Eyeworld

EW CATARACT 41 October 2017 prospective patients talk to another patient who has received the IOL so they can set realistic expectations. One of the most important aspects of the informed consent pro- cess is making certain that patients have realistic expectations of what they can achieve following surgery, according to Dr. Donnenfeld. "I want to make sure patients have good expectations of what they can achieve and the knowledge that they may need enhancements to get there and that there is a possibility that they may need a LASIK en- hancement as well," Dr. Donnenfeld said. Angle kappa Another area where the newer lenses may help is with angle kappa, or the difference between the geometric center of the pupil and the line of sight. "With the larger central optics of the low add MFIOL and EDOF IOL, it provides more wiggle room in terms of quality even if it is not perfectly centered," Dr. Yeu said. Dr. Yeu uses the Placido disk image, specifically reviewing where the patient's pupillary center falls in relation to the center of the cornea on the keratoscopic image, to show her what the difference in the angle is between their optical and pupil- lary center. "That information is very im- portant," Dr. Yeu said. Dr. Berdahl uses the OPD-Scan III (Nidek, Fremont, California) to ensure that the principle ray of light is going through the smallest central portion of the optic in the multifo- cal and not hitting one of the first refractors, which could produce glare and halos. Dr. Donnenfeld has found the iTrace (Tracey Technologies, Hous- ton) provides good information when using it to look for spherical aberration, coma, and related issues. Additionally, tomography provides helpful information about the poste- rior corneal surface. "We look for angle kappa espe- cially on patients who are hyper- opic," Dr. Donnenfeld said. "Signif- icant angle kappa is not an absolute contraindication but it is a relative contraindication." EW Editors' note: Dr. Donnenfeld has finan- cial interests with Alcon (Fort Worth, Texas) and Johnson & Johnson Vision. Dr. Yeu has financial interests with Alcon, Johnson & Johnson Vision, and Bausch + Lomb (Bridgewater, New Jer- sey). Dr. Berdahl has financial interests with Alcon, Bausch + Lomb, RxSight (Aliso Viejo, California), and Omega Ophthalmics (Lexington, Kentucky). Contact information Berdahl: johnberdahl@gmail.com Donnenfeld: ericdonnenfeld@gmail.com Yeu: eyeulin@gmail.com The Most Versatile Glaucoma Treatment in Ophthalmology Endoscopic CycloPhotocoagulation (ECP) • Mild to moderate glaucoma • Combine with Phaco and other MIGS • Advanced Glaucoma 1-866-906-8080 beaver-visitec.com Register at endooptiks.com "ECP is an ideal way to address moderately controlled glaucoma and cataract in one procedure." "ECP is an ideal way to address moderately controlled glaucoma and cataract in one procedure." Mr. Philip Bloom — MBChB, FRCS(Ed), FRCOphth Western Eye Hospital , Hillingdon Hospital, London, UK Nathan Radcliffe, MD Coney Island Hospital, NYU Langone Medical Center, NY, NY USA "Combining ECP with a variety of other MIGS procedures allows me to o• er a balanced therapy that is tailored to each patient." The Most Versatile Glaucoma Treatment in Ophthalmology Endoscopic CycloPhotocoagulation (ECP) Mild to moderate glaucoma Combine with Phaco and other MIGS Advanced Glaucoma "ECP is an ideal way to address moderately controlled glaucoma and cataract in one procedure." "Combining ECP with "Combining ECP with a variety of other MIGS a variety of other MIGS procedures allows me procedures allows me to o• er a balanced to o• er a balanced therapy that is tailored therapy that is tailored ECP Surgical Course — A New Perspective on MIGS Join us for breakfast at AAO and learn the basic techniques of ECP and combining MIGS. Location: Hampton Inn at the Convention Center Room: Antonine Date: Sunday, November 12 Time: 7:00 am registration and breakfast at 6:30 am Receive: Course certifi cate Booth 830

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