It is easy to overwhelm a patient with the information we provide during an initial consultation. When you build refractive IOLs into your practice, the patient has additional information to sort through, and it is even more crucial for us to educate and guide the patient into making a decision that is right for him.
Recently, I began using a patient education software program that enhances my aptitude for counseling patients. The IOL Counselor (Patient Education Concepts, Inc., Houston; and Eyeland Design Network, Germany) recreates several common scenes, including supermarket aisles, baseball stadiums, and city streets, in normal, presbyopic, and cataract modes (Figure 1), to allow the patient to assess his potential vision with various types of IOLs.
The software includes the vision assessment questionnaire (VAQ) designed by Stephen Dell, MD, which patients fill out before their initial visit; a 6-minute patient video and a tutorial video on how to use the IOL Counselor; IOL-simulated scenarios; an acceptance form; and a printable training manual.
Upon the patient's initial visit, I use the VAQ to quantify his lifestyle and personal needs. After visual acuity testing, I determine if the patient is a good candidate for a premium IOL. If so, I discuss the available IOLs and explain each one's mechanism of action. The IOL Counselor is a great adjunct technology to use in this process because it simulates real-life situations with monofocal and presbyopia-correcting IOLs. Its use in my clinic has dramatically increased the number of patients who choose premium IOLs because the simulations make postoperative outcomes more realistic for patients. They can imitate vision with and without the aid of a premium IOL to visually understand how they will see at near, intermediate, and distance vision. The IOL Counselor also depicts the presence of nighttime aberrations, including glare and halos. For patients interested in cataract removal surgery or limbal-relaxing incisions, an option to view animated surgeries is also available.
After I write my IOL recommendation on the bottom of the patient's VAQ form, he is directed to complete the IOL acceptance form, which informs him that the program's simulations do not guarantee individual postoperative visual acuity. The patient then watches the video and assesses which IOL is the best fit.
Sagittal views of various refractive errors, such as presbyopia and astigmatism, further enhance patients' understanding of each IOL technology. The bottom line is that patients have the opportunity to make informed decisions through visualization. When we watch the simulations with the patient, the consequence is an educated discussion about the available choices and options. In turn, we can devote our administrative time to educating the patient in common, defined terms.
I have found the IOL Counselor helps me discuss IOL options with my patients. Since I started using the product, I have had more patients choose premium IOLs. Use of the IOL Counselor will become more widespread among cataract and refractive surgeons, specifically in Europe. European surgeons should also spend more time with their staff and better educate their technicians about important tools, such as the IOL Counselor.
