Very interesting take. For most cases, I generally aim for about -0.15 but it depends upon the patient and their preop refraction. I'm still hesitant to flip my myopic patients into hyperopia, but you are right ... the hyperopic patients are generally pleased with anything.
This will definitely change my practice! Usually when you're picking IOLs, you have the option between about a -0.1 and a +0.1, and I usually err on the myopic side. Might start erring more on the hyperopic side! As for near targets, either for monovision or keeping a myopic patient with some residual myopia, would love to know everyone else's experience: when I used to aim for -2.5 with the Barrett formula, I was routinely ending up closer to -3. Now I aim for -2 or -2.15 at the most and they end up closer to -2.5 and they're really happy. I don't understand why it's so consistently good for plano, but inconsistent for myopic targets.
What about factoring in astigmatism? ie a patient has 0 sphere -1 Astigmatism (90°) - do you aim for SE plano or -0.5 (since -0.5 SE means 1 axis on zero and 1 on -1, whereas AE 0 would mean main 1 axis +0.5 and the other -0.5)
Great question following a great video ! I would love to hear what Dr Devgan has to say about it. ( perhaps answer is in the podcast, need to catch up on that :) ) I'm assuming that, like me, you have no way of correcting astigmatism other than through paired incisions in your armanentarium.
The question to patients was specific to dva satisfaction. But that is not the end all be all of a patients postop vision. Id be willing to bet they were more dependent on reading glasses or bifocals after surgery.
Very interesting take. For most cases, I generally aim for about -0.15 but it depends upon the patient and their preop refraction. I'm still hesitant to flip my myopic patients into hyperopia, but you are right ... the hyperopic patients are generally pleased with anything.
Definitely some food for thought. Check out yesterday’s podcast with Dr Schallhorn to hear all his specifics
This video will change my practice forever
Really good stuff Uday!
Thank you, that was so helpful. Now I can ask my surgeon to consider a little different prescription.
Does this dogma consider the effect of residual hyperopic refraction on near vision?
This will definitely change my practice! Usually when you're picking IOLs, you have the option between about a -0.1 and a +0.1, and I usually err on the myopic side. Might start erring more on the hyperopic side!
As for near targets, either for monovision or keeping a myopic patient with some residual myopia, would love to know everyone else's experience: when I used to aim for -2.5 with the Barrett formula, I was routinely ending up closer to -3. Now I aim for -2 or -2.15 at the most and they end up closer to -2.5 and they're really happy. I don't understand why it's so consistently good for plano, but inconsistent for myopic targets.
So true, I found Barrett s formula more towards myopic side. So I always pick a little hyperopia so I grt the desired result
Is there a link to the paper the odds ratio data comes from?
What about factoring in astigmatism? ie a patient has 0 sphere -1 Astigmatism (90°) - do you aim for SE plano or -0.5 (since -0.5 SE means 1 axis on zero and 1 on -1, whereas AE 0 would mean main 1 axis +0.5 and the other -0.5)
Great question following a great video !
I would love to hear what Dr Devgan has to say about it. ( perhaps answer is in the podcast, need to catch up on that :) )
I'm assuming that, like me, you have no way of correcting astigmatism other than through paired incisions in your armanentarium.
@@dmnxstd no, I do. Patients just have to pay a lot extra for astigmatism-correction, that's why I usually leave anything up to -1.5dpt
Thank you for sharing with us , one question for , can we consider mini monovision with Vivity?
Non dominant eye - aiming for -0.5D.
Has dr Schallhorn published these results, can not find this figure in his papers on patient satisfaction
I need to read the whole paper and check the cohort characteristics. I reckon 60 year olds will have different expectations than 80 year olds...
The question to patients was specific to dva satisfaction. But that is not the end all be all of a patients postop vision. Id be willing to bet they were more dependent on reading glasses or bifocals after surgery.
yes, of course. thought this was pretty clear from the video...