Advanced IOL Selection in a Low Night-Driving Patient With Bilateral Cataracts

This segment reviews a case-based roundtable discussion focused on advanced intraocular lens (IOL) selection in cataract surgery, highlighting the importance of patient-centered decision-making. The case involved a 69-year-old retired pastor engaged in foreign mission work who presented with bilateral cataracts, glare symptoms, and astigmatism. Faculty emphasized that successful outcomes with advanced technology IOLs begin with understanding the patient’s lifestyle, visual goals, and tolerance for potential visual phenomena such as glare and halos. Discussion centered on comparing multifocal options, including the enVista Envy and Odyssey lenses, as well as alternatives such as monofocal, mini-monovision, and light-adjustable lenses. Accurate biometry and astigmatism management were underscored, particularly when measurements are inconsistent and ocular surface disease may be a contributing factor. Ultimately, the enVista Envy lens was selected, with participants noting its strong near vision performance, forgiveness of small refractive errors, and favorable halo profile. The patient achieved excellent postoperative satisfaction and visual outcomes.