In this week’s issue of Ocular Surgery News, experienced cataract and refractive surgeon Y. Ralph Chu, MD, (Bloomington, MN) encourages fellow eye surgeons to learn more about the latest premium intraocular lens (IOL) technology and assess their own capabilities for offering multifocal IOLs and other premium lens implants to their patients who are seeking cataract surgery and/or presbyopia correction surgery.
In the article, Dr. Chu and other prominent cataract and refractive surgeons discuss the advantages of premium IOLs and factors surrounding the usage of these and other new eye surgery technologies.
Premium intraocular lenses include multifocal IOLs and accommodating IOLs to correct presbyopia and reduce the need for reading glasses, toric IOLs to correct astigmatism and aspheric IOLs designed to reduce glare and improve night vision.
Educating patients and managing their expectations about premium IOLs
Surgeon David F. Chang, MD, (Los Altos, CA) advises surgeons to educate patients about premium IOLs prior to surgery and to use concise, clearly understandable language about visual expectations after surgery.
Premium IOLs cost more than regular intraocular lenses, and the difference in cost typically is not covered by insurance and becomes an added out-of-pocket expense for patients, increasing their cataract surgery cost. The premium price of these lenses often leads patients to expect premium visual outcomes, says Richard L. Lindstrom, MD (Bloomington, MN).
John A. Hovanesian, MD, (Laguna Hills, CA) and Eric. D. Donnenfeld, MD, (Rockville Centre, NY) said that surgeons should discuss all available premium lens options with patients, including the strengths and weaknesses of each lens, and that it is critical for the surgeon to personally believe in the technology if they are to offer it to patients.
Refining outcomes after IOL surgery
Because people who choose premium refractive IOLs for cataract surgery or lens-based refractive surgery such as refractive lens exchange (RLE) often have high visual expectations, laser surgery is sometimes needed after premium IOL surgery to fine-tune visual outcomes, says Dr. Chu.
Dr. Lindstrom cited a recent study indicating that more than 95 percent of patients were satisfied with their visual outcomes after LASIK surgery, noting that many of these patients, too, needed a laser enhancement to achieve their best visual outcomes.
Popularity of premium IOLs is increasing
Apparently, many refractive surgeons are finding that the added benefits of premium IOLs outweigh the challenges of the new lenses, as recent research shows more surgeons in the U.S. are offering premium lens implants to their patients:
- According to a survey of cataract and refractive surgeons reported by Market Scope, 71 percent of surgeons responding said they offered premium IOLs to their patients in 2008, up from approximately 59 percent in 2007.
- Market Scope also estimates that 210,000 presbyopia-correcting IOLs were used for cataract surgery or other vision correction procedures in the U.S. in 2008, up from 153,000 in 2007.
Eye surgeons also are more frequently recommending premium IOLs for the correction of high myopia in patients seeking elective vision correction surgery.
In a 2008 survey of American Society of Cataract and Refractive Surgery (ASCRS) members, more surgeons responding to the survey preferred premium IOLs (40 percent) to LASIK (23 percent) for the correction of high myopia.
SOURCE: Surgeons considering premium IOLs must overcome fear of change, challenge. Ocular Surgery News, U.S. Edition. October 25, 2009.