![]() If there are any findings on the anterior segment or dilated fundus exam that will limit the patient’s visual potential, we typically recommend monofocal IOLs with or without monovision. There are many reasons to avoid MF or even EDOF lenses in patients that have limited visual potential: (1) loss of contrast sensitivity from the IOL, (2) the perceived lack of value of a premium IOL if the patient is paying extra out-of-pocket and not achieving their best potential vision, (3) remove the confusion postoperatively as to the cause of decreased vision-i.e., is it the IOL or some other ocular pathology? In this article we’ll focus on the anterior segment/cornea conditions that can affect the outcomes of premium IOLs, namely ocular surface disease, Salzmann’s nodular degeneration, epithelial basement membrane dystrophy, Fuchs’ endothelial dystrophy and irregular astigmatism. To come to that decision, we evaluate the patient from front to back-from the ocular surface to macula-and address any findings with them preoperatively in order to avoid any mistrust or surprises postoperatively. ![]() S ince I started implanting premium IOLs in 2002, I’ve learned when to offer these lenses and when to avoid them. After reviewing the iTrace, one can move on to the results of traditional tests, such as glare vision, biometry, and Snellen acuity.Artificial Intelligence for the Cornea SpecialistĭSO and Cultured Endothelial Cell Transplants: A Reviewīy Thomas John, MD, and Anny M.S. With the iTrace, surgeons no longer need to rely only on their subjective lens grading from the slit-lamp exam. Patients can easily understand their cataract “grade,” as the DLI scale shows how much optical distortion is coming from the lens, which I believe impresses them more than a trying to describe their cataract while holding a plastic eye model, for example. The latest software has made interpreting data more intuitive and user-friendly, with touchscreen or tablet displays.įor refractive consultations, when I enter the exam room, the first test I look at is the DLI display for each eye I then quickly know the cataract grade (or if the lens is still mostly clear and performing well) and also the amount of corneal astigmatism from the axial topography map. The compact device quickly measures the entire optical pathway to produce a dysfunctional lens index (DLI), enabling it to objectively grade lens opacity and separate visual aberrations due to the cornea and those attributed to the lens. The iTrace (Tracey Technologies) is an attractive diagnostic technology that features both topography and aberrometry. Tackling Ocular Inflammation and Pain With Lotemax Gel Following Ocular Surgery Tri-Moxi and the Dropless Cataract Surgery Revolutionĭisposable Gonioscopy in the OR and Clinic Shifting Gears in Glaucoma with Suprachoroidal Shunts Reflections on Fellowship Year: Five Lessons LearnedĬorneal Biomechanics for Detecting Subclinical Keratoconus Outstanding Female Leader in Ophthalmology: Sonia Yoo, MDīuilding a Five-Star Reputation with Online Reviews ![]() Outstanding Female Leader in Ophthalmology
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