Josh Johnston, OD, FAAO, evaluates the nuances integral to success with new technology for premium cataract surgery. He is the clinical and residency director at Georgia Eye Partners in Atlanta. Johnston reports he is a consultant to Alcon, Allergan, Bio-Tissue, Johnson & Johnson Vision and Shire.

BLOG: Presbyopia-correcting IOL provides personalized vision

Pairing extended depth of focus implants with low-add multifocal lenses can improve near vision.

Personalized medicine involves tailoring treatment to a patient's individual characteristics. It encompasses all aspects of care including risk assessment, prevention, detection, diagnosis, treatment and management. Personalized vision care follows the same model.

Dial it in

Today’s implant and laser technology gives cataract patients the opportunity to achieve a personalized visual outcome. Surgeons can correct presbyopia and astigmatism while at the same time providing patients with a clear range of vision from near to far. Depending on patients’ specific lifestyle needs, their visual acuity results can be tweaked using IOL strategies that employ different types of implants. The Tecnis family of presbyopia-correcting IOLs, for example, offers extended depth of focus (EDOF) technology and low-add multifocal implants that deliver high-quality, full visual range.

A study of patients with combined IOL implantation with the Symfony EDOF IOL and a low-add Tecnis multifocal +3.25 D demonstrated excellent uncorrected and corrected visual acuities from near through far distances, low dependence on glasses at all distances, and minimal or mild reports of visual symptoms at 3 months postoperatively (Black et al.). The personalized vision approach also improved patient satisfaction.

Lifestyle and visual needs questionnaires

A thorough conversation with patients about their visual needs is crucial as are well-designed questionnaires that allow eye care providers to be well-armed with key information before meeting the patient. Eye care providers should really make sure they are on the same page as patients, learning their needs, hobbies and personality. The Dell Questionnaire and the Johnson & Johnson Vision Lifestyle Questionnaire are great tools that help define patients’ vision goals.

Not only IOLs but also a patient's refractive target must be personalized to suit the patient's needs, lifestyle and optical system (eg, manifest refraction, aberration status). A comprehensive workup is needed of course, and patients should be counseled on what to expect from their cataract surgery and subsequent visual results. It's always helpful to have educational devices like models and videos.

When mixing and matching IOLs, surgeons often check to ensure the patent is happy with the result in the first eye. This can allow for adjustments to the second eye to further personalize the outcomes and ensure a successful result that delivers the patient's desired vision.

Customizing results

Combining IOL technologies like an EDOF implant with a multifocal IOL, surgeons can achieve a customized visual result for patients that allows them to participate in the activities they love and enhance their quality of life.

By choosing the best implant technology, carefully pinpointing patients’ visual goals and performing a detailed preoperative evaluation, eye care providers offer patients superior personalized visual outcomes.


Reference:

Black S. Clin Ophthalmol. 2018;doi:10.2147/OPTH.S175901.