
