aided by pharmacologic pupil dilation, but as many as 3% of patients
complain of chronic long-term ND.
So how do we correct the problem? We currently have a few surgi-
cal options at our disposal: exchange the IOL; place a secondary "pig-
gyback" IOL; and perform a reverse optic capture, with the optic
placed on top of the anterior capsule and the haptics still in the capsu-
lar bag. Based on some of the developments we've been seeing over-
seas, we may soon have some other alternatives available.
Practicing vigilance
Even under the best-case scenarios, research shows that "only" slightly
more than 90% of patients are satisfied with their IOL after cataract sur-
gery. In other words, as many as 7% to 10% of patients are dissatisfied
with their lenses even when all other risk factors have been eliminated.
ND or some other post-op complaint could be the source of this dissat-
isfaction.
This tells us that there are still some phenomena we don't fully
understand. That's why, as clinicians, it's our responsibility to be vigi-
lant and responsive to the needs of our patients. Such awareness will
not only help us as surgeons to give patients the outcomes they seek,
but also to rule out any retinal pathology that may lead to long-term
vision loss.
OSM
J U N E 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 9 3
Dr. Masket (avcmasket@aol.com) is an ophthalmologist with Advanced Vision
Care in Los Angeles, Calif., and a clinical professor of ophthalmology at Jules
Stein Eye Institute, also in Los Angeles.