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EW FEATURE
presbyopia-correcting IOLs a few
times. This was because the patient
was unable to adjust to the quality
of vision with this type of IOL. Dr.
Berdahl said it's important to have
an exit strategy that you should
discuss with the patient.
Managing patient expectations
In addition to under promising and
over delivering, Dr. Donaldson said
it's important to take the time to
understand what patients would like
to achieve from surgery and make
sure that their preconceived idea
is consistent with their potential
outcome.
"Know their goals for their
vision," she said. This includes
knowing the needs of patients'
occupations and what hobbies they
have that might have their own set
of visual demands.
"Watch out for myopic patients
as they have higher expectations for
their near vision," Dr. Donaldson
said. "This needs to be discussed
preop so they understand that their
near point may potentially change."
Perfect candidate
"There's no perfect candidate," Dr.
Berdahl said. "But the vast majority
of people are good candidates." In
his experience, patients are happy
with the results when the options
are explained to them clearly, when
they understand the value and the
cost, and when they trust that the
surgeon will do what's in their best
interest.
Patients with reasonable expec-
tations who are highly motivated to
increase spectacle independence are
the best candidates, Dr. Donaldson
said. "They should have a healthy
eye with solely the presence of a
cataract and no other confounding
pathology," she said. "A patient who
has a high degree of dependency on
glasses preoperatively is much easier
to please as compared to a patient
with a lesser degree of preop specta-
cle dependence." EW
Editors' note: Dr. Berdahl has finan-
cial interests with Abbott Medical
Optics (Abbott Park, Illinois), Alcon
(Fort Worth, Texas), Bausch + Lomb
(Bridgewater, New Jersey), and Calhoun
Vision (Pasadena, California). Dr.
Talley Rostov has financial interests
with Bausch + Lomb. Dr. Donaldson
has financial interests with Alcon and
Abbott Medical Optics.
Contact information
Berdahl:
john.berdahl@vancethompsonvision.com
Donaldson: kdonaldson@med.miami.edu
Talley Rostov: ATalleyRostov@nweyes.com
Limbal relaxing incisions created with the femtosecond laser according to surgeon nomogram
Source (all): Kendall Donaldson, MD
