Personality and patient expectations play into selection of presbyopia-correcting IOL
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KOLOA, Hawaii — Finding the right candidate for receiving a presbyopia-correcting IOL can be challenging, as is choosing the best IOL for that candidate, William B. Trattler, MD, said at Hawaiian Eye 2023.
While a high number of cataract patients make excellent presbyopia-correcting IOL candidates, borderline candidates identified in the preop evaluation include those with a history of myopic or hyperopic LASIK or radial keratotomy, as well as those with mild irregular astigmatism, epiretinal membranes or vitreomacular traction, Trattler said.
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Poor candidates for presbyopia-correcting IOLs may include those with reduced potential visual acuity and those with moderate Fuchs’ corneal dystrophy.
“Personality concerns can also be a big issue for patients, especially those with unrealistic expectations,” he said.
Talking with the patient to determine their visual priorities following surgery is helpful for the clinician to determine the best IOL that fits that person’s needs, as well as to set their expectations.
For example, if avoiding halos is the patient’s primary goal, the physician may consider an IOL with less range of vision than a trifocal IOL but a lower rate of night vision complaints.
“It's all about setting expectations,” Trattler said. “Some patients say they don’t care if they get night vision complaints, ... but for them having beautiful near vision is really important.”
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Pearls for selecting presbyopia-correcting IOLs for your patients. Presented at: Hawaiian Eye 2023; Jan. 14-20, 2023; Koloa, Hawaii.
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