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Aggressive approach needed for patients dissatisfied after IOL implantation
WESTON, Fla. — Understanding the best approaches to helping patients who are unhappy with their presbyopia-correcting IOLs after cataract surgery is essential to success, according to an ophthalmologist speaking here at the International Congress on Surface Ablation and SBK, conducted 1 day before the Association for Research in Vision and Ophthalmology meeting.
 Johnny L. Gayton |
Johnny L. Gayton, MD, discussed the challenges involved in tempering expectations of patients who said they want perfect or near-perfect vision after being implanted with a presbyopia-correcting IOL.
He also addressed the necessity of aggressively treating the most common complaints of patients postoperatively, namely dry eye, decreased vision due to cystoid macular edema and residual refractive error.
Dr. Gayton encouraged surgeons to recommend artificial tears, nutritional supplements and environmental changes — avoiding tobacco smoke or circulating air — to combat dry eye. He also suggested surface ablation as opposed to LASIK as a way to address residual refractive error after IOL implantation.
For patients with astigmatism who were poor candidates for limbal relaxing incisions, Dr. Gayton recommended toric IOLs. No matter which direction a surgeon chooses, the need for aggressive treatment and a straightforward approach is the key, he said.
"Get everybody on the same sheet of music, have everybody working together and accurately evaluate unhappy patients ... [and] you'll have a lot of happy premium lens patients, and you'll be very successful," Dr. Gayton said.