Retrospective Analysis Of The Refractive Outcome Of 200 Panoptix (100 Patients) For Spectacle Independence , Stand Alone Practice In Kolkata India With Basic Equipment For Preoperative Investigations

Analysis of the results  of  implanting Multifocal IOL's in an eye clinic which is department in a busy general hospital. There is no advanced technology in the OPD with basic equipment for pre operative work up. Assessment of patient satisfaction and overall spectacle independence  and refractive outcome is documented.

A retrospective analysis of 200 eyes( 100 patients) operated upon by Phaco and Femto , single centre , single surgeon ,where the eye  clinic is an extension of a general hospital.No dedicated counsellors and the peroperative work up does not entail pentacam or corneal topography. There is no Verion in the OT.

A retrospective analysis of 200 eyes( 100 patients) operated upon by Phaco and Femto , single centre , single surgeon in a basic eye department. No team of dedicated counsellors and the peroperative work up does not entail pentacam or corneal topography. Using clinical judgement based on past experience of multifocal IOL 's from 2003 onwards, suitability of a patient for Trifocal IOL keeping in mind the  profile and  expectations.

The degree of spectacle independence and overall patient satisfaction is calculated and complication's , dissatisfaction if any are documented.How to assess  patient expectations and assessment of when to opt for multifocal IOL's is concluded. The common pitfalls causing dissatisfaction are recorded .

Out of 100 patients, the overall spectacle independence for all distances was 85%. There was a near 90% satisfaction especially in middle aged hyperopes.Treatment of dry eyes pre operative was crucial for better results.Increase chair time , under promise and over deliver.  The author is satisfied with the results of the latest Panoptix IOL and cases when not to implant a Trifocal IOL from the experience of two decades are documented 

Not having high tech equipment or a team of dedicated counsellors meant one had to err on the side of caution rather than surgical bravado .

5% of patients were dissatisfied overall. 15% of patients did need some spectacles for eithe reading, computer and sometimes clarity at distance.

The surgeon must have a good understanding of the patient's need and desire for spectacle independence. Implantation of trifocals is no guarantee for total freedom from spectacles. Proper counselling pre operative helps control and analyse patients expectations. Clear clinical acumen and cross correlation between vision, spectacle power, personality,refractive error, keratometry , optical biometry helped the surgeon to grow a practice in Trifocal IOL's without high end equipment in OPD or OT