12 EyeWorld Asia-Pacific | March 2025 CATARACT by Liz Hillman, Editorial Co-Director How To Discuss IOL Options With Patients There are an abundance of choices available for patients and their respective visual scenarios or outcomes—especially with the great opportunity in the world of IOLs. These opportunities, however, also come with a challenge: how to discuss these options efficiently, in a targeted manner without overwhelming or confusing patients. EyeWorld spoke with three members of its Cataract Editorial Board to learn how they manage these discussions (multiple times a day) and gain insights on how their patient conversations have evolved over the years. ‘It sure does add up’ Rosa Braga-Mele, MD Dr. Braga-Mele begins her process of IOL selection and the patient conversation by narrowing down what she needs to focus on based on the patient’s eye anatomy. She noted several factors that could preclude patients from opting for certain advanced-technology IOLs. “Having said that, my patients are all given a sheet that shares what lenses are available, and it’s a broad brushstroke of lenses. Before they even see me to get anything done, they’re reading this list,” Dr. Braga-Mele said. “They have time while in the waiting room, to digest that, and may have some questions they want to ask regarding their eligibility. The first question I ask them is: do they mind wearing glasses, or do they want the opportunity to get rid of glasses for 90–95% of their tasks?” If the patient says they’re OK with wearing glasses, the conversation about their lens option can take just one minute. If the patient has astigmatism and is willing to pay for the lens, Dr. Braga-Mele said a toric IOL is a “nobrainer.” “I think the hardest category is the presbyopia-correcting lens category because it now becomes halo and glare that you have to discuss with your patient,” she said, noting that her conversation with patients interested in presbyopiacorrecting IOLs takes about 5 minutes, and they usually require an additional tele-consultation. If the patient is interested in a full range of vision and says they would tolerate halo and glare, Dr. Braga-Mele discusses trifocal options. If they’re interested in some range of vision but are less tolerant of halo and glare, she’ll discuss EDOF options. She then lets the patient go home and will schedule a phone consultation with them if they want to review the lens options further.
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