Eyeworld

7 who had an occupation that involved nighttime driving. After extensive counseling, I have implanted the ReSTOR +2.5 in patients who do significant nighttime driving and they are happy. Dr. Lane: It sounds like the addition of the +2.5 has expanded our armamen- tarium of what we are able to offer patients in terms of being able to allow some multifocality compared to the previous single offering of a +3.0 lens. Dr. Woodard: The defocus curve chart made it clear to me why this lens is more forgiving. This chart shows that this lens performs much more like a mono- focal and that the amount available for patients. So, patients are already aware of their options before I enter the room, which I think is important. When I get into the room, I ask the patient about the activities that are most important to him or her. I ask whether the patient drives at night, is a big sports person, reads a lot, is a musician, or is on the computer a lot. Then I find out what he or she is not willing to compromise. Patients are usually very matter of fact about this. I let the patient guide my recommendation based on the importance of his or her various activities. You can't go into a room telling a pa- tient what he or she wants. Dr. Lane: Since the ReSTOR +2.5 with ACTIVEFOCUS Optical Design lens has become available, are you finding that you are using more multifocals than you used to? Dr. Woodard: Absolutely. I think the lens is more for- giving, so I have broadened my criteria for patients who are post-LASIK. The topog- raphy doesn't have to be perfect. I have found that this lens is more forgiving in allowing these patients to still be happy. I always treat patients with ocular surface disease or dry eye before making a final decision. I would not implant any IOL in a patient whose ocular surface was significantly compromised. Dr. Tipperman: With the +3.0, I typically implanted this lens in patients who were spectacle haters and wanted to wear spectacles as little as possible, and who wanted a multifocal lens. With the +2.5, it's different. Part of the in- formed consent for mono- focal IOLs is telling patients that they will have good distance vision, and they will need reading glass- es for arm's length on in. Now, there is a multifocal that will provide a lot more functional vision at some different distances with- out the need for reading glasses all of the time. I am talking about multifocals to a different category of patients now that I have the +2.5. I'll see how they are doing with their first eye. If they have good functional vision at multiple distances, I'll match the second eye with the +2.5. If they like the +2.5, are not having any unwanted optical images, and wish the reading vision was a little bit better, I am comfortable implanting the +3.0 in the non-dominant eye. Dr. Cibik: It has increased the number of multifocal candidates in our practice because I think that there will be better patient out- comes and fewer patient complaints. I also think that has to do with the fact that I have great confidence in this lens. Prior to the availability of the ReSTOR +2.5 technology, I was very hesitant to use multifocal lenses in patients who had previous refractive surgery. After good counseling, I will consider the ReSTOR +2.5 in patients who have had myopic LASIK and in some RK patients. Also, in the past, I was reluctant to use a multifocal lens in anyone continued on page 8 †Data for AcrySof® IQ ReSTOR® +2.5 D IOL, +3.0 D IOL, and +4.0 D IOL mean defocus curves are from the Directions for Use for each respective IOL. 1. The methodology used to derive all defocus curve data was the same test methodology for each IOL. No direct clinical comparison is implied. Please refer to page 8 for impor tant product information about the Alcon products described in this supplement.

• Cover