Treat underlying corneal conditions to improve patient satisfaction with premium IOLs
Key takeaways:
- Cataract surgeons must improve their communication with patients about premium IOLs.
- Physicians should address underlying corneal conditions, over-pressurizing of the eye and vitreous floaters after surgery.
KOLOA, Hawaii — To improve patient satisfaction with premium IOLs, surgeons must address five key areas of cataract surgery, according to a presenter here.
At Hawaiian Eye 2025, John A. Hovanesian, MD, FACS, highlighted the importance of communication with patients about their IOL choices.
“We don't have to give up our trusted position in the patient's life to give them honest input,” he said. “I think starting the conversation the right way is really crucial.”
Hovanesian recommended ophthalmologists assure their patients that they are not trying to sell them anything but, instead, want to make sure they properly understand their choices.
“This is almost word-for-word what I say to patients in surgery: ‘I'm going to give you an implant that's probably the most important product you're ever going to receive in your life, because you're going to spend the rest of your life looking through it at every waking moment,’” he said.
Cataract surgeons must also prioritize treating underlying corneal conditions in patients. Recognizing decreased corneal sensation and addressing the causes will improve outcomes after surgery.
“We need to stop the forward progression toward surgery until we prescribe some form of treatment that's going to work, and in many cases reevaluate, because our results are going to be affected no matter what lens you use,” Hovanesian said.
In addition, he emphasized the importance of offering a wider option of presbyopia-correcting IOLs. Ophthalmologists must recognize what each IOL offers for different patient needs and move away from a one-size-fits-all mindset.
Surgeons should also move away from over-pressurizing the eye during surgery, according to Hovanesian, who highlighted data showing “significant reductions in corneal thickness and in AC cells at day one after surgery and reduced macular thickness at one week, indicating objectively that we are doing better when we pressurize the eye less and can still safely do surgery.”
Lastly, more data is needed on the role of addressing vitreous floaters and how it impacts patient satisfaction after surgery. Many patients implanted with premium IOLs report dissatisfaction related to vitreous floaters in their history, Hovanesian said.
“Don't be too ready to relegate a patient to the category of crazy or someone who can't be satisfied,” he concluded. “Think about what's happening in the vitreous for these patients. If we do that, we may achieve greater satisfaction more consistently.”
Collapse
Hovanesian J. Five things we’re doing wrong with advanced IOLs. Presented at: Hawaiian Eye 2025; Jan. 18-24, 2025; Koloa, Hawaii.
Read more about