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7 Dr. Scoper: During the past 1.5 years that I have been implanting with AcrySof IQ ReSTOR +2.5 D with ACTIVEFOCUS, I have made it a point to see all of my patients personally postop- eratively and ask them how they are doing. I have been just amazed at how well almost all of the patients are seeing postoperatively. If I also correct their astig- matism and hit their spher- ical equivalent correctly, they are going to have great uncorrected distance vision and be very happy with that vision. I have very few patients who are not totally pleased with their vision at distance and intermediate with ACTIVEFOCUS design. What role does your staff play in your IOL recommendation? Dr. Scoper: Our staff plays a major role, and patients receive all of their educa- tion about cataract surgery, femtosecond lasers, and different IOL options before they see the doctor. I'm a big believer that the doc- tor should do what only a doctor can do. I do not want to spend time explaining to patients what cataract sur- gery is, what an IOL is, and what astigmatism is. All of those things are explained to them before they get to me. As the patient is being worked up by the staff, the technician will write a note to one of our counselors saying that he or she ap- pears to be a very good can- didate for an ACTIVEFOCUS lens. The patient then sees the counselor before he or she sees me. They first see videos about different IOLs and cataract surgey choic- es to educate them about options to help them reach their best visual outcomes. Then, the counselor ex- plains what cataract surgery is, what astigmatism is, and how ACTIVEFOCUS multifo- cal design works. They also discuss what vision and out- come the patient can rea- sonably expect. The coun- selor also discusses price and will even get approved for care credit if the patient is interested. I then exam- ine the patient and make a recommendation. Dr. Hammond: In my prac- tice, I select the lens with the patient. I sit down and go through the entire exam and if there is astigmatism or corneal aberrations, we talk about those, and we talk about what patients want from cataract sur- gery, their hobbies, and their occupation. Then, I will make a recommenda- tion for the lens based on what the patient wants and what he or she expects from cataract surgery. My staff takes it from there and discusses cost with the patient. They are crucial in closing the deal and making sure that everything is well understood. So, they rein- force what I do, but I do the actual lens recommenda- tion and discussion with the patient. Where does an IOL with the ACTIVEFOCUS optic fit in your armamentarium? Dr. Weaver: I offer it to ev- eryone who is a candidate, which is a large part of my practice. The biggest decid- ing factor, at least in Talla- hassee, is cost. Tallahassee is a very middle-class com- munity, so I must explain to patients the value of what they are getting. I wish I could implant a lens with ACTIVEFOCUS in one eye and another lens in their other eye, and let patients choose. I believe they would all choose a lens with AC- TIVEFOCUS. Dr. Scoper: If patients have a healthy ocular exam and have a desire to be free of glasses at a distance, I ask if they would like to pull that distance vision into intermediate. I look at all of my monofocal patients who want good uncorrect- ed distance vision, and I offer them the addition of intermediate vision. You really don't have to give up anything. The only thing I tell them is that they will see rings around lights and have a little glare and halos at nighttime with this lens. If they are willing to accept that at night, then they can have uncompromised dis- tance vision with an ex- tended range of vision with ACTIVEFOCUS. What would you say to other eye surgeons about ACTIVEFOCUS? Dr. Weaver: Surgeons need to try this lens if they hav- en't already. Having an ORA will help as well. It allows you to be dead-on accurate in the sphere calculation, which is critical when you are doing premium im- plants, but even more so when you are aligning the axis of astigmatism. I rec- ommend using ORA when- ever implanting ACTIVEFO- CUS toric or ACTIVEFOCUS for patients without astig- matism because it helps me to hit the refractive target Dr. Scoper: If you have tried multifocals in the past and have stopped using multi- focals for whatever reason, give ACTIVEFOCUS optic a try because it is not just an- other multifocal. This hybrid design is a totally different lens, so I would encourage everyone to give it a try. My patients have never been happier. n References 1. Alcon Data on File. CSR C-10-016 (07 Aug 2013). 2. Vega F, Alba-Bueno F, Millán MS, et al. Halo and through-focus performance of four diffractive multifocal and intraocular lenses. Invest Ophthal- mol Vis Sci. 2015;56;3967-3975. Please see page 8 for Important Product Information. ACTIVEFOCUS ™ : Contrast at distance ‡,2 3 mm pupil 4.5 mm pupil AcrySof IQ Monofocal AcrySof IQ ReSTOR +2.5 D TECNIS ** Multifocal +2.75 D ‡ImagesderivedfromVega.,etal.atfigure2(fn5).Slitpatternbenchtestdisplayedinlogarithmicscaleofintensityfor haloassessmentatdistancevision.OnlyIOLsapprovedintheUSaredisplayed.

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