Eyeworld Supplements

4 • 2018 ASCRS Clinical Survey Key findings If a presbyopic patient without astigmatism desires spectacle independence and has no prior experience with monovision, more than two-thirds of respondents said they would prefer a presbyopia-correcting IOL over other options, such as monovision. However, respondents reported that only 9% of their current cataract surger- ies involve presbyopia-correcting IOLs, with concern over quality of vision and additional cost to the patient being the most common barriers. Twenty-one percent of respondents do not use presbyopia-correcting IOLs, how- ever, almost half do plan on using these types of lenses within the next 12 months. Of those who are implanting multifocal or extended depth of focus IOLs, more than 60% think you should be within 0.5 D of target in terms of sphere and cylinder for the best visual quality. Most respondents do not mix presbyopia-correcting IOLs in the same patient (49%). "Many surgeons have reservations about potential side effects, such as glare, halos, and compromised quality of vision, that may be associated with pres- byopia-correcting IOLs. Although lens technology has dramatically improved, we may still have patients who experience these symptoms and this may be difficult to predict. I also thought more U.S. surgeons would be mixing and matching IOLs. I was impressed that the rate was so much higher outside the U.S., however this most likely reflects the greater number of IOL options available internationally. "As for the results regarding a presbyopia-correcting IOL vs. monovision and other presbyopia-correcting options, I think the defining statement in this ques- tion is that the patient does not have prior experience with monovision. I would agree with the group; I would be more inclined to lean toward a presby- opia-correcting lens in patients who want spectacle freedom and who have 'no experience' with monovi- sion through LASIK, contacts, or natural asymmetric myopia." —Kendall Donaldson, MD ASCRS Cataract Clinical Committee What percentage of your CURRENT cataract procedures involve presbyopia-correcting IOLs? • Overall, on average respondentssaid 9% of their current cataract procedures involve presbyopia-correcting IOLs • Non-U.S. respondents are 2% higher than U.S., 11% to 9% • Overall, 21% do not use presbyopia-correcting IOLs • 49% of those not currently using plan to in the next 12 months All 9% US 9% NonUS 11% Average Pct n=874 38 What is the highest amount of residual cylinder you would be comfortable planning to leave in patients undergoing implantation of a presbyopia-correcting IOL? • Nearly two-thirds of respondents would leave 0.5 D or less, 64% • 4% of respondents would leave 1 D or more n=353 44 In patients implanted with a multifocal IOL, how much spherical deviation from your intended target do you consider to be visually significant (i.e., likely to have an impact on visual quality and patient satisfaction)? • 60% think 0.5 D or less • 6% think 0.76 D or more n=187 45 In patients implanted with an extended depth of focus (EDOF) IOL, how much spherical deviation from your intended target do you consider to be visually significant (i.e., likely to have an impact on visual quality and patient satisfaction)? • 61% think 0.5 D or less • 6% think 0.76 D or more n=180 46 Do you mix and match different types of presbyopia-correcting IOLs in the same patient, and if so, what is your most common option? • Overall, nearly half of respondents do not mix IOLs, 49% • U.S.: 38% • Non-U.S.: 67% n=213 53 Presbyopia

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