EyeWorld Asia-Pacific June 2019 Issue

EWAP JUNE 2019 Óx FEATURE W ˆÌ…“>˜Þ i˜Ãià >Û>ˆ>Li vœÀ those with `ˆvviÀi˜Ì ۈÃÕ> demands, surgeons have more >˜` “œÀi œ«Ìˆœ˜Ã vœÀ «>̈i˜Ìà who want to be less dependent on glasses. However, patients who have had prior corneal ÀivÀ>V̈Ûi ÃÕÀ}iÀÞ “>Þ ÀiµÕˆÀi special considerations when choosing which option is best. Brandon Baartman, MD , Vance Thompson Vision, Omaha, iLÀ>Î>] >˜` Kevin Waltz, MD ] ˜`ˆ>˜>«œˆÃ] `ˆÃVÕÃÃi` diagnostics, lens options, and potential postoperative issues. Goal of being glasses-free EyeWorld >Îi` À° >>À̓>˜ and Dr. Waltz to weigh in on how to approach patients who want distance, intermediate, and ˜i>À ۈȜ˜ ܈̅œÕÌ }>ÃÃià >vÌiÀ V>Ì>À>VÌ ÃÕÀ}iÀÞ° This is an important issue in ÀivÀ>V̈Ûi V>Ì>À>VÌ ÃÕÀ}iÀÞ] À° >>À̓>˜ Ã>ˆ`° º*>̈i˜Ìà ܅œ ՘`iÀÜi˜Ì ÀivÀ>V̈Ûi ÃÕÀ}iÀÞ ˆ˜ ̅i £™™äà >˜` i>ÀÞ Óäääà are now aging into the cataract `i“œ}À>«…ˆV] >˜` “>˜Þ >Ài Ã̈ ÛiÀÞ >V̈Ûi LœÌ…ˆ˜ ̅i ܜÀŽvœÀVi >˜` ̅iˆÀ «iÀܘ> ˆÛiÃ]»…i Ã>ˆ`° º/…i `iÈÀi vœÀ Vi>À >˜` v՘V̈œ˜> ۈȜ˜ ˆ˜`i«i˜`i˜Ì œv }>ÃÃià `œiØ½Ì }œ >Ü>Þ°» /…iÃi «>̈i˜Ìà V>˜ ÀiµÕˆÀi > œÌ vÀœ“ > ۈÃÕ> vÀii`œ“ «iÀëiV̈Ûi LÕÌ V>˜ >Ãœ Li ܓi œv ̅i “œÃÌ challenging due to the prior VœÀ˜i> ÃÕÀ}iÀÞ]…i >``i`° Dr. Baartman said that he >««Àœ>V…ià V>Ì>À>VÌ ÃÕÀ}iÀÞ Ì…i Ã>“i Ü>Þ ÜˆÌ…> «>̈i˜ÌÃ] Ài}>À`iÃà œv ÀivÀ>V̈Ûi ÃÕÀ}ˆV> …ˆÃ̜ÀÞ\ œÜ “ÕV…`œ ̅iÞ Ü>˜Ì to be able to do without glasses >vÌiÀ ÃÕÀ}iÀÞ¶ º-œ“i œv ̅iÃi patients are used to wearing reading glasses and don’t mind ÕȘ} ̅i“ LÕÌ Ü>˜Ì ̅>Ì Ƃ- ‡ ˆŽi ۈÃÕ> œÕÌVœ“i >Ì `ˆÃÌ>˜Vi >vÌiÀ ÃÕÀ}iÀÞ]»…i Ã>ˆ`° º"̅iÀà have converted to monovision >vÌiÀ ̅i œ˜ÃiÌ œv «ÀiÃLޜ«ˆ> and plan to continue using this vœÀ ëiVÌ>Vi vÀii`œ“ >vÌiÀ V>Ì>À>VÌ ÃÕÀ}iÀÞ°» i >``i` that even though both patient }ÀœÕ«Ã }i˜iÀ>Þ ܈˜` Õ« ܈̅> “œ˜œvœV> œ«ÌˆV] ̅i œÕÌVœ“i ˆÃ VÀˆÌˆV> vœÀ ̅iˆÀ…>««ˆ˜iÃÃ] and it’s important to nail the ÀivÀ>V̈Ûi Ì>À}iÌ° *>̈i˜Ìà ܅œ >Ài “œÀi ۈÃÕ>Þ demanding at intermediate >˜` ˜i>À “>Þ Li˜iwÌ vÀœ“ > “Տ̈vœV> œÀ iÝÌi˜`i` `i«Ì…œv vœVÕà œ«ÌˆV] À° >>À̓>˜ Ã>ˆ`° º ˆÃ̜ÀˆV>Þ] œ«ÌˆVà ̅>Ì Ã«ˆÌ light were not good options in ̅i «œÃ̇ÀivÀ>V̈Ûi VœÀ˜i>] LÕÌ Ì…>̅>à V…>˜}i`]»…i Ã>ˆ`] >``ˆ˜} ̅>Ì “>˜Þ ÃÕÀ}iœ˜Ã…>Ûi reported impressive outcomes ܈̅˜iÜiÀ ÌiV…˜œœ}Þ `ˆvvÀ>V̈Ûi œ«ÌˆVà ˆ˜ ̅i «œÃ̇ ÀivÀ>V̈Ûi iÞi] ˆ˜VÕ`ˆ˜} Ƃ- ] *, ] >˜` iÛi˜ ViÀÌ>ˆ˜ «>̈i˜Ìà ܈̅À>`ˆ> ŽiÀ>̜̜“Þ° º/…iÀi½Ã a lot that goes into these patient evaluations in terms œv `ˆÃVÕÃȜ˜ >˜` ÌiÃ̈˜}] LÕÌ nothing is as important as clear communication and a mutual ՘`iÀÃÌ>˜`ˆ˜} œv «>̈i˜Ì }œ>Ã >˜` «œÃÈLi ˆ“ˆÌ>̈œ˜Ã œv ̅i ÃÕÀ}iÀÞ]» À° >>À̓>˜ Ã>ˆ`° Dr. Waltz said that he does > œÌ œv ÀivÀ>V̈Ûi ÃÕÀ}iÀÞ >˜` «iÀܘ>Þ…>à “ÕÌˆvœV> i˜Ãið The main point to understand ܈̅> «œÃ̇ÀivÀ>V̈Ûi «>̈i˜Ì ˆÃ ̅iÞ½Ûi >Ài>`Þ ÃiÌ Ì…i“ÃiÛià >«>ÀÌ vÀœ“ ̅i >ÛiÀ>}i «>̈i˜Ì° -ˆ˜Vi ̅iÃi «>̈i˜Ìà «>ˆ` iÝÌÀ> vœÀ > ViÀÌ>ˆ˜ ÀivÀ>V̈Ûi œÕÌVœ“i] À° 7>Ìâ Ã>ˆ` ̅iÞ ˆŽiÞ ܜՏ` be interested in optimizing that œÕÌVœ“i >vÌiÀ ÀivÀ>V̈Ûi ÃÕÀ}iÀÞ° He added that the number one criterion in these cases ˆÃ «>̈i˜Ì “œÌˆÛ>̈œ˜° º v ̅iÞ Ü>˜Ì ˆÌ i>ÃÞ >˜` µÕˆVŽ >˜` `œ˜½Ì mind wearing glasses, that’s a by Ellen Stodola Þi7œÀ` -i˜ˆœÀ -Ì>vv 7ÀˆÌiÀÉ ˆ}ˆÌ> `ˆÌœÀ AT A GLANCE • /œ«œ}À>«…Þ V>˜ Li > ŽiÞ `ˆ>}˜œÃ̈V ̜œ° ˜œÜˆ˜} ̅i ë…iÀˆV> >LiÀÀ>̈œ˜ >˜` ̅i >L>̈œ˜ >Ài>à >Ài >Ãœ ˆ“«œÀÌ>˜Ì° • /…iÀi >Ài ܓi ˆ˜`ˆV>̈œ˜Ã ̅>Ì > «>̈i˜Ì ˆÃ ˜œÌ > }œœ` V>˜`ˆ`>Ìi vœÀ > «Ài“ˆÕ“ " ° v ̅iÀi ˆÃ >˜Þ iۈ`i˜Vi œv `iVi˜ÌiÀi` >L>̈œ˜ œÀ «ÀiÃi˜Vi œv È}˜ˆwV>˜Ì ̜Ì> VœÀ˜i>…ˆ}…iÀ œÀ`iÀ >LiÀÀ>̈œ˜Ã] ̅iÃi >Ài Ài` y>}ð • ̽à ˆ“«œÀÌ>˜Ì ̜ Vœ˜Ãˆ`iÀ ÌÀi>̈˜} ̅i œVՏ>À ÃÕÀv>Vi ̜ “>݈“ˆâi ̅i V…>˜Vi œv ÃÕVViÃð ˆÃVÕÃȘ} > «>˜ vœÀ >``ÀiÃȘ} ÀiÈ`Õ> ÀivÀ>V̈Ûi iÀÀœÀ ܈̅ «>̈i˜Ìà ˆÃ >Ãœ ˆ“«œÀÌ>˜Ì° Editors’ note: Dr. Baartman JCU ƂPCPEKCN KPVGTGUVU YKVJ #NNGTICP (Dublin, Ireland) and Refocus Group &CNNCU &T 9CNV\ JCU ƂPCPEKCN KPVGTGUVU with AcuFocus (Irvine, California) and Johnson & Johnson Vision (Santa Ana, California). œ˜Ì>VÌ ˆ˜vœÀ“>̈œ˜ Baartman: LÀ>˜`œ˜°L>>À̓>˜J vancethompsonvision. com Waltz: ŽÜ>ÌâxÈJ}“>ˆ°Vœ“ Considerations for patients with prior corneal refractive surgery Choosing which implant is best for these patients “Patients who underwent refractive surgery in the 1990s and early 2000s are now aging into the cataract demographic, and many are still very active both in the workforce and their personal lives. The desire for clear and functional vision independent of glasses doesn’t go away.” – Brandon Baartman, MD This article originally appeared in the March 2019 issue of EyeWorld . It has DGGP UNKIJVN[ OQFKƂGF CPF CRRGCTU here with permission from the ASCRS Ophthalmic Services Corp.