Following these 10 best-practice habits can help surgeons establish a standard of care for the countless surgeries they will perform throughout their careers.
1. Be prepared
Identify ocular comorbidities that may present intraoperative challenges and have a game plan. Conditions like small pupils, intraoperative floppy iris syndrome, loose zonules/phacodonesis, dense brunescent rock-hard cataracts, white intumescent cataracts, and posterior polar cataracts all pose potential risks, need proper approaches, and require the possible use of assistive devices intraoperatively.
2. Discuss lens options
Discuss appropriate lens options for the patient and desired target refractive outcomes. Cataract surgery is refractive. Patients may have high expectations of fast and painless surgery as well as excellent visual results, including the possibility of reduced dependence on glasses. Offer elective options of premium IOLs. It is also important to have the ability to conduct enhancements when needed.
3. Obtain reliable biometry, use appropriate lens formulas
This involves treating any pre-existing ocular surface disease (OSD), repeating axial length measurements when warranted for confirmation of differing eye lengths, and knowing which formula is suitable. Using the latest generation of multivariable formulas can enhance predictability of refractive results. Surgeons should also personalize A-constants for the most precise outcomes.
Elizabeth A. Davis MD, FACS
E: [email protected]
Dr. Davis is partner, Minnesota Eye Consultants, Bloomington, MD. She did not indicate any proprietary interests relevant to the subject matter.