EW San Francisco
Patient counseling
When counseling patients about IOL
choices, I warn them about night-
time glare and halos with multifocal
lenses. However, either because of
neuroadaptation or because I have
prepared them well, patient com-
plaints about glare and halos are
minimal in my practice.
Unfortunately, glare and halos
cannot be completely eliminated
because of the concentric ring de-
sign of multifocal IOLs. So, it is im-
portant to let patients know that
they will most likely experience it to
some degree. However, glare and
halos can also be caused by other
factors, such as ocular surface
disease, PCO, anterior basement
membrane dystrophy, or a poorly
centered IOL. Obviously, it is impor-
tant to pretreat any existing ocular
surface disease and perform meticu-
lous surgery with a well-centered
IOL. Small incision surgery with a
well-centered capsulorhexis con-
tributes to good refractive outcomes.
I also tell patients that while
they will have good vision overall, a
certain percentage of patients may
feel that their intermediate vision is
not as good as their distance and
near. Patients occasionally might
need a pair of glasses for intermedi-
ate work, like computer work. Often,
over the course of six months to a
year, patients find that they rely less
and less on glasses due to neuroad-
aptation.
Overall, I've had a very high
satisfaction rate, and that's why I've
continued to use these lenses. For
example, in a multicenter, prospec-
tive, open-label observation registry
evaluating the Tecnis one-piece mul-
tifocal IOL (Abbott Medical Optics,
Santa Ana, Calif.) in 106 patients,
we found that the majority of pa-
tients were satisfied or very satisfied
with their vision without correction
compared to their vision before sur-
gery (see Figure 1 and 2). However,
it is imperative not to oversell.
Multifocal IOLs are excellent
technology but patients need to
understand that nothing is perfect.
Dr. Davis is managing partner, Minnesota Eye
Consultants, and adjunct clinical assistant
professor, University of Minnesota. She can be
contacted at eadavis@mneye.com.
15
Achieving success with
multifocal IOLs
"
Either
because of
neuroadaptation
or because
I have prepared
them well,
patient
complaints
about glare and
halos are
minimal in my
practice.
"
Intermediate UCVA data from a multicenter clinical trial
Near UCVA data from a multicenter clinical trial
Source (all): Elizabeth Davis, MD
This supplement was produced by EyeWorld and supported by a grant from Abbott Medical Optics Inc.
Copyright 2013 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the editor,
editorial board, or the publisher, and in no way imply endorsement by EyeWorld or ASCRS.
Update on the latest in refractive cataract techniques and technologies
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