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Innovations | Sep 2009

Rationale for IOL Treatment Options

In this month's cover focus, expert surgeons from around the world provide their rationale for treatment options in eight case studies. These scenarios were generously supplied to us by William B. Trattler, MD, Editorial Board member to our sister publication in the United States, to demonstrate how patients' personalities and expectations influence our treatment plan. Every single expert responds to these case studies differently, revealing the enormous depth of treatment options available today. There is not one single option that satisfies every one of our customers, that's pretty obvious.

This cover focus overviews treatment options with which every cataract surgeon should be familiar. But how can this help you in your own office? First, it's not only important for you to have experience with different types of IOLs, it is also your duty to inform patients about the options they have. You must know the possible side effects and indications of these IOLs so you can predict patients' outcomes.

Second, one-size-fits-all is no longer applicable for modern intraocular implant surgery. Therefore, it is unacceptable to only propose one type of lens. Although it is impossible to be familiar with all IOL types available, it is important to continually educate yourself on innovations in this field. One way of doing this is to compare treatment options with your colleagues. Alternatively, articles such as this cover focus are instrumental in disseminating knowledge on what your peers are implanting.

Third, you must learn to (if you are not already) treat each patient as an individual case, catering to his personality and postoperative expectations. We all know that not every patient is capable of expressing his desires. To help us understand the needs and expectations of our patients, the Dell questionnaire is a great tool. By asking patients what they will expect from their visual capabilities after surgery—for instance, whether they will accept seeing halos around lights at night or a loss in their distance vision—you can select the most appropriate IOL for the case.

Fourth, the bottom line is that you, as the surgeon, are the expert. Today's patients typically come into your office having done their research and may even be convinced that they know what IOL is best for them; however, they are still seeking your opinion. Be armed with a wealth of options. Then, you are guaranteed to offer at least one option that suits each patient's needs. The more you show your patients that you are working with them, the more comfortable they will be in your care. The best way to accomplish this goal is to accumulate a solid base of technologies to present to patients.

Along with 16 other well-known colleagues from around the world, I have supplied answers to all eight case presentations, which start on page 50. I hope you find at least one interesting pearl or contemplate adding one of the technologies mentioned into your own armamentarium. As always, we welcome your thoughts and feedback in the form of a letter to the editor.