The right IOL?

Doctors must be careful not to raise their patients’ expectations

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I am very pleased to be invited to write this editorial for EuroTimes, which has a special focus this month on next-generation IOLs. As my colleague Soosan Jacob points out in this issue, intraocular lenses (IOLs) have come a long way since Sir Harold Ridley’s first implantation in 1949 after noticing inert acrylic plastic splinters from aircraft canopies in eyes of pilots during World War II. Currently, with more than six million IOLs implanted yearly, there is understandably tremendous research directed at improving visual and quality and at decreasing complications. As surgeons, our first obligation should be to to use the lens that we are most comfortable using. We should also ask ourselves what is the lens that is best suited to the individual patient? With increased use of social media, patients have greater access to information about the exciting new technologies emerging. They may think that after a lens is implanted, they will have almost perfect vision but we must have serious discussions with them about the need to have realistic expectations. Our message should be honest and simple. We will always do our best and we, like our patients, will hope for the best possible outcomes. It also needs to be pointed out that every procedure is different and every patient is different. Another challenge we face is the challenge of choosing the right IOL power, optical biometry, modern formulae and optimised IOL constants, and precise measurements of anterior and posterior corneal curvature by two or more devices have greatly improved IOL selection accuracy. Future developments such as intraoperative measurements to refine IOL selection and adjusting lens power after surgery may further improve outcomes. So how do we explain this to our patients? In my opinion, a good doctor is like a good teacher, with the gift of being able to explain complex ideas in a manner that is easy to absorb for the patient. I hope that after reading this issue of EuroTimes with a special focus on IOLs, you the reader will also have learned a bit more, so happy reading! Oliver Findl is Secretary of the ESCRS and Chairperson of the Young Ophthalmologists Committee
Tags: intraocular lenses