Eyeworld

September 2016 • Ophthalmology Business 7 and halos lasted for 6 months and he had punctal plugs placed 1 week postop. "It has caused me to be more aggressive with punctal plugs in my LASIK patients if they are feeling un- comfortable," Dr. Berdahl said. Dr. Sheppard said he experienced some symptoms—photophobia— after PRK, and the postop regimen made him appreciate how hard it is to remember to keep up with drops. He also delayed having his dominant eye operated on for 6 months, giving him the "enlightening" experience of anisometropia and reversed mono- vision. "We were still marginally paranoid that some bizarre haze or delayed healing complication might occur in the early days of PRK. I per- sonally connect with the fear factor and can now counsel with empathy," he said. Another takeaway for Dr. Berdahl came during the placement of the lid speculum. Dr. Berdahl said his doctor told him that while his eye was numb, his eyelids weren't, and warned he would feel some pressure there. This is something Dr. Berdahl now says to all of his patients as well to help alleviate some anxiety they might experience at this point. "When the procedure was done and the doctor said everything went great, I remember the relaxation that overcame me. That's an important celebratory moment for us," Dr. Berdahl said. "Now I lean down and whisper into [the patient's] ear and say, 'Congratulations, everything went perfect.' I can see, every time, their shoulders relax." OB Contact information Berdahl: john.berdahl@vancethompsonvision.com Greenwood: michael.greenwood@vancethompsonvision. com Sheppard: jsheppard@vec2020.com "I was nervous before I had LASIK even though I know almost everyone does great, and I had total confidence in my team and the technology we were using." Dr. Greenwood also said he experienced some nerves before each of his phakic IOL procedures, which were performed two days apart. "My blood pressure was a little higher than normal, but as soon as I started having the sedation, that helped. When it was time to go back for the surgery, I trusted my surgeon and I knew I was in good hands," he said. In the recovery room, Dr. Greenwood asked to sit near the window. "I could see so well already. It was just incredible," he said. Lessons learned Drs. Sheppard, Greenwood, and Berdahl said they have been able to apply their own surgical experience to their practice, if for nothing else but genuine empathy. Dr. Greenwood said the confi- dence he had in his team for the pro- cedure emphasized how important that is to establish with patients. "When I talk to patients, I want to make sure they trust me and that I earn that trust. I want them to know that I'm going to take care of them," he said. Dr. Berdahl said he describes his decision-making process to patients, helping guide them through their own from the perspective of some- one who truly understands what they might go through. But he has found the experience helpful in more spe- cific ways as well. "It helped me understand what the postop care is like, what glare and halos really mean. I tell my patients, 'After surgery your eyes will be dry. You will have glare and halos and you'll be light sensitive, but that will all go away with time. If the dryness lingers, we'll treat it,'" Dr. Berdahl said, explaining that his own glare the slit lamp oculars in the office," Dr. Sheppard said, adding that they were problematic in sports as well. Likewise, Michael Greenwood, MD, Vance Thompson Vision, Fargo, North Dakota, dreamed of having refractive surgery for years. Wear- ing glasses starting in the first grade before later transitioning to contacts, he ended up with his prescription being –13.00 –1.00 in both eyes. "When you're talking about refractive surgery, my options get pretty limited because I'm pushing the extremes of laser surgery with how much tissue you would need to remove and how much you can treat," he said. Phakic IOLs, however, were a good option, and when the timing was right after medical school and residency, he had the procedure in December 2015. "My vision now is better than it ever was in contacts or glasses," he said. "It was so much fun walking around the clinic, talking to every- one, and knowing I never had to put contacts back in." John Berdahl, MD, Vance Thompson Vision, Sioux Falls, South Dakota, couldn't tolerate contacts well due to dry eye, but he didn't mind his glasses. Patients were asking him though, "If LASIK is so good, how come you're still wearing glass- es?" This, and the fact that his wife said he looked better without glasses, led him to go under the laser. "I had access to tremendous sur- geons and I knew the risk-benefit was in my favor, so I went ahead and did it," Dr. Berdahl said. When the tables are turned Finding himself lying on the table instead of sitting at the laser was a poignant moment for Dr. Berdahl. "It's really hard for data to trump the human emotion of fear," he said, recalling how he at one point ques- tioned taking this "very small risk."

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