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Finishing the job happens months after premium IOL surgery
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Looking back on 7 years of experience with premium IOLs, I've come to learn that the most important exam we perform is the one that should come several months after surgery. It's at this time our premium implant patients feel they've reached their "final" result. It's at this time they tell their friends how well they are seeing and how much they'd recommend their surgeon. And it's at this time we surgeons really prove our commitment to the patient.
Beware the patient who has mild residual refractive error or mild posterior capsule opacity (or both) and is only marginally happy with his or her vision. The patient who says, "I'm doing OK, doctor. I guess it's all right," is not raving to her friends about your surgical skill. Rather, she's probably telling them, "I paid more than $4,000 extra, and I still can't see well."
You can turn this minus into a plus, and you owe it to your patient and your practice to do so.
Those of us with LASIK experience know it's in the patients' best interest to discourage unnecessary enhancements when patients are marginally happy after surgery. With minor ametropia after LASIK, enhancement doesn't improve satisfaction. In many cases, it only prolongs postop dry eye.
In premium IOL patients, though, most marginally happy (or unhappy) patients get great symptomatic improvement with a YAG capsulotomy, a refractive enhancement or both.
For this reason, it's become our practice at Harvard Eye Associates to see all patients 4 to 6 months after premium IOL surgery to gauge both their refractive outcome and their satisfaction with surgery. Those who are doing well are always a pleasure to see, and the visit reinforces to our doctors and staff why we offer premium IOLs. Those who are doing marginally well get the royal treatment: We suggest a YAG, or we do an enhancement at no charge. In either case, the patient becomes our greatest advocate and enthusiastic ambassador, and we know that we have finished a job well done.
Dr. Hovanesian's educational videos and other materials can be found at www.bettereyesurgery.com.