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Cover Stories | Feb 2009

Five Tips for Better Outcomes With Premium IOLs

The successful integration of these technologies into your practice starts and ends with you.

Since the Centers for Medicare & Medicaid Services' ruling in 2005 permitting Medicare patients to select premium or lifestyle lenses (ie, toric, multifocal, and accommodating IOLs), the market for these technologies has grown markedly. In essence, there has never been a better time for patients who are suffering from cataracts to evaluate the options available to them.

We ophthalmologists have been using the term refractive cataract surgery for some time. With the advent of premium lenses, however, we now have a real option for helping our patients achieve spectacle independence for most, if not all, of their daily needs. Refractive cataract surgery has come of age.

There are some challenges that you will face when incorporating premium lenses into your daily practice. This article shares some tips for a successful integration of these new technologies.

The choice of an IOL is an important one for patients. I cannot overemphasize that they will remember a message delivered repeatedly by your practice. It is therefore vital that they hear the same message when they make their appointment, interact with your technicians, schedule their surgery, etc.

In order for your practice's message to be consistent, your staff must have a thorough understanding of the different available IOLs and must use similar terms and visual aids to describe the lens options. I suggest holding a meeting early in the process of integrating premium lenses into your practice in order to provide staff members with the necessary details. You may want to meet regularly thereafter to ensure that everyone remains current on the new devices and techniques you may be implementing. Emphasize to your staff that premium lenses are important to you and the practice.

Your employees may suggest that you see fewer patients each day, because the staff has more information to discuss with them. Additionally, your employees may request visual aids in the form of brochures, magazines, DVDs, and the like. Involving your staff will help grow your practice.

What a cataract is, how it develops, and the surgical options for its treatment are a lot for patients to understand. Often, patients are shocked to learn that they require surgery. They are anxious about the procedure and may not understand everything that it involves. Being presented with all of the lens options at the same time as the initial discussion of cataracts and cataract surgery can overwhelm patients.

Providing them with information in advance helps patients to make better decisions during their consultation. One option is to make your practice's Web site as educational as possible. Include not only a definition of a cataract and its treatment but also provide details on the different IOL options. Mailing out this sort of information in advance of a patient's appointment can also be effective.

Have patients fill out a quality-of-life questionnaire, either in advance of their visit or in your office. Several of these surveys are available, and many IOL manufacturers have versions that they will provide to you. The purpose of these questionnaires is to help patients consider the different IOL options and which type of lens is of most interest to them. Oftentimes, patients' family and friends assist in the survey's completion. I find that these forms allow my patients to formulate important questions for me to answer during their visit.

Encourage patients to bring a family member or friend to their consultation. In my experience, family members and friends often contribute to an informed discussion, help alleviate patients' confusion, and assist in making decisions. The materials my practice mails to patients in advance invite them to bring a family member or friend to their visit for support.

Although many manufacturers provide brochures and materials for patients, I prefer to offer my own information for two reasons. First, my materials are less likely to be biased toward a particular product. Second, they are more likely to set realistic goals for surgery. A major component of the success of premium lenses is reasonable expectations on the part of the patient. It is important to emphasize that we do not have the ideal lens for each patient. The goal of surgery with premium lenses is to improve patients' quality of life.

Premium lenses are in their infancy. This is an exciting time in cataract surgery. Patients now have choices we surgeons never dreamed of 5 to 10 years ago. They now have the opportunity not only to obtain clear vision but also to improve their quality of life postoperatively. As people live longer, more active lives, quality of life becomes increasingly important. We ophthalmologists should therefore embrace premium lenses as we advance and refine refractive cataract surgery.

Kerry D. Solomon, MD, is Professor of Ophthalmology for the Storm Eye Institute at the Medical University of South Carolina in Charleston. Dr. Solomon may be reached at (843) 792-8854; solomonk@musc.edu.

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