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EW San Francisco Patient counseling When counseling patients about IOL choices, I warn them about night- time glare and halos with multifocal lenses. However, either because of neuroadaptation or because I have prepared them well, patient com- plaints about glare and halos are minimal in my practice. Unfortunately, glare and halos cannot be completely eliminated because of the concentric ring de- sign of multifocal IOLs. So, it is im- portant to let patients know that they will most likely experience it to some degree. However, glare and halos can also be caused by other factors, such as ocular surface disease, PCO, anterior basement membrane dystrophy, or a poorly centered IOL. Obviously, it is impor- tant to pretreat any existing ocular surface disease and perform meticu- lous surgery with a well-centered IOL. Small incision surgery with a well-centered capsulorhexis con- tributes to good refractive outcomes. I also tell patients that while they will have good vision overall, a certain percentage of patients may feel that their intermediate vision is not as good as their distance and near. Patients occasionally might need a pair of glasses for intermedi- ate work, like computer work. Often, over the course of six months to a year, patients find that they rely less and less on glasses due to neuroad- aptation. Overall, I've had a very high satisfaction rate, and that's why I've continued to use these lenses. For example, in a multicenter, prospec- tive, open-label observation registry evaluating the Tecnis one-piece mul- tifocal IOL (Abbott Medical Optics, Santa Ana, Calif.) in 106 patients, we found that the majority of pa- tients were satisfied or very satisfied with their vision without correction compared to their vision before sur- gery (see Figure 1 and 2). However, it is imperative not to oversell. Multifocal IOLs are excellent technology but patients need to understand that nothing is perfect. Dr. Davis is managing partner, Minnesota Eye Consultants, and adjunct clinical assistant professor, University of Minnesota. She can be contacted at eadavis@mneye.com. 15 Achieving success with multifocal IOLs " Either because of neuroadaptation or because I have prepared them well, patient complaints about glare and halos are minimal in my practice. " Intermediate UCVA data from a multicenter clinical trial Near UCVA data from a multicenter clinical trial Source (all): Elizabeth Davis, MD This supplement was produced by EyeWorld and supported by a grant from Abbott Medical Optics Inc. Copyright 2013 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or the publisher, and in no way imply endorsement by EyeWorld or ASCRS. Update on the latest in refractive cataract techniques and technologies AMO Saturday supplement_SF2013-dl.qxp_Layout 1 4/19/13 11:27 PM Page 15

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