3045: Early IOL exchange to change Rx
Performing an early IOL exchange just a few weeks after primary cataract surgery is straightforward and technically easy, as capsular adhesions are minimal and the lens optic can be easily visco-dissected from the bag. In this case, a couple weeks following cataract surgery in the second eye, the patient was dissatisfied with the mild myopic target set for monovision in this near eye, preferring best uncorrected distance acuity instead. The surgeon safely explanted the original lens and inserted a new IOL targeting bilateral emmetropia with a plano goal; however, eliminating the myopic offset means the patient now relies on reading glasses for all near tasks. Watch the video to see the efficient surgical maneuvers for early lens exchange and analyze the critical pre-operative counseling trade-offs involved in pseudophakic monovision versus bilateral emmetropia. How do you approach the decision to exchange an IOL versus giving patients additional neuroadaptation time when adjusting to monovision? Please comment your thoughts below.
