by Paul Batson, O.D. Center Director VisionAmerica of Birmingham Adoption of Advanced Technology Intraocular Lenses (IOL) such as Toric IOL's continues to grow. They are a great option for the correction of corneal cylinder during cataract surgery with or without multifocal optics. As such, I thought it would be good to share three quick pearls for managing patients who are candidates and choose to receive these lenses: 1. It's all about corneal cylinder, so maximize the ocular surface! When determining if a patient is a candidate and then deciding which IOL to use, the primary focus is the amount, orientation and regularity of the corneal cylinder. To accurately measure this cylinder, patients need to be out of contact lenses and the ocular surface treated for any pre-existing surface disease (dry eye, basement membrane dystrophy, etc.). 2. Let your patients know their options. Failing to educate a patient on their options is essentially making the choice for them. This is something that needs to be avoided. Cataract surgery is a once in a lifetime procedure and patients deserve the opportunity to know their options when it comes to choosing an IOL. If patients have .75D of corneal cylinder or more, make sure that you at least mention that a toric IOL may be an option for them. Look at the corneal cylinder as part of your cataract patient evaluation.
3. Post-Operatively, evaluate the patients cylinder outcome. This needs to be evaluated objectively and subjectively; subjectively with a refraction beginning at the one-week post op visit and objectively through evaluation of the toric markers which should be oriented to the axis of the steep corneal power. Any unexpected outcomes should be discussed with the surgeon as soon as possible. Fortunately, rotation away from the planned axis is pretty rare. I hope you find these tips helpful in your daily practice. The national average for adoption of ATIOL's is roughly 9% of all cataract surgeries. Hopefully this will give you a rough estimate to benchmark against in your own practice. If you ever have questions, either preoperatively or postoperatively, please feel free to give us a call.
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10/25/2023 02:57:02 am
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10/25/2023 03:01:19 am
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