SEP 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/82503

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Page 66 of 103

September 2012 Premium IOLs February 2011 EW SECONDARY FEATURE 67 tions for removal may be fibrosis, Z syndrome, or severe posterior vault, Dr. Safran said. "The main reason I have for re- moving multifocals is patient dissat- isfaction with vision, particularly ghosting," Dr. Safran added. Higher order aberrations cause After cutting IOL in half, first half is removed faction with the function of the lens is due to the lens design or second- ary to residual untreated refractive error, dry eye, posterior capsular opacification (PCO), or need for ad- ditional time for neuroadaptation," Dr. McCabe said. Sometimes an anatomic prob- lem could be degrading images. A patient may have hidden macular Now second half of implant can be removed through small incision problems, anterior basement dystro- phy, epithelial dystrophy, or cornea problems related to corneal guttata. Hopefully, a skilled surgeon will be able to catch these issues before implanting a multifocal, said Steven G. Safran, M.D., Lawrenceville, N.J. "They're fair-weather lenses," Dr. Safran said. "It's like a hot air balloon ride. If the weather is won- Finally the new implant is placed in the capsular bag. Case is completed Source (all): Steve Safran, M.D. derful, you can go up with caution. You don't want to do it if it's rainy or windy or miserable out. If you have any kind of pathology, a multi- focal can be a deal breaker in terms of the patient's happiness." Specifically, Crystalens (Bausch + Lomb, Rochester, N.Y.) will some- times have to be removed because of a bad configuration. Other indica- patients to be dissatisfied with the quality of their vision, even when they're 20/20, Dr. Tipperman said. "If you put a monofocal lens in, their quality of vision is much better," he said. Timing an explantation Popular discourse dictates that a lens should be removed sooner than later. "Do it as soon as you have an idea that it needs to be done," Dr. Safran said. "If you know very early on that an exchange will be needed, it's easier to do it before there has been a lot of fibrosis." continued on page 68 Discernment at the Speed of Light Now know precisely what degree of correction your patients will require, for both eyes, in only 20 seconds. Now youu can can discern which 80% of your patients* will need basic refinement to achieve 20/20 or better. In addition, you'll know: t – and why t Which patients have night driving issues and may require a second Rx t Which patients have high order aberrations that may not be correctable t How to successfully elevate the total patient experience Scan the QR code to learn more about the next era in refraction systems. Refraction: WF@4.00 WF@6.00 Diff Refraction:VD = 13.75mm Sph Cyl -1.00 +0.75 -8.00 -9.00 -1.00 +0.50 +1.25 +0.75 Axis Axis RMS 48 58 10 RMS 0.17D 0.54D 0.17D 0.54D When the OPD-Scan III report indicates 'WF', the patient will require only a basic refraction- saving 5-7 minutes per patient. On average this represents 80% of your patients.* AAO U 3319 800.874.5274 www.marco.com *Data based on national averages. X FRACTION:WAAVWAVEFRONT OP VEFRONT OPTIMIZED REFRA AXION PTTIM IZED REFRA

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