Successfully pairing IOLs with eyes calls for proper pacing of appointments, knowing and educating patients, and accurately analyzing data during the preoperative and surgical planning stages, a presenter said at Hawaiian Eye 2014.
Moving too swiftly through the preoperative stage overwhelms patients and yields inaccurate data, Cynthia Matossian, MD, told colleagues.
“Decouple the cataract consult appointment from your surgical testing appointment,” Matossian said. During the cataract consult, the cornea is barraged with anesthetic drops, mydriatic agents, dyes and applanation devices, she said, which makes it difficult to obtain accurate measurements. Furthermore, patients are not prepared at the initial appointment to commit to a type of implant.
“Give them time, educate them, bring them back, and you’ll see your conversion rates will absolutely go up,” Matossian said.
Asking about a patient’s occupation, hobbies and driving preference influences the choice of IOL, she said.
“Somebody who is a hairstylist, for example, has very different needs than someone who is a truck driver and stares at oncoming headlights all night long,” she said.
Reviewing the patient’s ocular history and current medications prepares patients and physicians for the possibility of a “refractive surprise,” she said.
Matossian implements 2 weeks of ocular surface preparation before surgery, and if the patient has pre-existing dry eye disease, she discusses it with the patient preoperatively.
“Let them know that they have pre-existing ocular surface disease and that you, as the surgeon, are not giving them dry eye after the surgery,” she said.
Correct interpretation and personalization of data derived during the ocular surface assessment, biometry appointment, angle kappa review and topography measurement all dovetail into the decision of which IOLs to offer, she said, noting that she offers a standard lens as well as an advanced technology lens.
“Happy patients become your ambassadors of goodwill,” she said. – by Steve Ahern
Disclosure: Matossian is a consultant for or is on the speakers bureau for Abbott Medical Optics, Alcon, Allergan, Bausch + Lomb, Lenstec, Marco Ophthalmic and TearLab. She does contracted research for Lenstec, Physician Recommended Nutriceuticals and TearLab. She is a stock shareholder in Physician Recommended Nutriceuticals.