2. Premium IOL, High CostPremium IOL, High Cost
Advantages ClaimedAdvantages Claimed
UNAIDED Distant,UNAIDED Distant,
intermediate and nearintermediate and near
visionvision
Freedom from glassesFreedom from glasses
Old age, PhysicallyOld age, Physically
handicappedhandicapped
Indoor life style, day timeIndoor life style, day time
outdoor activityoutdoor activity
DownsideDownside
Compromised quality,Compromised quality,
contrast sensitivity at allcontrast sensitivity at all
rangesranges
Glare, at time unbearableGlare, at time unbearable
in night drivingin night driving
Some need glasses forSome need glasses for
near, extra lightnear, extra light
Not suitable for skilledNot suitable for skilled
fine work e.g. surgeonsfine work e.g. surgeons
Co-MorbiditiesCo-Morbidities
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3. SatisfactionSatisfaction
Inversely proportionate to ExpectationsInversely proportionate to Expectations
Lesser the expectations, betterLesser the expectations, better
satisfactionsatisfaction
Pre-OP visionPre-OP vision
““Other Eye” visionOther Eye” vision
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4. Importance of of Preop VisionImportance of of Preop Vision
Accurate uncorrected / corrected preopAccurate uncorrected / corrected preop
vision:vision:
Good preop vision is aGood preop vision is a
contraindicationcontraindication ..
Advanced cataract in old age groupAdvanced cataract in old age group
appreciate betterappreciate better
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5. Visual Potential of the eyeVisual Potential of the eye
Clinical JudgmentClinical Judgment
History, AmblyopiaHistory, Amblyopia
Pin hole visionPin hole vision
Colour visionColour vision
Co morbidities, AMD,Co morbidities, AMD,
GlaucomaGlaucoma
Special investigationsSpecial investigations
PAMPAM
OCTOCT
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9. Choice of IOLChoice of IOL
Personal experience, Ease of ImplantationPersonal experience, Ease of Implantation
Regression analysis, results of all previousRegression analysis, results of all previous
casescases
Good track record,Good track record,
““No Proprietary/Financial Interest”No Proprietary/Financial Interest”
Literature reviewsLiterature reviews
Independent of “Phaco-Independent of “Phaco-machine bundling”machine bundling”
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10. Multifocal SelectedMultifocal Selected
Distance, Intermediate and nearDistance, Intermediate and near
Distant + intermediate orDistant + intermediate or
Near + IntermediateNear + Intermediate
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13. Surgical SkillsSurgical Skills
Are you confident of putting Multifocal in your :Are you confident of putting Multifocal in your :
Parents,Parents,
In-laws,In-laws,
Near relatives,Near relatives,
Friends, Doctor ColleaguesFriends, Doctor Colleagues
If yes, we proceedIf yes, we proceed
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19. Pre OP CounselingPre OP Counseling
Discourage High expectations due to high costDiscourage High expectations due to high cost
Mention glare and reduced contrast sensitivityMention glare and reduced contrast sensitivity
Show advantage of good range of SpectacleShow advantage of good range of Spectacle
free “Intermediate” visionfree “Intermediate” vision
Highlight need for glasses for too far or too nearHighlight need for glasses for too far or too near
visionvision
Extra light for readingExtra light for reading
Consider “Other” eye conditionConsider “Other” eye condition
Keep option of monofocal open in TechnicalKeep option of monofocal open in Technical
difficulties during surgerydifficulties during surgery
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20. Best way to learn SwimmingBest way to learn Swimming
Jump in the PoolJump in the Pool
Mistakes are the best teachers if youMistakes are the best teachers if you
respect themrespect them
All spoon feeding teachers are BIGAll spoon feeding teachers are BIG
MistakesMistakes
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