Refractive Considerations for Premium IOLs

A patient presents with glaucoma, previous refractive surgery, ocular surface disease, and a desire for greater spectacle independence.

Emily M. Schehlein, MD

Glaucoma Today

Key Takeaways Individuals with glaucoma can have high visual expectations in addition to ocular comorbidities and a history of refractive surgery. Customizing refractive cataract surgery to the patient is essential. Optimizing the ocular surface preoperatively, reducing the medication burden, and educating patients on the benefits and limitations of advanced technology IOLs can help optimize their postoperative satisfaction. Refractive cataract surgery in patients with glaucoma warrants special consideration, particularly because glaucoma rarely exists in isolation. Patients may have history of previous ocular surgery, other ocular comorbidities, and specific visual goals that influence IOL selection and surgical planning. This case highlights an individualized approach to refractive cataract surgery in a patient with glaucoma, previous refractive surgery, ocular surface disease, and a desire for greater spectacle independence. CASE PRESENTATION A 71-year-old man with stable mild glaucoma in the right eye and moderate glaucoma in the left eye presented for cataract surgery. The patient’s ocular history was notable for myopic LASIK performed more than 30 years earlier, a mild epiretinal membrane in the left eye, and mild ocular surface disease, likely due to topical glaucoma therapy. His BCVA was 20/30 OD and 20/40 OS, and he had significant glare symptoms. He had experienced a hyperopic shift and was becoming increasingly dependent on glasses to correct hyperopia and astigmatism (Figure 1).

Myopia: Assessing Management Efficacy

Ensure you are slowing myopia progression and, therefore, reducing long-term ocular risk.

Maria Liu, OD, PhD, MPH, MBA

Modern Optometry

Breaking News From the AAO Annual Meeting in New Orleans (Part 1 of 2)

Eyetube

Eyewire News the Podcast reports on new products and breaking news live from thee American Academy of Ophthalmology meeting in New Orleans. Learn more about your ad choices. Visit megaphone.fm/adchoices