April 05, 2009
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When carefully selected, presbyopic IOLs can be used in glaucoma patients

SAN FRANCISCO — Surgeons may successfully implant presbyopia-correcting IOLS in glaucoma patients, but only if they take great care to match patients to the appropriate lenses, a cataract surgeon said here.

Samuel Masket, MD
Samuel Masket

Samuel Masket, MD, speaking here at Glaucoma Day at the American Society of Cataract and Refractive Surgery meeting, added that surgeons should not simply be "occasional users" of presbyopia-correcting IOLS.

He said glaucoma patients face specific challenges when undergoing presbyopic IOL implantation, including optic neuropathy, zonulopathy, pupillopathy, maculopathy and keratopathy.

"Not to make you fear it — I think it's do-able — but you have to match, very carefully, the lens to the patient," Dr. Masket said. "You need to know what's available in the United States today — we have two diffractive multifocal lenses and one refractive lens and one accommodating lens."

He called toric single-piece acrylic IOLs a "slam dunk winner" for the glaucoma patient, posing no image degradation or loss of contrast sensitivity.