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EW SHOW DAILY
2018 ASCRS•ASOA Annual Meeting, Washington, D.C.
Retina essentials every cataract and
refractive surgeon should know
by Lauren Lipuma EyeWorld Contributing Writer
The good news is there are no
macular contraindications to im-
planting toric IOLs, Dr. Miller said.
However, it is not a good idea to im-
plant a toric IOL in a patient whose
eye will require a rigid contact lens
after surgery—that is, a patient
whose eye has significant corneal
irregularities. This includes cases of
keratoconus, pellucid marginal de-
generation, corneal scars, Salzmann's
nodules, or when a patient has had a
penetrating keratoplasty, he said.
There are also situations where
implanting a multifocal IOL might
not be best. These include cases
where the patient has any kind of
vision-limiting comorbidity in either
eye because multifocal lenses reduce
contrast, Dr. Miller said. The ideal
multifocal candidate is a patient
who wants spectacle independence,
C
ataract and refractive sur-
geons often need to take
retinal considerations into
account when performing
surgery. In Saturday af-
ternoon's "Retina Essentials for Cata-
ract and Refractive Surgery" sym-
posium, retina specialists discussed
how to best manage patients with a
variety of retinal issues.
Kevin Miller, MD, Los Angeles,
kicked off the conversation with
pearls for when to implant premi-
um IOLs in patients with macular
disease. Premium IOLs offer cataract
patients spectacle independence,
but premium lenses create premium
expectations because patients are
paying at least partly out of pocket,
Dr. Miller said. Macular pathology
can reduce quality of vision, so there
are some instances when it is inap-
propriate to implant a premium IOL
in a patient with macular disease.
continued on page 36
Dr. Adelman discusses how to differentiate between TASS and endophthalmitis.
