One of the most important aspects of how we talk about laser cataract surgery and premium IOL options with patients in our practice is framing the conversation. For example, I say, “Normally, I use the laser for surgery.” If he or she is a candidate for a multifocal lens or an extended depth of focus implant, such as the Tecnis Symfony from Johnson & Johnson Vision, I start the discussion with that as the first lens option. I say, “We need to use a clear lens implant for surgery. That lens is prescription, and it is going to reset your vision.” I explain that one type of lens option will “give you a range of vision so you can see far and you can see your phone.”
What they want
Remember, at this point in the consultation, I know the patient’s hobbies, by glancing at their vision questionnaire to see if there are any specific visual demands (eg, does the patient do really close work or high-definition distance tasks). Plus, patients report if they prefer reading glasses or not, giving me an idea of their targets. I have found that most patients’ answers are pretty spot on.
My conversations about astigmatism are easier now than before having the laser. As mentioned in my last blog, patients in my practice watch a video of the laser and they have a sense of what it does during the procedure. It follows that I tell them that their astigmatism will be corrected by the laser. If the patient has a higher amount of astigmatism, I am going to recommend a toric lens, so I change my wording.
For example, I might say: “The laser does multiple steps in cataract surgery. The laser makes a very precise opening in the cataract in one second, creates the incisions and breaks up the cataract, so we don't need to use as much energy and heat. Also, the vision step of correcting astigmatism, which improves vision without glasses.” The concept makes sense to most patients, and it fits with what they assume we do with the laser.
Technology is the answer
I focus on the precision of what the laser does rather than specifically explaining how the laser works. This makes the conversation about the outcome that the patient has indicated he or she desires. This is in contrast to the approach of having a list of technologies to offer the patient and starting at the bottom of the pyramid. Beginning a technology discussion with basic options and working up results in emphasizing price in the patient’s mind rather than their vision.