EyeWorld India December 2014 Issue

30 EWAP CATARACT/IOL December 2014 OCULUS Asia Ltd. Hong Kong Tel. +852 2987 1050 • Fax +852 2987 1090 www.oculus.de • info@oculus.hk OCULUS Pentacam ® HR The new Belin / Ambrosio Display III: Unique for keratoconus and ectasia detection based on corneal tomography Combination of 5 corneal elevation and pachy- metry parameters into one final overall index • for quick visual inspection • for quick decision making • comprehensive but intuitive ONLY available for Pentacam®! • database for hyperopic patients • novel pachymetric parameter ARTmax presbyopia-correcting lenses for patients,” Dr. Braga-Mele said. This was thought to be a good topic to cover because there are very happy multifocal IOL patients as well as some very unhappy multifocal IOL patients. “It’s best that the ophthalmologist have an armamentarium of options and make the correct choice for the patient,” she said. This white paper aims to broaden the knowledge base and serve as a reference article for which patients should be receiving multifocal IOLs and which should not. How was the review conducted and what topic areas are cov- ered? A comprehensive search on the peer-reviewed literature on the topic was conducted. Each member of the Clinical Committee took on a subject heading to do a literature search. Dr. Braga-Mele also served as the editor for the paper, putting it together and writing an introduction and conclusion. Each contributor was assigned a particular section of the manuscript and performed a literature review pertinent to their assignment, Dr. Hoffman said. “Some of the manuscript may have been based on personal experience, such as my section on patient selection and managing preoperative and postoperative expectations.” The paper covered preoperative management of expectations, patient screening, operative considerations, managing complications, and managing the unhappy surgical patient, Dr. Hoffman said. Key messages and conclusions There were a number of important points and conclusions discussed within the paper. “The key message is multifocal IOLs are a good option for most patients, but they’re not for everyone so you need to understand your patient’s needs, you need to understand your patient’s ocular anatomy, and the patient needs to be made aware of the possible side effects and contraindications of the multifocal IOL,” Dr. Braga-Mele said. “If you’re all on the same page, then a happy patient will be produced.” However, if a patient is wary about a multifocal IOL, he or she should be counseled on other potential options. It is also important to remember that there are some unhappy multifocal IOL patients, Dr. Braga-Mele said. Surgeons need to know the steps for counseling them or offering other options. Dr. Hoffman said that by using good surgical technique and performing surgery on properly selected patients, most patients can be made happy with multifocal IOLs. “Proper patient selection and managing expectations, in my view, are the most important criteria for a successful outcome,” he said. “Multifocal IOLs are not for every patient, but each patient should be made aware of their existence and properly counseled as to whether or not they would be a good candidate for the technology.” Dr. Henderson agreed the importance of preoperative counseling was one key message of the paper. Patients should know that vision can fluctuate in the early postoperative period and that these lenses do not deliver perfect uncorrected vision at all distances under all light illumination. “Making sure that they are aware that there are limitations will yield happier patients and prevent surprises,” she said. EWAP Editors’ note: Dr. Henderson has financial interests with Alcon (Fort Worth, Texas, U.S.), Bausch + Lomb (Bridgewater, NJ, U.S.), and Abbott Medical Optics (AMO, Santa Ana, Calif., U.S.). Dr. Hoffman has no financial interests related to this article. Dr. Braga-Mele has financial interests with Alcon, Allergan (Irvine, Calif., U.S.), and AMO. Contact information Braga-Mele: rbragamele@rogers.com Henderson: bahenderson@eyeboston.com Hoffman: rshoffman@finemd.com Multifocal - from page 29