CataractCoach™ 2212: What refractive target is best for distance vision?

Рет қаралды 6,970

2 ай бұрын

Yesterday's CataractCoach Podcast featured Dr Steven Schallhorn and it was a fascinating discussion that taught me so much. Using a big data approach he analyzed patient satisfaction after monofocal IOLs and a goal of plano for best distance vision. The results were surprising because they contradict the old dogma of cataract surgery that you should aim for -0.50 for best distance vision. That's not the best approach according to his data. By the way, remember back when you didn't realize how much benefit you would get from watching a 5 min cataract video every day? Yup, there is even more benefit from listening to an hour podcast once a week! I am confident that you will love the podcast and you will learn so much to benefit your patients.

Пікірлер: 15

@TimRoot-dotcom 2 ай бұрын

Very interesting take. For most cases, I generally aim for about -0.15 but it depends upon the patient and their preop refraction. I'm still hesitant to flip my myopic patients into hyperopia, but you are right ... the hyperopic patients are generally pleased with anything.

@UdayDevgan 2 ай бұрын

Definitely some food for thought. Check out yesterday’s podcast with Dr Schallhorn to hear all his specifics

@kkpoon329 2 ай бұрын

This video will change my practice forever

@VeraStucki 2 ай бұрын

What about factoring in astigmatism? ie a patient has 0 sphere -1 Astigmatism (90°) - do you aim for SE plano or -0.5 (since -0.5 SE means 1 axis on zero and 1 on -1, whereas AE 0 would mean main 1 axis +0.5 and the other -0.5)

@dmnxstd 2 ай бұрын

Great question following a great video ! I would love to hear what Dr Devgan has to say about it. ( perhaps answer is in the podcast, need to catch up on that :) ) I'm assuming that, like me, you have no way of correcting astigmatism other than through paired incisions in your armanentarium.

@VeraStucki 2 ай бұрын

@@dmnxstd no, I do. Patients just have to pay a lot extra for astigmatism-correction, that's why I usually leave anything up to -1.5dpt

@MrRedalertcc 2 ай бұрын

This will definitely change my practice! Usually when you're picking IOLs, you have the option between about a -0.1 and a +0.1, and I usually err on the myopic side. Might start erring more on the hyperopic side! As for near targets, either for monovision or keeping a myopic patient with some residual myopia, would love to know everyone else's experience: when I used to aim for -2.5 with the Barrett formula, I was routinely ending up closer to -3. Now I aim for -2 or -2.15 at the most and they end up closer to -2.5 and they're really happy. I don't understand why it's so consistently good for plano, but inconsistent for myopic targets.

@leos3003 2 ай бұрын

Thank you, that was so helpful. Now I can ask my surgeon to consider a little different prescription.

@vsharmaophth 2 ай бұрын

Thank you for sharing with us , one question for , can we consider mini monovision with Vivity? Non dominant eye - aiming for -0.5D.

@MountainView21 2 ай бұрын

I need to read the whole paper and check the cohort characteristics. I reckon 60 year olds will have different expectations than 80 year olds...

@jamiebeckman5189 2 ай бұрын

Is there a link to the paper the odds ratio data comes from?

@alexanderpothof2653 Ай бұрын

Has dr Schallhorn published these results, can not find this figure in his papers on patient satisfaction

@PeterLombardGuam 2 ай бұрын

The question to patients was specific to dva satisfaction. But that is not the end all be all of a patients postop vision. Id be willing to bet they were more dependent on reading glasses or bifocals after surgery.

@UdayDevgan 2 ай бұрын

yes, of course. thought this was pretty clear from the video...