How to Present RLE to Patients in Three Simple Steps
Take the challenge out of discussing dysfunctional lens syndrome.
George O. Waring IV, MD
What was once a challenging patient consultation for refractive surgery can now be streamlined. During the past decade, my colleagues’ and my approach to educating patients on their conditions and our understanding of how best to serve their needs has evolved. Years ago, when presbyopic patients would present for LASIK to reduce their dependence on reading glasses and bifocals, we would recommend a refractive lens exchange in cases where there was early lenticular opacity and/or hyperopia. Not infrequently, patients were taken aback at the suggestion of a lens-based procedure. For many years, we performed LASIK in these individuals, and frequently they would come back within 5 to 7 years complaining that their LASIK had “worn off.”
AT A GLANCE
• The term dysfunctional lens syndrome (DLS) characterizes a spectrum of changes that occur with age and that include presbyopia, opacification, loss of image quality, and higher-order aberrations.
• In patients with DLS, it can make more sense to exchange the aging crystalline lens for an appropriately selected IOL instead of performing LASIK now and cataract surgery years later.
Enter the concept of the dysfunctional lens syndrome (DLS) and the use of advanced diagnostics to aid in its detection and proper staging.
WHAT TO KNOW
Below I outline three tips on how to present refractive lens exchange to patients.
Tip No. 1: Use an advanced ocular analysis and include a digital “lens-centric” examination. With this approach, we often find that baby boomers presenting for LASIK do not have clear lenses; i…