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Comanagement of cataract surgery can improve outcomes
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Ophthalmologists and optometrists can improve cataract surgery by working together before and after surgery.
Optometrists who make the correct referral for cataract surgery can help prepare patients for a procedure both mentally and physically, Sondra Black, OD, said at the American Academy of Ophthalmology meeting in New Orleans.
“Optometry right now does 85% of the general eye exams, so all those cataract patients are sitting in your practice. It is really important that we as optometrists take control of these patients and make the right referral, start talking to the patients about what is out there in lens options and make sure that the patient is prepared for surgery,” Black said.
What a patient wants
Optometrists first need to make sure their patients are ready refractively for surgery, meaning they have a good ocular surface before undergoing the procedure. Dealing with dry eye and making sure patients have a “good, healthy tear film” should be addressed before they are referred to a surgery center, Black said.
If these issues are not addressed, then surgery may be delayed because a poor ocular surface can affect biometry readings as well as increase the risk for healing issues, she said, and the surgeon must deal with the problem instead before the patient can move forward with surgery.
Patients also need to be made aware by their optometrist about what surgical options they will be given when they are first examined by an ophthalmologist, she said.
“These options now include great presbyopia-correcting IOLs such as the Symfony extended depth of focus lens (Johnson & Johnson Vision), which gives these patients this great flexibility in their vision. They are able to see distance, they are able to see the computer, and they are able to see the majority of their near without glasses with good, clear crisp quality of vision. You want to make sure the patient understands they may be given that option when they go forward with surgery,” Black said.
An important relationship
Comanaging can help patients better understand their options before cataract surgery, OSN Refractive Surgery Section Editor John P. Berdahl, MD, told Ocular Surgery News.
Before meeting with an ophthalmologist, if patients have had dry eye treated and identified “how they want to use their eyes” after surgery, they can have an easier process and take advantage of all that is available to them, he said.
“ODs and MDs need to realize that we each serve the same boss: patients. So, simply, we want to work together for whatever is best for patients, both clinically and logistically. Make it easy for the patient to get the best care possible,” Berdahl said.
If an optometrist has a patient who is looking to be free of glasses, that is a perfect patient for premium cataract surgery using a presbyopia-correcting IOL and this should be noted on the surgical referral form, Black said.
When ophthalmologists and optometrists work together, it can improve all facets of the surgical process.
“This is something where optometry and ophthalmology should be working together. It makes the ophthalmologist’s life a lot easier because a patient is coming in fully prepared. It makes an optometrist’s life a lot easier because then they’re getting back a very happy patient at the end of the day. This should be a refractive comanagement procedure,” she said. – by Robert Linnehan
- Reference:
- Video: Refractive cataract surgery works best with effective comanagement. https://www.healio.com/optometry/comanagement/news/online/%7Be5133579-c1bf-4993-a28d-f3d3117702a4%7D/video-refractive-cataract-surgery-works-best-with-effective-comanagement. Published Nov. 17, 2017. Accessed Dec. 6, 2017.
- For more information:
- John P. Berdahl, MD, can be reached at Vance Thompson Vision, 3101 W. 57th St., Sioux Falls, SD 57108; email: john.berdahl@vancethompsonvision.com.
- Sondra Black, OD, can be reached at Crystal Clear Vision, NVISION Eye Centres: Toronto LASIK and Cataract Surgery, 33 Hazelton Ave., Toronto, ON M5R 2E3; email: sondra.black@crystalclearvision.com.
Disclosures: Berdahl reports no relevant financial disclosures. Black reports she is a consultant for Johnson & Johnson, AcuFocus and Labtician Ophthalmics.