Would you yourself choose to receive a presbyopia-correcting IOL for either refractive or cataract surgery purposes? Why or why not, and what type of lens would you choose if you elected to have this surgery?
GEORGE BEIKO, BM, BCH, FRCSC
Yes, especially as I have reached the age where I begin to encounter presbyopic symptoms, I would consider presbyopic lens implantation. Recognizing that I am an obsessive ophthalmologist with some engineering tendencies, who has been spectacle independent up until recently, and who is very particular about the quality of vision I desire, I would choose mini monovision. I have been impressed with the high quality and range of visual outcomes and relatively low incidence of dysphotopsia with this approach. My lens of choice is the Tecnis (Abbott Medical Optics Inc., Santa Ana, CA), and I would target -0.25 D in one eye and -0.75 D in the other.
ALAN M. BERG, MD
I believe that, when choosing the appropriate implant for any patient undergoing refractive lens exchange or cataract surgery, his or her needs and occupation are the most important factors to consider. Because I am an eye surgeon, if I were to undergo either of these procedures, I would select the Crystalens (Bausch + Lomb, Rochester, NY), because it would offer me excellent distance and midrange vision. I would have my nondominant eye undercorrected for a mild degree of monovision, as my vision has been this way for years. Although I have implanted multifocal lenses with great success, in my case, I would choose the Crystalens.
RICHARD J. MACKOOL, MD
If I required cataract surgery, I would first undergo implantation of the AcrySof IQ Restor IOL +3.0 D (Alcon Laboratories, Inc., Fort Worth, TX) in my nondominant eye. Assuming that I did not develop significant glare or halo problems, I would have the same IOL implanted in my dominant eye. If I did develop symptoms, I would have an aspheric monofocal IOL implanted in my dominant eye. This arrangement would permit night driving because the dominant eye with the aspheric monofocal IOL would be glare free.
MARK PACKER, MD
I would choose a presbyopia-correcting IOL if I had deteriorating visual function due to cataracts. I currently have a little bit of myopic astigmatism, and I only have to wear glasses for night driving. I consider myself relatively spectacle independent for a 52-year-old, and I am not considering refractive surgery. However, if I needed cataract surgery now, I would travel outside the United States to receive the Synchrony (Abbott Medical Optics Inc.) in both eyes. I like how the design of this IOL approximates the physiology of the crystalline lens, maintains an open capsule, and moves in response to ciliary contraction and relaxation.
Section Editor John F. Doane, MD, is in private practice with Discover Vision Centers in Kansas City, Missouri, and he is a clinical assistant professor with the Department of Ophthalmology, Kansas University Medical Center in Kansas City, Kansas. Dr. Doane may be reached at (816) 478-1230; jdoane@discovervision.com.
George Beiko, BM, BCh, FRCSC, is an assistant professor of ophthalmology at McMaster University, a lecturer at the University of Toronto, and a private practitioner in St. Catharine’s, Ontario, Canada. He receives research support from Abbott Medical Optics Inc. Dr. Beiko may be reached at (905) 687-8322; george.beiko@sympatico.ca.
Alan M. Berg, MD, is in private practice with Berg-Feinfield TLC Vision Correction in Burbank, California. He acknowledged no financial interest in the product or company he mentioned. Dr. Berg may be reached at (818) 980-2020; aberg@bergfeinfield.com.
Richard J. Mackool, MD, is the director of The Mackool Eye Institute and Laser Center in Astoria, New York. He is a consultant to Alcon Laboratories, Inc. Dr. Mackool may be reached at (718) 728-3400, ext. 256; mackooleye@aol.com.
Mark Packer, MD, is a clinical associate professor at the Casey Eye Institute, Department of Ophthalmology, Oregon Health and Science University, and he is in private practice with Drs. Fine, Hoffman & Packer, LLC. He is a consultant to Abbott Medical Optics Inc. and was a principal investigator for the Synchrony IOL. Dr. Packer may be reached at (541) 687-2110; mpacker@finemd.com.
