Eyeworld Supplements

2 anterior chamber depth and the lens thickness measurements by optical biometry allows the user access to all the features of the most advanced formulas. 2 Expanding your premium lens population Because of increased precision with biometry, it is likely that a higher percentage of our premium lens pa- tients will have accurate outcomes. Combined with newer generation formulas (Holladay 2, Haigis, and Olsen), the Lenstar represents the current state-of-the-art optical biometer. The Lenstar is, in short, chang- ing how we approach the process of IOL power calculations. By allowing the user access to every part of the measurement process, along with the ability to edit the results against validation criteria, there is a signifi- cant increase in the control over the final accuracy. This precision makes the Lenstar an excellent device for surgeons who are looking to opti- mize their outcomes for all patients, as well as expand their premium lens patient population. References 1. Hill WE, Osher R, Cooke D, et al. Simulation of toric IOL results comparing manual ker- atometry to dual-zone automated keratometry from an integrated biometer. J Cataract Refract Surg. 2011; 37 (12): 2181-2187. 2. Lam S. Comparison of age-derived lens thickness to optically measured lens thickness in IOL power calculation: a clinical study. J Refract Surg. 2012;28(2):154-155. Dr. Hill is in private practice, East Valley Ophthalmology, Mesa, Ariz. He can be contacted at 480-981-6130. EW San Francisco 2013 Monday, April 22, 2013 2 Achieving optimal outcomes with multifocal IOLs Advanced continued from page 1 Preop evaluation and intraop astigmatism management are critical to success P articularly as new IOLs become available, and as more Baby Boomers require cataract surgery, interest in refractive options will continue to climb. Most ophthal- mologists believe that appropriate cataract patients should be informed about these options as part of the surgical informed consent. Deter- mining which patients are good candidates for a multifocal IOL is a complex process, but if properly selected and informed, a certain per- centage of our cataract population will be thrilled with the results. Careful patient selection and effective preoperative education and counseling are time consuming, but extremely important. Patient satis- faction is very much a function of preoperative expectations, and our messaging competes with the inter- net, boastful friends, comparison to LASIK, and the power of suggestion that they will be rid of eyeglasses. Understandable and effective com- munication about expectations is just as important as the ability to make a proper capsulorhexis. I begin preoperative education by mailing handouts and my modification of the Dell refractive questionnaire to all cataract patients prior to their ap- pointment. These carefully worded handouts explain presbyopia and astigmatism and the non-covered elective refractive options, so that patients will be better prepared to make a decision regarding their IOL. Creating a multifocal optic with two disparate focal points entails some optical compromise. Preopera- tive preparation and the patient's personality and motivation can facilitate adaptation to unwanted images such as halos. Summation from bilateral multifocality helps to by David F. Chang, MD " Determining which patients are good candidates for a multifocal IOL is a complex process, but if properly selected and informed, a certain percentage of our cataract population will be thrilled with the results. " David F. Chang, MD Please refer to page 8 for important safety information about the Alcon products described in this supplement. Preoperative right and left eye topography and wavefront analysis of a patient who desires a multifocal IOL. The corneal higher order aberrations (within the green outline) are computed from the same corneal diameter as the patient's scotopic pupil. The high amounts of coma and spherical aberration increase the risk of poor visual quality with a multifocal IOL. Source: David F. Chang, MD continued on page 3 Alcon Monday_SF2103 8pages-DL_Layout 1 4/21/13 7:54 PM Page 2

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