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Preop preparation leads to EDOF IOL success
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WAIKOLOA, Hawaii — Surgeons should know what visual results to expect from extended depth of focus IOLs to best match them up with patient needs, according to a speaker at Hawaiian Eye 2019.
“I’m a big believer that there is no perfect lens out there and you really have to take the time out with your patient, personally to really decide if this has the right optics for them,” Sumit “Sam” Garg, MD, said at Hawaiian Eye 2019.
Understanding defocus curves is important to understand where the lens has its sweet spots, Garg said.
“EDOF are not so great on near sight, so it’s important to counsel your patients about the need for reading lenses” he said.
He is a big believer that physicians must take the time with a patient, personally, to decide if EDOF lenses have the right optics for their needs.
EDOF lenses have some advantages over multifocals, “you don’t get two sweet spots, it doesn’t split light in the same way and studies show that you get a good tolerance to unexpected refractive surprises, and a better tolerance to residual errors,” Garg said.
Another important consideration is taking into account where the patient is starting from. “Are they a low myope? Are they 40 years old versus 80 years old? What are their needs?” he asked.
Various lenses are available from different manufacturers that can help to customize lens choice for these patients.
“Dominance is a thing I look for in these lenses,” he said. “With the Symfony lens, I try to get as close to plano as I can in the dominant eye and in the non-dominant eye you have options.”
Using visuals is very important. Garg recommends a visual simulator by Johnson & Johnson Vision which shows their family of lenses, he said. The simulator shows what astigmatism looks like, as well as halos, glare and spiderwebs.
“Being meticulous in your IOL calculations is important, really taking into account posterior corneal astigmatism has been a nice addition for us and on the J&J calculator there’s a way to select that or de-select it when managing patients,” Garg said.
In summary, Garg recommends matching patient goals and reasonable expectations to the technology, which may mean using a different lens technology in each eye. – by Abigail Sutton
Reference: Garg S. Tips for success with EDOF IOLs. Presented at: Hawaiian Eye; Jan. 19-25, 2019; Waikoloa, Hawaii.
Disclosures: Garg is on the speakers bureau for Johnson & Johnson Vision.