Management of Complications and Unhappy Patients in Multifocal and Accommodating IOL Implantation
Purpose
To describe 9 steps system for improving patient's satisfaction with presbyopic intraocular lenses, and managing all complication that will occur.
Methods
Unhappy patients were divided into 2 categories: A- Unhappy Patients whom underwent surgery in our clinic were managed as followed: 1-Preoperative Investigation: optical biometry, OCT, corneal map including aberrometer, Pelli-Robson Sensitivity Chart, and refraction. 2-Preoperative education and expectations 3-Intraoperative management 4-Respectively treatment (both E=eyes) 5-Management of residual error 6-Management of IOL centration 7-Macular condition 8-Corneal and surface disease 9-Capsular opacification B- Unhappy Patients whom underwent surgery in other clinics were managed as followed: 1-Postoperative steps 2- Decision to extract.
Results
Patients whom were informed and learned the expectations and complications (e.g. halos around the light, residual refraction error, patient may need refractive surgery to correct the refraction error, recentering the lens, or even lens extract) showed highest satisfaction and were more acceptable for any measurements we did after implanting the lens.
Conclusion
There are many things we can do to improve visual outcomes in patients with presbyopic IOL lens, and the unhappy presbyopic IOL patient can be converted to the happy postoperative patient.