EyeWorld India March 2021 Issue

FEATURE 8 EWAP MAR C H 2021 by Liz Hillman Editorial Co-Director What IOL would you choose, Doc? P atients often seek their ophthalmologist’s expert opinion for the IOL they would recommend if they were in the patient’s situation. As a resident at Northwestern University, Hercules Logothetis, MD, and his mentor Robert Feder, MD, actually asked ophthalmologists about the technology they would choose for themselves. 1 “As a resident learning cataract surgery, I became interested in IOL selection and would survey mentors and peers about what they would choose if they were the patient,” Dr. Logothetis said, speaking about what spurred this research. “I thought it was important to know if surgeons were comfortable performing surgical techniques on patients that they may not choose for themselves. That question is complicated. Just because a surgeon prefers one option over another for themselves, it doesn’t mean they don’t support the safety or efficacy of the option they don’t choose.” Contact information Logothetis: herculeslogothetis@gmail.com This article originally appeared in the December 2020 issue of EyeWorld . It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. Dr. Logothetis and his coresearchers used a 29-question survey to ask surgeons about not only IOL choice but also femtosecond laser-assisted cataract surgery (FLACS), their IOL preferences for patients, their personal perspective of risk, and more. The survey garnered 347 responses (328 of which were analyzed) in a 1-month period. The average age of survey respondents was 50.3 (±12.8 years), and most (67%) had been in practice for more than 10 years. More than 60% of respondents were presbyopic. About 85% of respondents performed cataract surgery, and 67.7% used presbyopia- correcting IOLs to some extent. Ninety-three percent of respondents said quality of vision would be most important in their own cataract surgery, and 43.1% said glasses independence would also be important to them (25.4% said it wouldn’t be important to them). If they had minimal astigmatism, most of the surgeons said they would select a monofocal IOL set for distance (34.5%), followed by 26.8% who would select a monofocal set for monovision, 13.7% a diffractive echelette, 9.5% multifocal, 3.7% accommodative, and 11.9% other. Further, 54.6% of surgeons who had implanted more than 50 multifocal IOLs in their own patient base would select a presbyopia-correcting IOL option for themselves. “Surgeons who implanted at least 50 multifocal IOL are two times more likely to select a presbyopia-correcting IOL option,” the study authors reported. If there was more than 1.25 D of astigmatism, 60.3% said they would select a toric monofocal. As for FLACS, the research showed that 55.4% of those surveyed were not certified to perform FLACS; 19.3% of respondents used femtosecond laser at least once a week. When asked if they would want FLACS for their own surgery, 15.4% of respondents said yes, 31.5% maybe, and 52.9% no. Of those who used the femtosecond laser at least once a week, 55.9% said they would have it for their own surgery. Dr. Logothetis said he and